Angels of Death: The Female Nurses

Healthcare serial killers (now referred to as HCSKs or SHCKs) have become prominent in the media over the past decade, and yet around the world nurses are still killing patients:

Vickie Dawn Jackson

• In July 2002, Vickie Dawn Jackson, 36, was indicted in Texas for four counts of murder at Nocona General Hospital. Prosecutors believe that she injected lethal doses of mivacurium chloride, a muscle relaxant that temporarily stops a person from breathing, into elderly patients to end their lives. Several vials of that drug turned up missing. Ten bodies were exhumed to run tests and early in 2004, Jackson was indicted on three more counts of capital murder, one count of attempted murder, and one count of injury to a disabled person. She is suspected in as many as 25 deaths, according to Associated Press reports. Her trial is scheduled for October 2004.
• Christine Malèvre was charged with the murder of seven patients in 1997 and 1998 at a lung hospital in Mantes-la-Jolie, France. She confessed and said that she had wanted to help them to die out of compassion. In fact, according to Reuters, she said that she had assisted around 30 patients to die, but then she reduced that number to two and claimed she had done it at their request. Two others, she said, had been accidents. She had written a book about her acts, called My Confessions, apparently in an attempt to bring attention to the need for euthanasia for incurable and painful diseases. Families of her victims denied that those people had made any such request to have help ending their lives. Malèvre was sentenced in January 2003 for six of the deaths to a prison term of ten years. She is also permanently banned in France from working as a nurse.
• "Martha U" was chronicled in Paula Lampe's book, The Mother Teresa Syndrome, after being convicted in 1996 of murder in the deaths of four elderly patients. (Lampe is also detailing the de Berk case above in another book, and she offered her study for this article.) Martha U was suspected of killing nine patients. She had worked for 20 years in a geriatric nursing home and had used insulin to overdose the patients. In two cases, the patients apparently had angered her, one by showing anger himself and the other by throwing food at her. Nevertheless, she insisted that she had killed to end the patients' suffering. Yet she had murdered patients who were not as ill as others in the same room. If anything, Martha U was clearly inconsistent. She had made statements, according to Lampe, to the effect that she could not stand people dying, and she had resuscitated one patient who could have died peacefully. Lampe viewed her as having narcissistic personality disorder and a hero complex. None of the patients who died were considered to have been terminally ill. Martha U was a loner but also a compulsive helper. Immediately upon her arrest, she confessed.
• Lampe, living in the Netherlands, used Martha U's case to discuss the fine line between aggression and the desire to be needed. Those caregivers with self-esteem issues and other personal needs may go over the line. Lampe, a former nurse, said in the book that Martha U did not murder to help others but to end her own unbearable feelings of "transparency." In other words, she was satisfying her own needs rather than the needs of her patients. The "helping" aspect was actually a compulsion, and that kind of addiction can lead to murder. Referring to an FBI theory, Lampe indicated in a news report that "killing gives psychopaths who have such a low self-esteem a sense of power. That fact that they carry a secret, namely 'I have killed someone and nobody knows,' also gives them power."

Christine Malèvre

Several professionals are now attempting to devise what could be termed a "prospective profile" of HCSKs, hoping to devise a constellation of red flags that colleagues can become aware of and use effectively. Lampe suggests that those nurses who seem compulsive, secretive, and consistently in the area of emergencies or Code Blues ought to be the focus of more scrutiny. Beatrice Crofts Yorker, associate professor of psychiatric mental health nursing at Georgia State University, has collected numerous cases and noted that many involved injection of non-controlled medications — perhaps an area of concern for hospitals. She, along with others in law enforcement, indicate that the following signals should be taken quite seriously:

• Statistically, there is a higher death rate when the suspected person is on shift
• The suspect deaths were unexpected
• The death symptoms were also not expected, given the patient's illness or procedure
• The suspected person is always available to help
• He or she is often the last one seen with the victim
• The suspected person has moved around from one facility to another
• Other staff members give that person nicknames like "death angel"
• The person is overly interested in the death
• Other patients have complained about the person's treatment of them
• The person is secretive or has a difficult time with personal relationships
• The person has a history of some form of mental instability or depression

Identifying such people as soon as possible requires documenting patterns of behavior and finding physical evidence that links the suspected individual to the crimes.  Unfortunately, intentional killers, as well as people who become addicted to killing as the result of a mercy killing or two, have the perfect arena in which to get away with murder for long periods of time. Hospitals are places of trust and the means to kill patients are readily available. In addition, medical murders are not easily detected. Stopping this phenomenon requires a sharp eye, an awareness that any care facility is vulnerable, and a desire to ensure that suspicious people be taken seriously.