University of East Anglia 2012

Nursing, Nepal Pokhara

I went to Nepal at the end of my second year, August 2012, for 4 weeks. I was on the ICU at a large regional hospital for 3 weeks and in Nalma (the Village Heathcare Experience) for 1 week. The best advice I can give with regards to an overseas elective is just go for it! You might have no idea what to pack, what you will see or how to say hello in Nepali but it doesn’t matter because you will learn and have an unforgettable time in a beautiful country!

Placement

The ICU has 8 beds, each with monitoring and ventilating capacity. There was 1 nurse for every 2 patients. The nurses start at 8am and I recommend nursing students start at this time too, so you can be there for the nursing handover as well as carrying out the personal care.

The ward round is where all the doctors review the patients; it starts at 10am and throughout the day you carry out various tasks such as inserting NG tubes, dressings, ECG recordings etc. At the time I went, there were second year Nepali student nurses on rotation around the hospital, so I was never the only student nurse on the ward. The student nurses are taught in English as well as Nepali, an although they may be a little shy, just start talking to them and they can help you with all sorts of enquiries.  The staff nurses may also be a little shy but keep persevering and they will open up to you and ask you questions - they are just not used to speaking English.

Nepal is such a family focused country. On most wards the family were responsible for all the care we consider basic nursing, such as washing and feeding; with a family member sleeping on the ward too. However, due to the nature of ICU, we had visiting times where family would come in with lunch and dinner for the patient. The hospital is far from what we see in the UK; the floors are dirty, they reuse a lot of items that we see as disposable, things are just done differently. It may not be what we are used to but this is how it is in Nepal.

Sights

Nepal is a beautiful country and really worth exploring. There is the lake, where you can hire a boat out and enjoy the views, or row to the other side and trek up to the World Peace Pagoda. I also did white water rafting and paragliding, organised from places in Lakeside. There is also a lot of history; we visited a Buddhist monastery and sat in while they chanted, it was so calming!

If you want to spend a few days trekking, then you can do Poon Hill, I hope the views are better for you than they were for me! I could see 5m then just thick fog! Other people I stayed with in the house did Annapurna Base Camp trek. Nepal has beautiful scenery so take a good camera!

With other people in the house, it's easy to just ask people who they went with when they did activities. The social atmosphere also means you can get a group of you together and go out. 

The House

The house you stay in is comfortable, there is plenty of space and in most cases you share your room with one other person, so you make friends pretty quickly! There is a living room, dining area and roof terrace/balcony where you will find people relaxing and chatting. There is no washing machine, so it’s either hand washing or laundry in Lakeside. The food is amazing; if you have a request or want to try something specific, the chef is very friendly and is more than happy to cater for what you want. The BBQ on the Wednesday on the roof is lovely; you have great food, chilled view and a beautiful view (if the sky is clear!) of the Annapurna range. 

Twice a week is language lessons with Prem, who is a very knowledgeable teacher who has several languages up his sleeve! Prem is awesome, the lessons are fun and I recommend you go to them and ask all sorts of questions (we had a good lesson on the Nepali caste system!). With me it took a little while to get used to the Nepali language, I felt like I could never remember a phrase, but after a little while you get used to it and before you know it you’re picking new words up all the time. 

The Village healthcare experience

The week in the village was the best part of my trip, as everyone I was with agreed. I went to Nalma, which is a harder, longer trek, but I figured if you can do Poon Hill you can do Nalma! The views are amazing and the guide has fantastic English. He does a lot in the community of Nalma and seems to know everyone!

The family you stay with are wonderful. They speak very little English, so you really have to brush up on your Nepali, but we had a lot of fun interpreting! The food is delicious too - you will never be hungry as they have a massive appetite and will give you seconds and thirds! The tea is the best! I don’t like tea but in Nalma I couldn’t get enough of it!

In the evenings you go with the guide to do various activities such as seeing the other communities within Nalma, cooking and dancing. I even wrote exam papers for the local school’s English test!

The health post is open 10-2 and you see whatever walks in, from 3 month old babies to a 90 year old. The conditions and complaints are just as varied as the age range. Don’t expect to sit back and watch what goes on – you will be given the stethoscope or  the thermometer or the BP cuff and are expected to diagnose the patient. You will have the health post worker with you so don’t worry! It is invaluable experience; it really boots your clinical skills and judgement. An invaluable tip…take a wind up torch, an umbrella and an open mind!

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