On April 5, 2020 a panel of the Inquiry Committee approved a Consent Agreement between BCCNP and Fiona Commins of Vancouver, to remediate practice issues related to documentation, assessment, critical thinking, Nurse Practitioner (NP) knowledge and skills, patient safety and professional communication. From April to October 2018, while working as an NP in an inpatient pediatric psychiatric program, the Registrant had unsatisfactory documentation on at least ten occasions, including a lack of differential diagnoses and absent or incomplete patient assessments and histories. She failed to follow up on a urine screen, had a 1-day delay in completing a vital portion of a physical assessment and ordering diagnostic testing. Staff nurses expressed concerns about her communication style within the multidisciplinary group, her knowledge of care escalation and medical clearance, and her ability to practice autonomously without physician oversight. While caring for a youth with a history of self-harm and suicidality, she twice failed to complete a risk assessment after the youth suffered self-inflicted injures, failed to adequately document wound assessments, and required a physician to assist her in assessing a fingernail injury. When the youth disclosed that he had a razor blade in his possession and had used it to inflict his injuries, she did not document this disclosure in the patient record nor do a safety assessment. She emailed notification to two practitioners who were not present nor working for the next two days.
The Registrant has voluntarily agreed to terms contingent on whether she is practising as an RN or an NP. Regardless of designation, she has agreed to complete coursework on documentation and communication and to review competencies related to physical and suicide assessment. If she works as an NP, she agreed to review the expected competencies of an NP and complete a robust orientation followed by a minimum 12-week period of supervision.
The Inquiry Committee is satisfied that the terms will protect the public.