Medicosnext
Pushpa Chapagain
She serves as the Supervisor of the Intensive Care Unit at UDM-NINAS. Beginning her journey at the institute as a young and dedicated staff nurse, she was mentored by some of the most esteemed senior nurses, including direct guidance from Professor Upendra Devkota himself. Over the course of more than 15 years, she has grown into a pillar of the neuroscience team earning deep respect from her colleagues for her clinical expertise, leadership, and unwavering commitment to patient care.
Neuroscience nursing in Nepal has witnessed a steady yet transformative evolution over the past few decades. From an era with little to no structured neurological care to the development of specialised neurocritical care units staffed by trained neuroscience nurses, the progress has been both remarkable and inspiring.
A Generalist Era
Until the early 1980s, Nepal’s healthcare system was largely focused on addressing pressing public health challenges: infectious diseases, childhood malnutrition, family planning, maternal health, and basic hospital-based care amongst others. Nurses operated in generalist roles, offering essential care but without disease-specific specialisation or standardised clinical protocols to guide the care.
A Defining Shift
A turning point came with the return of Dr. Upendra Devkota, a visionary after completing his neurosurgical training in the United Kingdom. His leadership and foresight were instrumental in elevating the role of nursing in neurosurgical care and ultimately shaping neuroscience nursing as a vital specialty that it is today.
A small six bedded Neurosurgical Unit at the top floor of Bir Hospital was established and nurses were assigned to the unit. The non availability of physicians for the unit meant that the nurses had to be taught the skills to monitor critically ill neurosurgical patients.
Shaping the Neuroscience Nursing
To meet the demand, selected nurses began to receive focused hands-on training in neurosurgical nursing care under the mentorship of Dr. Devkota. Over time, these nurses became the first generation of neuro nurses in Nepal, laying the groundwork for what would evolve into a respected and essential speciality.
Mrs. Urmila Shrestha, former Matron of UDM-NINAS and one of the first nurses to work with Prof. Upendra Devkota at the Neurosurgery Unit of Bir Hospital, recalls:
“After returning from the UK, Prof. Devkota emphasized achieving the same high standards of care and hygiene he had observed abroad. He believed it was crucial for patient safety and infection prevention. Despite multiple efforts, the results invariably fell short of his expectations! That’s when he decided to send three of us for specialised training to the UK to the same institutions where he had himself trained.’
To elevate the professional standing of the nurses, Prof. Upendra Devkota actively encouraged them to present papers at scientific conferences and personally mentor nurses in preparing their scientific presentations. He took immense pride in their achievements and was often heard referring to them affectionately and proudly as “my nurses.”
Refining the Legacy
Following the establishment of the National Institute of Neurological and Allied Sciences the first dedicated neurosciences hospital in Nepal an era of comprehensive care modality emerged covering the needs of the patients of neurosurgery, neurology, and neurorehabilitation under one roof. The nurses were trained to follow evidence-based protocols in the care of neurological patients in the areas of:
1. ICU patient care
2. Operation theatre preparation and management
3. Post-operative neurosurgical nursing
4. Care of stroke patients at the dedicated Acute Stroke Unit
5. Comprehensive stroke care including neurorehabilitation
6. Smooth functioning of the bi-plane Cathlab
7. Educating families and advocating for patient-centred, evidence-based care
A Legacy That Lives On
Prof. Devkota passed away in 2018 but his vision continues to inspire the nurses at UDM-NINAS, which is home to over 150 nurses, each playing a vital role in patient care, from acute management to long-term rehabilitation.
Compassion in Action in the Era of Advancements
In today’s rapidly advancing medical environment, where cutting-edge technology plays a vital role in patient care, the essence of nursing- compassion, empathy, and human connection remains irreplaceable. While machines can monitor vitals and sophisticated systems assist in clinical decision-making, they cannot provide the comfort of a kind word, the warmth of a reassuring presence, or the trust built through genuine care.
At UDM-NINAS, this delicate balance between technology and compassion is not only valued but practiced every day. In high-pressure settings like the stroke unit or the ICU, nurses are at the frontlines, interpreting advanced clinical data while also offering emotional support to patients and their families during some of the most vulnerable moments of their lives.
