Nurse Teach Reach – Australian nurses reach out to nurses in Nepal

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Nurse Teach Reach is a unique organisation – Australian nurses reaching out internationally to help train and support other nurses. Lucy Rowe, a Neurosurgical Intensive Care nurse, formed Nurse Teach Reach after a working holiday in Nepal. Here, Lucy tells a truly inspiring story.

I chose nursing as a career because of the amazing opportunities it could offer – the lure of international travel and international aid was a big reason, though the reality of achieving this can be difficult once you’re part of the workforce. I’ve always been an avid traveller and am always planning my next trip, generally to developing countries. I’m captivated by their vibrancy, poverty and extreme difference from my relatively sheltered life in Sydney.

I soon realised I couldn’t travel forever and with some pressure from family, accepted that I needed to combine my nursing career and my love for travelling in some amazing job.

I found it extremely hard to find that dream job – so I ended up creating it!

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I started Nurse Teach Reach Inc after a working holiday in Nepal in 2012. I’d originally volunteered with a Nepali organisation for an eight-week medical program. On arrival, I learnt that this ‘grassroots’ organisation was actually run by a very rich Nepali family living in the US. At first I felt a little cheated – I wanted my hard-earned program fees to be spent in Nepal and on the longterm development of the volunteer program. Sometimes I wish I’d done more research, but ultimately it was a decision that led me to create Nurse Teach Reach, so I’m glad I did it.


The Nurse Teach Reach volunteer promo.

I was placed in a small hospital that had no need for my specialist Neurosurgical Intensive Care skills. I quickly learnt I needed to change this program so I could be of most use to the people of Nepal. I discussed my issues with one of the visiting doctors and found myself in the BP Koirala Memorial Cancer Hospital in Chitwan under his direction. I spent seven weeks here working on the Neurosurgical Ward alongside Dr Bal Krishna Thapa and Sister Janaki Uprety. I taught nurses how to perform an accurate Glasgow Coma Scale, how to assess pain, how to do a physical assessment and how to be more confident in their communication styles. I finished the placement by running a one-day Neurosurgical Education Day for nurses and doctors. This was extremely well received and I was encouraged to do more education and in-services.

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As my time at the hospital neared an end, I approached the Directors of Nursing and Senior Sisters and asked if I would be welcome back in the future. They were extremely interested and expressed their desire for continued improvements in their nursing education. I suggested that for long-term development I would need to bring a team of nurses – regularly. There is no point in teaching one nurse at only one point in time – there is no sustainability in that method! I proposed a train-the-trainer program and suggested that through my nursing connections I could bring a team of volunteer nurses to Nepal to start a longterm partnership with the hospital.

After much research, I was surprised to find that my idea was relatively unique. Most medical aid organisations are focused on doctors. No organisation really focused on longterm nursing education and on promoting professional development. Any nursing organisations I found were mostly related to community nursing and public health. And here I was at a crossroads – I wanted to help nurses in Nepal, but there was no organisation that provided this unique opportunity. So I created one!

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In Australia, I discussed my ideas with close nursing colleagues and together with Cardiothoracic Intensive Care nurse Peta Alford, we created Nurse Teach Reach (NTR) – an international non-government organisation (INGO) that has now been working in Nepal since 2012. Our main goals and objectives are to improve the quality and access to continuing education programs for nurses in Nepal.  Three years later and NTR runs three educational programs in Nepal, across four hospitals, focusing our efforts in Emergency Nursing, Intensive Care and General Surgical/Medical.

Since 2012 we have run over eight programs with more than 30 international volunteers. We’ve found that by using social media and the strong nursing community, we’re able to access a variety of nurses from different backgrounds who are interested in helping overseas. Together we aim to empower local nurses and encourage them to access and utilise the latest information and research. Our focus has been on teaching complete physical assessment and then integrating it into the nurses’ everyday practice.

It hasn’t always been easy – changing any workplace environment is always challenging –but overall we have found a real improvement in the nurses’ work and confidence.

