June 6th update as to schedule


Update
CCNEPal has completed the sessions in Pokhara.
I loved meeting all the people there. Dr. Umid Shrestha of Paschimanchal Community Hospital and Matron Sushila Neupane of Charak Memorial Hospital were wonderful hosts. ‎ I thank them. They are visionaries for the future of critical care in Pokhara.
I gained much appreciation for the level of skill to be found among the interns and medical officers from Manipal College of Medicine.
I think the ICU at Charak Hospital is every bit as well-organized as any ICU in the Kathmandu Valley. An ICU is measured by the skill of the nurses, not by the equipment list.
Students in the nursing sessions came from PCH; Fishtail Hospital; Fewa City Hospital; Western Regional Hospital; and  Gandaki Medical College as well as from Baglung, Damauli, and Gorkha.  I was joined for one session by Tina Byrnes, RN from Sydney who is conducting a nursing project in Kirtipur under the aegis of PHECT, an Ozzie quasi-governmental entity.  I think I gave her a few ideas.
I did not previously know there was a “New Road” in Pokhara. ‎
Bharatpur, College of Medical Sciences
June 4th was a bus trip to Bharatpur for the next leg of the journey. I’m trying to minimize bus travel.
I got to the tourist bus station okay and used the toilet there. Normally I wouldn’t add such a detail, but the electricity was off and the toilet was pitch black dark. Not even one photon. Ever try to use an unfamiliar bathroom in the dark? I didn’t want to use my smartphone flashlight for fear of dropping it in ” the hole”.   In the process of getting my trousers back up, my wallet slipped from my pants pocket. I ran back for it when I noticed it missing, almost left it behind. I do a lot of “check twice, you’re not coming back here again” when I travel, glad to have developed the habit of patting myself down.‎
From Pokhara to Mugling the road travels through a scenic region that evokes “The Shire.” Looking out the bus window was a travelog of village life in the hills – verdant fields, people tending to tasks of daily life. The road between Mugling and Narayangarh was a mess, due to a widening project. Many stretches of one-lane road. The drivers were patient with each other. ‎ It will be great when it’s done. Just not now. The Nepali method of road widening seems to always start with demolishing the previous road. ‎ This is the road that hangs on the steep side of  a river gorge. There are places where it seems like the engineers just flung it up there to see if it would stick.
 We’ll have three sessions of the course here at CMS.
June 5, 6, 7 – 4th-year B Sc nursing students. (thirty)
June 8, 9,  – MBBS/interns. (twenty)
June 12, 13, 14 – 3rd-year B Sc nursing‎ students. (thirty)
My contact person here is Mrs. Sita Parajuli, Matron of the Hospital and Campus Chief.  Sita Ma’am was in Tansen for many years, so even before I met her here in 2011 we shared many mutual friends.  Sita Ma’am has advanced nursing in the Terai. Due to the education system here, CMS faces turnover among the nursing staff. Young PCL graduates stay two years then go for their BN degree (this system is being changed because of this very problem). Sita is always growing the leaders and the staff.
June 15th, 16th and 17th are open dates. I’ve been asked to work with one of the small hospitals here, this is not confirmed.  If I do, I’ll post it for possible students to join, who may be otherwise unafilliated.
Janakpur?
June 18th I leave for Janakpur, home to the famous temple. I am told they are starting up an ICU in that city. The time is just flying by.
Kathmandu?
I’ve gotten inquiries about Kathmandu sessions. There are none planned. I’ve spent ample time in Kathmandu in the past. About 800 nurses and doctors there got my training.  Sure, there is demand for more, but Kathmandu has many people who could be teaching this.
A comment about mission of CCNEPal
CCNEPal’s goal is to promote critical care skills using a training method exemplified by the BLS and ACLS courses of the American Heart Association (AHA) in USA. We are emphatically *not* part of AHA, and this course does *not* lead to AHA certification. Due to AHA’s impeccable and authoritative  scientific research about resuscitation, we do teach the AHA standard when we can – adapted to the needs of Nepal. Participants learn in Nepali language. You do not need to be expert English speaker to benefit from this training.
It has been obvious from the beginning that we need to teach “what ACLS is” before we can teach how to do it. That is why we offer our sessions to the largest number of nurses and doctors possible. We are trying to create a medical culture shift that recognizes ‎the need for trained nurses in critical care.
What is “sustainable?”
A couple of years ago, I met a USA doctor from a famous USA medical center who told me what I was doing was “not sustainable.” In the meantime, that same doctor trained about a dozen people in her sub-specialty. ‎ It will be ten years before the training she did will come into general knowledge. That was a drop in the bucket considering that Nepal has thirty million people. By comparison, CCNEPal has trained 2,300 as of this year, and many of them used their new skills on April 25th, 2015. The nurses and doctors who need this knowledge are the young ones at the beginning of their careers, now working directly with patients. Persons who come to Nepal to train need to find a way to reach a broad audience, and not limit it to the senior doctors doing mainly administrative work.  “Train the trainer” is more difficult to do and implement that some might think.  I ten words or less: what I do is more “sustainable” than what that other person was doing.
If you are a foreign medical personnel thinking of coming here to train, you are invite to browse this blog.

About Joe Niemczura, RN, MS

Experienced nursing educator and problem-solver. I have fifteen years of USA nursing faculty background. Add it with 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. I travel outside of Kathmandu Valley as well. When the recent violence happened, I knew the cities - I had trained people in those locations. 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. Global Health Nursing is not all sweetness and light; not solely milk & honey and happy moms and babies.
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One Response to June 6th update as to schedule

  1. I’m proud of your work, Joe. Much future success. Your living environment is tough to say the least. The roads there are difficult as well. Keep up your good work in Nepal. 🙂

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