By Shawn Kennedy, AJN editor-in-chief
Having some down time over the holidays can be a good chance to catch up on some reading. Because so much of my work entails reading manuscripts submitted to AJN about nursing practice and research, I look for my leisure reading to be something not connected to nursing.
Well, the book I recently read—a quick, engaging read—was about nursing, sort of. The book was Charles Graeber’s The Good Nurse: A True Story of Medicine, Madness and Murder, the story of nurse-turned-serial-killer Charles Cullen. While I find the title to be a bit sensationalist, the book is not. There’s no real answer as to why Cullen did what he did—Cullen apparently had a miserable childhood, was often a target of bullies, had failed marriages and made many suicide attempts to gain sympathy or attention. Graeber doesn’t really seek to answer the why of what Cullen did but instead focuses on his behavior and relationships.
The chilling aspect of the story is how easy it was for Cullen to get away with his killing through the use of essential technology relied on by nurses for the care of hospital patients. The medication and computer systems that he manipulated to cover his tracks also eventually allowed an intrepid nurse colleague to help police prove their case—only a nurse knowledgeable about the day-to-day use of the systems could uncover the wayward patterns.
But the real issue that comes through is how hospitals, fearing litigation, would simply dismiss Cullen when other nurses voiced concerns about his practice, allowing him to find work elsewhere and become someone else’s problem. That’s something I think many nurses might relate to—I certainly can. I worked with a couple of nurses early in my career who, when we reported to the administration that there were consistent errors in the narcotic count or missing medications when they were working, were given a chance to resign or be fired. Neither was ever reported to the board of nursing.
AJN covered the Cullen case in our March 2004 issue—this link will take you to that month’s news section, where Cullen’s story (“Dial M for Murder or L for Lawsuit?”) is on page two (use the pdf version for best viewing). Also that year, former editor-in-chief Diana Mason addressed the issue of nurses’ silence about colleagues’ practice in an editorial that resulted in many letters.
I wonder—could this happen again? I believe technology has improved to make it more difficult to give the wrong medication, but the real question is whether hospitals—or other nurses—are more likely to take action today rather than just passing such a problematic employee along for others to deal with.