June 9 2018 update on anatomy lab for our training course on critical care skills

The first session for this year’s series of training programs in Nepal was held at National Trauma Center, part of Bir Hospital, for a group of BN nursing students. One member of the class had previously taken the course and asked if I was still doing the anatomy lab.

I used to always make time for this and in fact, a picture of two gloved hands holding a heart serves as the profile pic for CCNEPal FaceBook page.

These days? well, no, I haven’t been including it.

Why not?

There was no good answer, so – we enlisted various class members to  go to their local fresh shop and find “en bloc heart and lung assemblies” – and we had an educational time that revealed many secrets of the heart.

I wrote about this five years ago, and here is the link: https://wp.me/p1pDBL-fp

We are now at a large Kathmandu hospital where we are training four batches of nurses with thirty people in each. We are including the lab in all four sessions of the course.  The use of this material of to advance scientific knowledge, and the goats would have been harvested anyway. In fact, the lungs would have been fed to neighbor dogs. There is a nearby fresh shop that supplies five each time, one for each group of six students.  Enough to allow each student to get a close look.


We make a systematic tour of elements of the heart, lungs and trachea, finding such things as the pericardial sac, the valves and the coronary arteries. No matter how well the teacher can draw, there is no substitute for seeing the actual structure. Each nurse who participated will now make better physical assessments of their human patients because of the knowledge they gained.

Here is an example from YouTube that shows one way to do the dissection. https://youtu.be/XH4K4b0N_Yw I think it has the info, but I don’t lead my own labs that way – she’s is a bit passive, doing all the handling herself. It’s more fun to make the students handle it themselves and discover it for themselves.

Not wasting anything

One thing to point out: when we are finished I end up with about eight pounds of organ meat. I don’t simply throw it in the trash. I take it home and recycle it. Each set of heart & lung gets cut into small pieces. I bring it up to the roof of the Guest House for the crows to enjoy.


I do not waste the flesh or put it in landfill. As many as three dozen crows swoop in to take morsels back to the nest for their young. There is one day per year in which crows are venerated on the Hind calendar.  This batch of crows is getting food every day for two weeks.

The crows get excited when they see me climb the spiral stairs to the top patio.

The One Mystery

So far, no group has been able to identify the structure of the heart from which True Love emanates. We will keep searching.







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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