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Nursing Excellence

The Online Newsletter for Children's Nurses
e-Edition, Volume 1, Issue 3 

Williams and Norgaard
Magnet LogoNICU Nursing in Nepal

Leslie Williams, BSN, RNC-NIC
Jennifer Norgaard, MSN, RNC-NIC, CNS

 In the summer of 2009 we two were joined by team members from Children’s Hospital Central California and others from across the United States for an adventure of a lifetime. Our mission was to fulfill a nearly three year project designed to train staff and provide ongoing clinical support for the opening of one of the first neonatal and pediatric intensive care units in the country of Nepal.

A country of nearly 30 million, Nepal is bordered to the north by China and to the south by India. The country struggles with an infant mortality rate of 62 per 1000 live births compared to the United States rate of 6.3 per 1000 live births with a life expectancy at birth rated in the lowest quartile comparatively throughout the world. The needs of this beautiful country are great and the financial resources few. Patan Hospital, the focus of our efforts, located in the city of Patan in the Kathmandu Valley is known for its compassionate care and high values. Patan, which began as a small missionary hospital, has emerged as a busy acute care city hospital providing primary care as well as specialty services both to the local people as well as to patients coming from diverse geographic areas within Nepal.

Preparation work for the trip included the development of training curriculum along with the procurement of supplies and learning manuals to leave with our new friends. We arrived with suitcases brimming with donated baby clothes from staff in the NICU at Children’s. Our curriculum, focusing on the care of critically ill newborns, was developed for a group of approximately thirty-five nurses and physicians working at the hospital. This curriculum included didactic lectures along with daily hands on scenario based exercises that allowed the participants the opportunity to practice and apply skills as they were learned. The six bed pediatric and six bed neonatal units were newly built and furnished with much of the latest available technology including infant incubators, warming tables, IV infusion pumps and state of the art ventilators and blood gas machine. The technology enhancements contributed greatly to the success of the intensive care units, however, much is still needed to continue and sustain the efforts of the team. We learned that often donated supplies are expired and cannot be used, and once things are used, they cannot be replaced. In Nepal there is no such thing as a disposable or single use item; gloves and syringes are washed for re-use, nasal cannulas have to be cleaned for use on other patients, and sometimes something as simple as a feeding tube can also be used as an umbilical catheter if the need arises.

For us, the experience will never be forgotten. We learned about new cultures, beliefs and values. We are in awe of the beautiful, generous and skilled people we worked with and taught. Their passion to improve the outcomes for the patients they care for was evident in every spoken word and action. The joys and struggles of being a nurse (or sister as it’s called in Nepal) are no different than here. We celebrate the joy in a life saved with the families it has impacted and smile and rejoice with each other on a job well done.


In This Issue
Seasons of Change
Change and Transition
Career Path to Success
Decreasing Medication Errors Through Reporting of Unusual Occurrences
Demystifying Simulation
Breastfeeding: Improving the Health of Baby and Mom
Addressing Parent’s Fear of the MMR Vaccine
NICU Nursing in Nepal