I was uncomfortable reading this story because I just cannot fathom doing harm to a patient. There were multiple times in the story when I would pause and just think "How can he be okay doing this to people?" and "What the hell is wrong with this dude?" Honestly, when I have to give a medication at work, I'm breaking out the calculator and making sure that the dose is right several times before I even give it. We even have rules in place where certain medications have to be checked by more than one nurse so multiple people check the dose several times before it reaches the patient. This guy was BLATANTLY putting insulin in normal saline bags, loading syringes with overdoses of digoxin and injecting the heart medication right into the patient without a second thought, overdosing patients on medications that paralyze the body. It was crazy! I have always had a difficult time understanding mental illness. I understand that the body and brain can experience such severe stress that one can 'just snap', but this guy was cold and calculating.
What really made me angry was that hospitals were not held accountable for their hiring practices. All this was going on from the late 1980s until around 2003 in New Jersey and Pennsylvania, so it's fairly recent history. He was able to continue to get jobs! He worked at at least NINE DIFFERENT HOSPITALS. I started nursing in 2008. At that time we had to get fingerprints, a background check, a drug test and more. At the time, I thought all that testing was standard for nursing. Come to find out, it was all implemented after this guy was caught and convicted! Maybe if these protocols were in place back then he would have been either caught earlier or not allowed to enter the field of nursing in the first place. However, with his mental illness, he may have still found a way to harm people.
As a side note, there is currently no 'national' nursing license. Nursing is regulated state by state. This is a problem. I am a huge proponent of a national nursing license. Charles Cullen was able to go from New Jersey to Pennsylvania because each state requires a different license so he could easily hold a license in both states and they may or may not communicate with each other about his questionable history. A lot of nurses have multiple licenses, especially if you live in a 'tri-city' area that covers multiple states like NY-CT-NJ or DE-MD-VA or NJ-DE-PA. Even I hold a license in two states because I live in a 'tri-city' area.
The book is very well written with accurate sources and footnotes that cite those sources. The author does an excellent job of making the reader think about several hot button topics like mental illness, hospital transparency, patient rights, patient safety, hospital safety, and hiring practices. I thought more about my career while reading this book than I have since being a nurse. I've never been exposed to the underbelly of it and I think that's why it made me uncomfortable and incredulous. That's why it stuck with me. I love my job and can't imagine anyone being in this field and behaving the way this guy did. This book will stick with me for a while. If you're in the health field, I highly recommend it. Even if you're not in the health field, I think it would still be an interesting read. Not good for the beach or vacation, because you may be sad or enraged afterwards. Save this one for Fall/Winter.
