International Nurse’s Day is May 12th, celebrating the birthday of Florence Nightingale. Florence Nightingale is revered in South Asia, though she never travelled there. It is attributed to a report she wrote for the British Raj, reforming the public health system of India, over the course of forty years of her life.
You will still see pictures of Florence Nightingale in hospitals in Nepal, usually in the Matron’s Office. Here’s the one from Crimson Hospital, in Manigram, Rupandehi district.
Every nurse in Kathmandu was walking in the footsteps of Florence Nightingale right after the quake.
Nurses needed in Nepal?
Since the earthquake, there is a lot more interest in the health system of Nepal – nurses and doctors from western countries are interested to volunteer for earthquake recovery. Here is the best advice about volunteering. In this early period, some specialized skills are needed, but don’t come without a sponsoring organization. Be advised, there are ample nurses and doctors within the country to meet their own needs for personnel. If you have never done international nursing, Nepal is not an easy “first Asian country.” feel free to send email to firstname.lastname@example.org to get advice on how to prepare for serving in this country.
If you do come to Nepal, here is something you can donate to nurses that will be incredibly useful, and is “sustainable.”
Some facts about nursing in Nepal:
Nurses in Nepal performed heroically during the recent earthquake, especially in Kathmandu. Normally nurses never get media coverage, but this has changed. Let’s hope that a new level of media coverage of nursing issues will emerge from this tragedy.
Nursing school in Nepal
Young women can go to nursing school at the age of sixteen, enrolling in a PCL program (Proficiency Certificate Level) for three years.
An in-depth description of Nepal Nursing Education can be found here.
There is one doctoral program for nursing, located at Institute of Medicine in Maharajganj, a neighborhood of Kathmandu. There are M Sc programs, but until recently most nursing leaders studied abroad for their graduate degree.
There is a “Nepal Nursing Council” and they are members of the International Council of Nurses. The Council has valiantly upheld standards for nursing education despite a politically unstable government.
Most often, nursing students live in a hostel at the hospital that sponsors the school. These hostels enforce strict rules such as no cell phones, no appearing in public unless in uniform, and the like. The students often live five-to-a-room with the same girls for three years, and develop lifetime bonds. There is nothing like sharing a bar Cadbury’s chocolate between friends.
The school uniform is sometimes a Kurtha Suruwal (“Punjabi”) but often a colorful saree. Nursing students still wear a cap at many schools.
Every PCL nurse is also a midwife. The curriculum involves delivering a dozen babies under the supervision of an older nurse. The nursing students live in a society with strict gender rules. Though they have delivered babies, it is often the case that they themselves have not been on a “date” or had a boyfriend in the traditional sense that an American would define.
The PCL nursing curriculum is centralized and standardized by a government agency.
In the past five years, more young women are enrolling in “B. Sc.” nursing programs.
Males are not allowed to enroll in nursing school. They go to Health Assistant program instead.
Nursing as a career in Nepal
Traditionally, nursing as a career choice was frowned upon by upper caste Nepalis, because it involved contact with body fluids of other castes. This has begun to change since nurses have gone abroad, earned money outside the home, and sent remittance back to Nepal. Also, investing in the young woman’s education will bring a better choice when the time comes for arranged marriage, which is still widely practiced in Nepal.
There is an active “brain drain” of experienced nurses from Nepal to western countries such as U.K., Australia and India. For a discussion of factors related to this, click here.
Nepali nurses abroad
Many Nepali women are going abroad for nursing education in USA or India but they face obstacles when they return. A person with a “foreign” (American) RN license is required to take the Nepali version of NCLEX to get a Nepali RN license, even if they are a Nepali citizen.
In Kathmandu, forty per cent of passed-out nurses are unemployed or working as unpaid “volunteers.” B Sc prepared nurses are viewed as lacking in skills and too outspoken.
There is a Nepalese American Nurses Association named NANA, based in Queens New York.
The model of care most widely practiced in Nepal is “Functional nursing,” in which assignments are divided by task.
Specialty nursing, (such as ICU nursing) is in it’s infancy in Nepal. Such things as ecg analysis or principles of Advanced Cardiac Life Support are not widely taught to nurses. Many nurses work for international Non-Governmental Organizations (NGOs) on public health projects.
The author of this blog has written two books on health care in Nepal, The Hospital at the End of the World and The Sacrament of the Goddess. Each has been described as “required reading for any nurse of doctor planning to volunteer their services in Nepal.”