CCNEPal report of summer 2019 activities


I am back in USA this week, and next week I resume teaching at a nursing college in Tampa, Florida. The flight from Nepal to USA was uneventful but long. Oh wait – I lost my wallet and one of my bags got lost – but overall it was okay. I would recommend Quatar Airlines to anybody.

I was in Nepal eighty-two days. I taught thirteen sessions of my course, and awarded 317 certificates to nurses and doctors. This was fewer sessions and certificates than past summers where I tended to teach about 24 sessions and got close to 600 certificates each time. I had a number of requests to teach additional sessions that I was not able to fulfill, due to travel requirements or the heat.

CoMS Bharatpur

Most of the sessions were at College of Medical Sciences in Bharatpur. This host agency has an airconditioned classroom which has ample space and they supported conditions that made it easy to feel good about the quality of learning we could provide. My partners there have known me since 2011. They provide fooding and lodging (with aircon!) and they were always upbeat. As in past summers, I note that the students at CoMS are more often from the Terai and indeed to complete their government service in Terai; this is important because Terai needs to work more on outcomes for health than other regions. I think I could walk into any number of subsidiary hospitals in Terai and be greeted by a nurse or doctor who took my course at CoMS. Like all good Universities, CoMS serves as a knowledge node from which expertise billows out.

CoMS was kind enough to allow me to teach a session to nurses and faculty of NPI Hospital and NPI college of nursing. I had previously taught a session at the NPI hospital but in an area that lacked aircon.

Aircon?????

Yes. For some reason, the heat in Terai got to me this summer more than in previous visits. We were on the fringe of the same weather system that produced such killing heat in Delhi and Rajasthan for the early part of the summer – 42 degrees C every day. Many people in the region died of heat-related illness.

From https://earthobservatory.nasa.gov/images/145167/heatwave-in-india In South Asia, there is less night-time cooling than you would expect.

I knew it would be hot, but not this hot. My problem is, I can only go to Nepal in summer due to my teaching job. I was asked to teach in other Terai locations, but declined to do so unless there was air con. Also, my highly- anticipated trip to Nepalgunj was postponed indefinitely due to heat, then flooding.

Kathmandu

I taught only one session in Kathmandu, at Bir College of Nursing. The audience was BNS students. These persons are returning for a Bechelor’s Degree. The pathway for them is get their PCL, then work two years and return to school. Most of this group were working in the system of government hospitals, and one of the priorities of the Ministry of health is for the BNS students to focus on critical care skills. So the group was an ideal target audience for me. They were so much fun to work with. I returned there a week later for a daylong session on ecg reading, something I don’t normally do.

Other hosts in Kathmandu

I can legally teach my sessions in Kathmandu because I have an RN license in Nepal. However, there were two other host agencies operated by the government that originally wanted me to teach, then requested me to show a letter from the Ministry of Health to authorize my teaching. This is also a pathway to “legally” teaching, but one which I was told by the Nepal Nursing Council that was not needed by me. So the first plans went nowhere. I am exploring the idea of taking steps to get such authorization from the MoH for next year. There are about thirty hospitals int eh government system trying to upgrade their critical care skills, and I am thinking this might be a good focus.

I returned to Terai for one session, at Bharatpur Hospital. The roster there also included faculty from NPI, and from Balkumari and from Maya Devi College, in addition to the nurse who serves as Regional Burn Coordinator.

My daughter the tourist

The last two weeks of the summer were devoted to tourist activities. My older daughter finally visited me in Nepal and we had fun. She later said how much she loved the people and culture here and that “it was the trip of a lifetime.”

The only festival that take place during monsoon is “Gathamuga” in which the frogs save the world. (more or less). It was so much fun!

The itinerary included three days in Chitwan seeing wildlife and interacting with elephants.

Julie never was in the presence of a loose monkey before this trip.

She also got a kurtha jangrawal at a place in Indra Chowk, and went on a yoga retreat.

The kurtha jangrawal is associated with the Newari cultural group. I think she looks terrific wearing this. Lots of videshis buy a sari or a kurtha, but few have this tailored for themselves.

It was good to stop and smell the incense.

Airway Management Trainer

How could I forget! CCNEPal organized a crowdfunding campaign to donate one of these to CoMS. We made a handover on July 25th.

This training tool will provide education to MBBS students, Interns, Medical Officers, and nurses at CoMS for decades. Because the school sends graduates throughout Terai, it is a resource to improve the technical skills for the entire region.

Time to reflect

I now have six or eight months to think about how CCNEPal can help advance the practice of critical care in Nepal. I will be thinking of ways to move the project forward in future years. I expect to decide about the 2020 trip in March or April, then send out an announcement as to available time slots and sessions in April or May.

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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