April 21 2018 Update on CCNEPal summer trip to Nepal

The ticket(s) have been purchased.

CCNEPal is (usually) a one-person circus of teaching and we never know whether any given trip to Nepal will be the last one. I have been saying this since 2007, the first year I visited Nepal, that “I don’t think i will ever do that again” – and yet, I do.

Nepal is a bigger country than you think

I am a volunteer, and I always am amused when I meet some other medical person (usually a young MD) and they tell me “Oh, soon they won’t need your training any more; I’m here in Nepal and I am training them how to do critical care. ”

Yes, more than one person has said something like that to me. So, I ask for more detail. Then they say, “I’m here for two weeks and I will work with a dozen people.”

Nepal has 30,000,000 people, 22 medical colleges, hundreds of nursing colleges, and many cities outside of Kathmandu Valley. There are seven medical colleges in just the Kathmandu Valley, and a government health bureaucracy as well.

So, more training is needed to ramp things up. A lot more. Um, I trained 3,200 people in many regions of Nepal over 110 sessions during a ten year period. And we are still getting up to speed. I am happy to say that more Nepalis are stepping up and teaching it themselves, which is the way it should be.

To get ready this year I spent $$$ buying teaching materials for ACLS and PALS.

acls instructor package 2015I always teach as much of the latest protocols as I can, though the American curriculum needs to be adapted to reflect things like the availability of drugs and equipment. I get the protocols from the American Heart Association and this year I got all the bells and whistles – the complete “Instructor Package” including books DVDs and posters.

pals instructor package

I also bought the stuff to present the latest Pediatric Life Support standards and protocols.

I have been updating some of the key handouts from my “usual class” so they make it easier to run each course.


I will arrive in Kathmandu the 17th of May and begin the first session the 20th, at a major school of nursing in Kathmandu, one where the students come from all regions of Nepal and will return home after their degree. I will be teaching in Kathmandu for about three weeks, during which time we will award about 200 certificates.

After that I get on the bus to Bharatpur, where I will spend two weeks. I am not sure what to expect on the Mugling-Narayangarh road!

mugling road landslide

the main road from Kathmandu to the outside world goes through a spectacular river canyon and has been under reconstruction since the Dawn of Time. Lots of twists and turns. I try to minimize trips on this road. 

I will spend a week teaching in Janakpur also while in Terai.  If you wish to host my training, read this previous blog entry on what is needed. This requires a large classroom and at least 30 learners.

Colleague with a Secret Identity?


Nurses never bring attention to themselves. My colleague is carrying on in the finest tradition of selfless secret identity. 

A person with extensive experience managing ICUs in USA will be with me, and I will do a blog introducing her soon. She is a USA RN with many years of experience who wishes to share her expertise with her Nepali peers. For now she will be a “mystery person” – isn’t it cool to travel with somebody who has their very own secret identity? Here is the first clue as to who, exactly, she may be.



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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