You are now reading the blog to accompany a project that trains Nepali nurses and doctors in critical care skills using a 2- or 3-day course based on the American Advanced Cardiac Life Support (ACLS) course. ( let me be clear: we are not the “official” course). My summer trip for 2017 is a bit shorter than usual, but we still managed to train about 350 nurses and doctors in 13 sessions ( actually, session #13 has not finished quite yet) and BLS to 40 dental students (I don’t usually teach BLS as a standalone course, but that is another story).
I plan to return to Nepal in 2018, and I’m thinking about what the goals would be. To some degree we are still educating people as to what ACLS is and why it is needed. We are making progress on that front, and in the planning for summer 2017 we received many more requests to partner with host sites than we could possibly fulfill.
We’re still working to develop more Nepali professionals with the expertise and confidence to lead this course. To truly be an independent teacher of this material requires a lot of experience and confidence, more than you would be able to develop in just a weekend-long “train-the-trainer” course. There needs to be a support system to go along with it, something we take for granted in USA. A sense of community and shared purpose built around the idea that we can prevent excess deaths with better emergency response in this specific area. The people who need the training are the young nurses and docs at the bedside in off hours, and though the “seniors” need to understand it, we have to agree that the “seniors” are not really the ones who need it the most.
One theme to emerge this year was the specific need for a parallel course in pediatric emergencies. This was requested from a variety of contacts. In USA there are several such courses, the best known being “PALS” – Pediatric Advanced Life Support. So – why not?
I do not believe that PALS should be adopted widely in Nepal lock-stock-and-barrel any more than I believe that the USA ACLS course is appropriate for Nepal. First and foremost, the USA course requires that all sessions and discussions be conducted in English-only, a requirement that is simply ridiculous especially in rural Nepal. Also, the pedagogical framework of the South Asian educational system in which Nepali nurses and doctors are immersed is a consideration. These courses are at their best when they focus on practical hands-on psychomotor skills, and effective training needs to be designed with this in mind.
Having said that, I am interested to find some people with USA acute care pediatric experience who are PALS-I (or PEARS-I, another similar course) who would be interested to come to Nepal in 2018 and teach it. Any takers?
Terms and conditions
the deal would be:
You would pay your own airfare.
You would need to commit to a month here. You would need to study the culture beforehand. No helicoptering in and out.
You would need to agree to use materials and methods appropriate to the audience. No PowerPoint, no long lectures. A good place to start exploring the approach would be the any of the sites that describes “Low Dose High Frequency” (LDHF) training. There are many, just Google the term.
You need to decide in fall 2017 whether you want to do this, because there is a lot to learn before you go the first time.
I should add that I have a friendly relationship with the Center for Medical Simulation here in Kathmandu. They are Nepal’s one-and-only American Heart Association Official International Training Center. If you want to start by teaching the American PALS course as is with no adaptations to Nepal, I am certain they would be thrilled to collaborate with you.
CCNEPal is a grassroots shoestring training operation, and we are looking for like-minded persons who wish to join us as we teach and train. Feel free to browse this site and the related links ( see the column at right). For more info send an email to firstname.lastname@example.org.