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Children’s Nurses Help Establish First NICU and PICU in Nepal


Premature and medically fragile babies and critically injured children in Nepal now have a better chance of survival thanks to the volunteer efforts of three Children’s Hospital Central California nurses.Leslie Williams and Jennifer Norgaard at patient bedside

Neonatal Intensive Care Unit (NICU) nurse Leslie Williams, RNC-NIC, and NICU Clinical Nurse Specialist Jennifer Norgaard, RNC-NIC, MSN spent nearly a month in Nepal this summer at Patan Hospital to help set up the country’s first NICU. For two weeks they trained the staff in neonatal care. Then Williams and Norgaard provided around-the-clock clinical support for one week once the six-bed unit opened.

“Nepal has one of the highest infant mortality rates in the world,” Norgaard said. “They didn’t have any kind of intensive care and very little prenatal care so anything you can do to get these mothers and babies care will help survival rates.”

Nepal’s first Pediatric Intensive Care Unit (PICU) opened during the same time frame. Patient Throughput Manager Vanessa Mendoza-Darrell, RN, MS spent a month providing clinical support and bedside instruction in the NICU and PICU after they opened. She also gave lectures on critical care to physicians.

Vanessa Mendoza-Darrell cares for patient with Nepali nurses“There is a huge gap between intensive care medicine in the United States and the Third World and just being able to help in the education of the Nepali staff has been fulfilling,” Mendoza-Darrell said. “It was one of the best moments in my nursing career.”

Their trip to Nepal was the culmination of a two-year Friends of Patan Hospital NICU/PICU project that involved developing curriculum, working on protocols, and securing donations for equipment and supplies. Williams, Norgaard and Mendoza-Darrell worked with an international team of volunteers including physicians, critical care nurses and a respiratory care practitioner to ensure their efforts would meet the educational needs of the Nepali staff.

“They didn’t consider us teachers, they considered us friends,” Williams said. “It was really a wonderful experience to learn about the type of nursing they have there and make a difference by changing their practice and helping their babies.”

The three Children’s nurses quickly learned there are vast differences between nursing practice in the United States and in Nepal. In addition to caring for patients, Nepali nurses take on a number of other duties, such as cleaning equipment and delivering meals. Williams, Norgaard and Mendoza-Darrell encouraged them to focus more on patient care, hand hygiene and infection control.

“They do a wonderful job with the little resources they have,” Williams said.

Williams, Norgaard and Mendoza-Darrell realize this is just the beginning of a new era in medical care in Nepal that will need ongoing support to thrive. They hope to return to Patan Hospital next year to continue working with the nurses.

“We have made a commitment to ensure that these units succeed and survive,” Norgaard said. “There might be smaller babies we can save.”

The team of volunteers from Children’s Hospital, which also included retired respiratory care practitioner and clinical educator Beth Case, was the second largest in Nepal and that number may grow in the future.

“I have talked about this project so much that fellow hospital staff are interested in going,” Mendoza-Darrell said.