Competence

I've always been interested in how it is that certain nurses are judged incompetent, and what the logical conclusion to this is. The Nursing & Midwifery Council publishes details of all the cases it hears here and here.

Of course you can never get the whole story from reading these, but it probably gives you a good idea. Some people get away with the most extraordinary things, whereas others are struck off for things which seem (to the reader at least - there may be more beneath the surface) to be minor.

There is almost a paranoia in some areas of nursing, because of this, about "covering your back". The most innocuous events are religiously recorded in the notes, the minutiae of the decisions and perceived failings of other professionals are scrupulously written down. "Incident forms" are filed whenever somebody makes a mistake (unless it's you, in which case you do your damndest to keep it quiet). Everybody is petrified that somebody is going to pull up their notes some day and think "Aha! This nurse recorded a temperature of 37.2 degrees on the obs chart but didn't think to mention anything about it in the written notes! They must be negligent - let's get 'em!"

Which is why it surprises me that something like this can go on, apparently with the knowledge of a number of other healthcare professionals, and nothing is done about it. What is even more bizarre is that this clearly negligent midwife is actually publicising the story as a triumph of her clinical skills (when it appears to be more of a triumph of good luck), and still nothing is done about it.

Whilst I'm not a midwife, and claim absolutely no knowledge of pregnancy or childbirth, I can spot a critically ill patient, and could have done a better job of keeping that woman safe. Unfortunately, it would have involved admission to a hospital, which apparently is not acceptable. Now, I'm fairly liberal when it comes to these things - I support people who want to birth at home (although I can't think why they'd want to!), and I'm all for nurses (and, by extension, midwives) developing their practice and working more independently. But stories like these just push these causes back even further, and achieve the very opposite of what they are intended to. The sooner we get rid of dangerous practitioners like this, the sooner the rest of nursing and midwifery can move forward and get the respect we deserve.