Plan now for course with CCNEPal in summer 2019

Destination – the future!

Now that Christmas is over, it will fade out of sight in the rearview mirror as we hit the gas for our destination – 2019. Naturally it starts out as a year full of promise.

Destination – picking up the USA team.

Every good road trip benefits from companions. As in the past, I am willing to bring others with me to experience Acute Care Global Nursing. I am particularly interested to find people to teach PALS and pediatric critical care. The ability to “Code Switch” or learn how, is essential. If this is you, contact me.

Destination –  Kathmandu!

CCNEPal will return to Nepal in summer 2019 for about ten weeks, beginning in mid-May – the day after my teaching job here in Florida wraps up the spring semester. I will fly into Kathmandu of course, spend a day or two organizing things, then head off to the Terai.

Destination – Widespread Clinical Competence!

The main question for me is how to maximize the teaching of the course I do so as to reach the widest possible audience. Last year I had the pleasure to re-connect with persons who I taught five or more years ago and I was flattered when they relayed how important that course had been for them, in terms of building confidence and competence in emergency situations. At this point, I have trained about 4,000 nurses and doctors. It’s true that many joined Nepal’s medical “brain drain” – I bet that 300 are now using those skills in Australia. But most are still in Nepal and there has been progress in shifting the mindset.

Since I first started going there specifically to teach critical care skills, there have been many positive developments. The Nepal Society of Critical Care Medicine has gained prominence and taught more short courses – The one titled BASIC has become more accepted. The Critical Care Nurses Association of Nepal was formed and they have helped develop critical care preceptorship models that are now being adopted more widely.  The Center for Medical Simulation came into being and they run a fully-certified American Heart Association International Training Center, along with having all the manikins and simulators we take for granted in USA. Many nursing faculty from schools around the country of Nepal have taken the course and they too, will bring new confidence passing the skills to their students. During the 2015 earthquakes, hundreds of nurses and doctors trained by me were able to use their skills to save lives. Also as a direct outcome of my training, many Emergency Rooms and Critical Care Units are now equipped with the communication skills and de-escalation techniques that mitigate the threat of “thrashing.”

Destination – the Terai!

As in the past, most of my efforts are centered in the Terai as opposed to Kathmandu. When I left Nepal in 2018, I was talking with my main partners in Terai about ways to use one of the medical colleges as a more well-defined home base so that nurses and doctors in the region could come there.  I need to see if this is still on the agenda. If we can collaborate effectively,  we will be able to schedule twelve or fifteen sessions of the course right from the git-go and each one will have the maximum number of enrollees.

To arrange a session of training with CCNEPal in 2019

I will still have availability to go to other regions to teach. A few years back I wrote the terms under which I will deliver a session. Here they are, again.

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How to host a training session with CCNEPal summer 2019

Contact me by sending email to

I will travel to locations outside Kathmandu if the host can do the following:

  1. provide a class space suitable for the program. This  needs to be a big space. We move around a lot during this class. It needs: 1) a whiteboard (I do not use PowerPoint) 2) thirty chairs, 3) five patient beds or trolleys for the role play scenarios. 4) air con if possible. The classroom needs to be away from a patient care area. ( we make a lot of noise).img_20160710_144458_panorama_edit
  2. provide a roster of thirty nurses and/or doctors or MBBS students for each session of two, or three days. Nurses take a 3-day sessions and MBBS take the 2-day/ Each participant must attend all sessions of the same class to get the certificate (in other words, the three day class is a three day class – not three one-day classes). arrange for morning chiya and lunch, if there is not a cafeteria.
  3. The sessions are for PCL nurses, B SC nurses, or MBBS. I do not register ANMs in the class. It’s okay if the person is a recent graduate, but the persons need to be working in acute care or intending to work there.
  4. while at a place outside of KTM Valley, the host provides fooding and lodging. I live simply, it can be at a guest house, no need for finest hotel in town. I eat  DBT etc so I’m okay with local food. At some locations, they lodge me in a private room on cabin ward. ( they do not need to check my vital signs though!)
  5. My preferred schedule is to teach six days per week, either two three-day sessions (for nurses) or three two-day sessions (for doctors). I travel on Saturday and repeat. In summer 2016 I stayed two weeks in Pokhara, two in Bharatpur, two in Janakpur, and three in Biratnagar before returning to Kathmandu.
  6. I try to make a “circuit” of sessions, not go out-and-back from Kathmandu all the time. It’s more efficient.
  7. I supply the certificates. I keep a minimum amount of photocopy but we need about six pages per person.
  8. My Nepali is poor ( I am ashamed to admit). Strange as it may seem, that is not an insurmountable obstacle if there are some English speakers. I adapt my teaching techniques so as to “Code Switch” in a certain way. If a person has no English, this may not be the class for them.

Destination – home again!

I have loved the past trips to teach in Nepal, but I also love my present teaching job.  At the end of the summer, the jalopy pulls into the driveway, we shake the dust out of our clothes, and resume our “normal” lives.


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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