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On our most recent trip to Nepal, in April 2015, we commenced our newest Emergency Nursing Program at one of the largest tertiary hospitals in Kathmandu, Tribhuvan University Teaching Hospital (TUTH). Our plan was to develop specialised Emergency Nurse Training programs and we’d gained significant support from key stakeholders within Nepal. We attended the 3rd Nepal Emergency Medicine International Conference and supported the organisers by running a specific Emergency Nursing Day, the first of its kind in Nepal. We met with many of Nepal’s most senior nurses and discussed the development of Emergency Nursing as a specialty in Nepal.

After the inspiring conference, our team of volunteers had a weekend in the Nepali jungle and it was here we found ourselves in the middle of the massive 7.9 magnitude earthquake on April 25.

The recent earthquakes in Nepal have killed over 8500 people and damaged nearly one million homes, schools and public buildings. The response to the disaster was swift, but was significantly hampered by Nepal’s difficult geography and unstable political climate. Widespread international support was pledged immediately and intense media coverage showed the world the struggles of the Nepalese people, however it took days, even weeks, for most of the aid to flow to the areas of greatest need.

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As a small INGO already present within Nepal and with longstanding, established relationships with many medical facilities, NTR was able to provide immediate emergency care at TUTH in Kathmandu before any significant aid had reached Nepal. Larger local and international organisations had significant bureaucratic hurdles to manage and protocols to follow and had their hands tied until approval was given to act. NTR swiftly changed from an educational team to a disaster relief team and provided frontline management and triage to the large numbers of patients flowing into the Emergency Department.

A Nurse Teach Reach volunteer talks to the media within the ED.

The Emergency Department was divided into Red, Yellow and Green zones and patients were triaged on arrival and directed to the appropriate zone. We split up into three teams and worked tirelessly. The local medical and nursing staff were overwhelmed with the huge numbers of patients flowing into the hospital grounds and many staff and patients were too scared to go inside the buildings for fear of further earthquakes and building collapses. We focused our attention on supporting the local Emergency Nurses wherever we could – we provided equipment, supplies and medications for free to anyone who required them. Our team of volunteer nurses worked with patients of all ages, many of whom had suffered severe injuries – it was a difficult time, but we were rewarded with the overwhelming gratitude and compassion of the Nepali people.

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Once the Emergency Department regained control, NTR moved onto the issue of dwindling medical supplies. We purchased and provided essential medical supplies and equipment to smaller local teams travelling to remote districts and smaller hospitals within the Kathmandu Valley. Often the medical kits supplied by NTR were the first medical aid to reach devastated villages. Our partnership with the Nepal Association of Disaster and Emergency Medicine (NADEM) allowed us to work alongside a local organisation to provide remote health camps and first aid training to over 150 high school and university students. In the aftermath of the earthquakes, we identified that empowering the youth of Nepal was key to effective redevelopment.

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The future of Nepal is difficult to predict. Monsoon season is just beginning and the need for long term shelter and sanitation solutions is obvious. The prediction is that a second public health disaster will affect Nepal as cholera and dysentery can spread quickly through the numerous internally displaced persons camps.

Nurse Teach Reach has a longstanding commitment to providing education and training to the nurses of Nepal. We will be returning to Nepal in October and November and again during 2016 to promote public health and support the strained health care system. We’ll continue working at our current hospitals and explore the need for further programs. We also aim to have the specialised Emergency Nurse Training program up and running by 2016.

If you’ve ever been interested in sharing your skills and knowledge with nurses globally, then please contact Nurse Teach Reach and we can discuss our upcoming volunteer programs with you. We aim to place volunteers within their area of specialty so they can be the most effective and provide the most up-to-date knowledge to local nurses.

Contact:  info@nurseteachreach.org

Nurse Teach Reach: www.nurseteachreach.org

NTR earthquake relief page: www.nurseteachreach.org/earthquake-relief.html

NTR blog: www.nurseteachreach.org/blog

NTR on Facebook: www.facebook.com/NurseTeachReach

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