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Concerns about practice

​​Celia, the head of the midwifery department, has concerns about some of Sara's competencies as a midwife. During a recent hospital delivery, Sara appeared not to understand the basic principles of ​fetal health surveillance and was unable to recognize signs of fetal distress. ​

Derek, the perinatal nurse who reported the situation to Celia, told Celia that Sara had difficulty making life saving decisions and required direction during the neonatal resuscitation. Based on the reported concerns and the risk to public safety, the hospital restricts Sara's privileges and files a complaint with BCCNM.   

Complaint​​ process

Celia sends a written complaint to BCCNM outlining the areas of concern in Sara's midwifery practice.  
In the letter Celia informs BCCNM that the hospital has imposed restrictions on Sara's hospital privileges due to their concerns about Sara's competence in fetal health surveillance, neonatal resuscitation and managing emergencies.

The complaint is sent to BCCNM's Inquiry Committee for review.  After reviewing, the Inquiry Committee authorizes further investigation into the complaint and Sara is made aware of the complaint and investigation.

The findings of the investigation are summarized and shared with the Sara for a response.

Sara's response​​

Sara responds to BCCNM that she:

  • recertifies annually in Neonatal Resuscitation Program (NRP) and biannually in Fetal Health Surveillance as required by BCCNM
  • acknowledges that she should have called the obstetrician when the fetal heart rate became abnormal
  • states that collaboration with Derek to manage the neonatal em​​ergency was lacking

The inquiry d​ecision​

The Inquiry Committee reviews the investigative documents and Sara's response.  They conclude that Sara should have more closely monitored the fetal heart rate; that the abnormal fetal heart rate readings were not responded to in a timely manner; that she failed to appropriately consult and collaborate with the nursing staff. The panel found no evidence that the Sara's neonatal resuscitation was inadequate.

Sara signs a BCCNM consent agreement agreeing to:

  • recertify in the neonatal resuscitation program (NRP) within three months,
  • complete a Fetal Health Surveillance course within six months, and
  • take a communications course approved by BCCNM within six months

 Sara is able to continue to practice as a midwife after meeting the requirements in the consent agreement.

Did you know?​

As a registrant of BCCNM you are required under Section 32.2 of the Health Professions Act to report, in writing, to a health professional's regulatory body if you believe that their continued practice might be a danger to the public.
See Health Professions Act, section 32.2.