CCNEPal planning for summer 2016

CCNEPal is an ongoing educational project since 2011. We have trained 2,170 nurses and doctors in Nepal to use a particular set of critical care skills.

May 1st Update

I bought my ticket and I arrive May 16th to TIA.  I expect to scurry around Kathmandu doing errands for a day or two then get on a bus outside the Valley. First stop I am hoping for is Pokhara for two weeks.

The Big Audacious Goal


MBBS interns at CMC in Bharatpur. These young docs were willing and enthusiastic. A bright spot for Nepal’s future. In the recent exams, the aggregate scores for CMC were among the highest in the country.

CCNEPal’s goal is to promote cardiac critical care training throughout the entire country of Nepal so that it is “owned” by every medical school  and a broad movement of nurses and doctors are comfortable with using and sharing these skills.

Please refer to the report of 2014-2015 activity of CCNEPal to learn my assessment of present capability. The conclusion? Kathmandu Valley has got some good things going, and the best return for the effort will be from work in the Terai.

infographic of medical education in Nepal 5

Half the population of Nepal lives in Terai. All the medical schools in Terai are non-governmental, i.e., “private” – and I should add, in this region of Nepal there is a higher per centage of Hindi speakers.

For those Nepalis thinking about taking the training? It’s easy to find a person who took it before….. ask them if it was worthwhile.

And if you are one of those persons who did take it before… tell your friends. Ask your employer to host the training. I don’t charge a fee, but when it’s outside KTM I do ask for fooding and lodging.

Also – If you took it before – please join me as one of my “assistants” – it’s more fun the second time around.


In May of 2013, CCNEPal started routinely including an anatomy lab in the 3-day session for nurses, to make up for gaps in science preparation ( something I had done in USA for years). For this we obtain en bloc heart-lug assemblies of mutton from local fresh shops. Here’s a shot of the coronary arteries.

Train-the Trainer takes more than just two weeks

We are trying to develop Nepali nurses and doctors to teach these skills and use them in daily practice throughout Nepal, so that it will be “owned” by a wide cross-section of Nepalis. What we do goes beyond the usual “train the trainer” program. The leaders of this course need to be persons who are using the skills in daily practice, but also able to effectively debrief according to what just happened.  When we model these skills in class, the participants begin to use them to critique their skills in the clinical setting.

Read past blog entries to get the course objectives, outlines, etc.


CCNEPal uses role play to teach nurses and doctors about situational awareness. These are the actors from the first session at Crimson Hospital in BTWL, May 2015

I will be returning to Nepal for summer 2016. I have not bought my ticket yet, but it will be roughly May 20th to August 10th. As in the past, I don’t schedule sessions of my courses until I get there. I am humbled at the positive word-of-mouth references people give to the training.

General plan


I will spend a few weeks at Karnali Academy of Health Sciences in Jumla. This is to fulfill a promise I made to a person who is now passed; but – also a separate promise I made prior to the earthquake in 2015.


I plan to do a road trip through the Terai.



Bharatpur (x2),




I will go to BPKIHS in Dharan; and LMC in Palpa. I wanna go to Janakpur. I will return to Pokhara as well.

Traveling to widely dispersed cities becomes “my other life.”  I have friends in all these cities – in some cases they know each other but mostly not – and, people in Kathmandu don’t necessarily know my friends elsewhere…… something amazing always happens on these road trips…. I just don’t know what it will be.

I know it will be hot.

Unlike all the previous places,  I know nobody in Janakpur.  Anybody out there able to introduce me to Janakpur?

Pokhara? why not! I was there twice before and trained about a hundred nurses.

And yes, somewhere on the way I will teach in Kathmandu.

How to schedule?

So if there are nursing schools, medical schools, or hospitals that wish to host me, please contact me and we will set up some dates. I am especially eager to go outside Kathmandu Valley and to areas I have not been before. send email to:

Maybe this is finally the year I will take a trek……

PS – For those persons in USA – If you are an ACLS-I or PALS-I  and you want to help out in Nepal, please contact me. What I do is not part of the American Heart Association, but I know the folks who run the one-and-only AHA ITC in Kathmandu, and they would love to have you affiliate with them.


About Joe Niemczura, RN, MS

These blogs, and my books, and videos are written on the principle that any person embarking on something similar to what I do will gain more preparation than I first had, by reading them. I have fifteen years of USA nursing faculty background. Add to it fifteen more devoted to adult critical care. In Nepal, I started teaching critical care skills in 2011. I figure out what they need to know in a Nepali practice setting. Then I teach it in a culturally appropriate way so that the boots-on-the-ground people will use it. One theme of my work has been collective culture and how it manifests itself in anger. Because this was a problem I incorporated elements of "situational awareness" training from the beginning, in 2011.
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6 Responses to CCNEPal planning for summer 2016

  1. Deepti Singh Gautam says:

    I am Deepti,and I contacted you before too.
    I just saw that you are coming to Nepal .
    Is there any other way so I can contact you when you are in Kathmandu valley.
    I also want to know how to get training from you when I am not working at present?

    Thank you

  2. Umid Shrestha says:

    Dear Niemczura, RN, MS,

    We are very happy to hear about your planning for summer 2016 in Nepal.

    The nurses here in Pokhara, trained by you for the critical care are using their skills to care the patients in the hospitals of Pokhara. We are very much thankful to you for your previous visit to Pokhara.

    I would like to request you to visit to Pokhara for this time also.

    Your stay and program in Pokhara can be hosted by *Paschimanchal Community Hospital (PCH)*, located at Buspark, Prithvichowk, Pokhara-9, which has recently started ICU/CCU and will be very obliged to have your service to train the nurses in the local community of Pokhara.

    There are two medical colleges in Pokhara: Manipal College of Medical Sciences and Gandaki Medical College. If your cardiac care training can be delivered to intern MBBS doctors/ students in Pokhara, PCH will be happy to coordinate to bring those junior MBBS doctors/ students for your training.

    It would be better, if we know the tentative date of your visit to Pokhara, so that we can manage accordingly here.

    Please let us know the total number of the nurses or intern MBBS doctors/ students, that can be included in your training.

    Mario, who was very helpful in coordinating the program during your last visit to Pokhara, has already left to Australia. However, now, we have other volunteers who are ready to work with you.

    Thank you once again.

    With best regards,

    Prof. Dr. Umid Kumar Shrestha, MD, PhD Pokhara, Nepal

    Proposed program to be hosted by:

    Paschimanchal Community Hospital Department of Critical Care Buspark, Prithvichowk, Pokhara-9, Nepal

  3. Judy Phillips says:

    You are wonderful. Please know I am interested in next year, 2017. I have many years of critical care experience. I have ACLs, BLS, CCRN. I am a family nurse practitioner as well. Thank you for all you do! Judy Phillips, DNP, FNP-BC, AOCN, CCRN

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