The Good Nurse Analysis - Book Report/Review Example

The Good Nurse Analysis and Review Number Brief of Book The world learnt of what night nurse called Charlie Cullen had been up to in the previous 16 years, in 2003. Feared to rank amongst the most notorious serial murderers of all time, Charles Cullen had killed in his wake a priest, a judge and several other persons (Graeber, 2012). The first half of the book containing a number of crimes is quite grim as the killings are very impersonal. This half merely serves as a prelude even though it highlights Charlie Cullen’s traumatizing childhood and tendency towards suicide. The book takes more dramatic shape at the training in the burns unit section when Charlie seemingly developed the mindset of claiming patients’ lives, especially those that were barely fighting to survive. In the beginning, Charlie started by flooding the IV bags of patients with insulin that elicited shock in the victims. Charlie pays very little caution to what the patients pass through but fascinates the reader in the manner in which he follows up on the patients’ wellbeing by browsing the systems of the hospital and keeping to keep him updated on the progress of his poisoned victims and to select new targets. Another intriguing aspect is his command in the manipulation of the automated Pyxis system to gain access of medication. Charlie would, before the upgrading of the system, order his favorite and fatal digoxin drug that is conventionally used to treat congestive heart failure, grab the drug and then cancel any traces of the transaction. In the end, when his newly found friend Amy Loughren at the Somerset starts to scrutinize his activities, she realizes that indeed Charlie had had been on alarmingly numerous occasions (contrary to the norms of a normal life saving nurse) been obtaining medication from the dispensing system then deleting the order from the system (Graeber, 2012). Charlie’s most notable traits are his in-depth insight on the protocols at the hospitals he worked in, a superior grasp of medical brinkmanship and a strong determination to play any medical center that was naïve enough to employ him. The book however, exceeds the fact of Charlie’s murderous tendencies with the causes of his pathology barely striking the reader more than the numerous attempts by the various medical institutions and their administrators to hide these crimes. The investigation by the police into Charlie’s conduct is another highlight of the book, providing a great thrill to the reader. The author portrays the different hospitals as desirous to know very little regarding the undertakings of the employed nurse Charlie as they do not want the name of their institutions to be soiled by such damning revelations as Charlie’s case portended, thereby continually risking the lives of several other patients in the path of Charlie. However, at the Somerset, two brilliant police officers, Tim Braun and Danny Baldwin who were later praised for the brilliant efforts in the matter, start to investigate Mr. Cullen. They are especially intrigued by the errors in Charlie’s records and the blatant efforts of the hospital’s lawyers to evade questions regarding Mr. Cullen’s conduct. It takes five months for the center, Somerset, to admit that it had in its hands, five patient incidences that could not be explained. The behavior of the hospitals described in the entire book is insane in failing to solve the murders that are taking place in their vicinities. One Somerset lawyer maintains that nothing comes to mind concerning Charlie’s perceived misconduct although another admits that Charlie Cullen was an odd duck. The officers conducting the investigations are severely deceived for instance when they are misinformed by a risk manager that the center’s Pyxis system does not keep previous records and so there was no need in verifying Charlie’s history. However, upon further investigations, interactions with the manufacturers of the Pyxis system reveal that the Pyxis system does store records of previous events and one needed just pull up the required data. The manufacturer is quite frankly baffled at the allegations and asks Detective Baldwin over the phone if something was wrong with their system. This is one of the sudden eureka moments and breakthroughs that are witnessed in the course of the investigation. Another breakthrough taikes place when the most crucial witness in the book, Amy Loughren, is advised by one of the administrators in the center to refer any further inquiries from the police to the lawyers of the Somerset (Graeber, 2012). Reasons for Selecting the Book and Relevance to Course Objectives I picked this particular book as it directly relates to my field which is medicine. I found it rather disturbing to discover that there are those who contravene their oaths of care for the sick to injure their patients (Sellman, 2011). Patients attend medical centers with the trust that medical personnel will look after their wellbeing rather than risk their lives even more. It is baffling that someone like Charlie Cullen, a Navy vet and a nurse’s aide, went back to school to attain Bachelor’s degree in Registered Nursing. It is a huge shame that the hospital could hire Charlie Cullen even with the glaring inconsistencies regarding his quality and ability to perform such essential tasks. Even at the time that they discovered something amiss with him and the crimes he had committed, instead of following the legal route, they resorted for the safe option of ending his work contract and letting him walk away so as they would preserve their reputation. The number one priority of the hospital ought to have been to care for the lives of others by they chose the opposite when they let this murderous and unstable man walk away with the potential of hurting more persons in future. This silent dismissal of Charlie Cullen deeply aches my heart and conscience as a physician and it seems that some of his previous employers even gave him positive reviews following his termination (Sellman, 2011). In the current global setting I imagined that the best a former employer could do was confirm dates of employment rather than further serving as references for a former disgraced employee. Furthermore, I find it concerning that the criminal would constantly engage the head of the pharmacy and insist on conducting the re-stocking on his own. In the light of the on-going investigations, I imagine this would have been a clear pointer for the pharmacists head to raise suspicions and report this sustained conduct with the investigators. I am however, not surprised that the other hospital staff considered Charlie Cullen great as it is a common attitude in the workplace and in teams. However, it is deeply regrettable that the hospital contravenes the code of ethics that states that the healthcare executives are directly responsible for the wellbeing of the patients and others that they tend to/ are in their care (Sellman, 2011). Synthesis/ Overview The main character of the story, Charlie, had a troubled childhood and came up last, the only boy in the family of eight. He was born so late in his parents’ lives that his father passed away before he was born. He grew very close to his mother and was totally devastated when his mother also passed away following a car accident. He constantly mistreated by his older siblings (sisters) and their boyfriends. To give his life some meaning and purpose, Charlie decided to join the Navy but later grew a strong disaffection for the Navy (Graeber, 2012). Charlie then joined, as the only male, the nursing school following his return to civilian life. It is during his school years that Charlie met and fell in love with who would later become his wife, Adrienne. Following their marriage, Charlie attained his first employment. Charlie and Adrienne had a baby girl in the first year of their marriage. However, soon afterwards, Adrienne discovered weird behavior from Charlie especially towards their daughter and the dog. As time passed by, she noticed even more queer behavior such as hostility towards the dogs and excessive consumption of alcohol even in the presence of their children. Adrienne later decided that enough was enough and consequently divorced Charlie and obtained custody of their two daughters. Charlie shifted from one job to the other. The norm was that at first he would perform well then later on develop some abnormal behavior that would cause his employers to be unhappy with him. At his maiden job, in St Barnabas, he was suspected of loading patient IV bags with insulin. Same too, in his second hospital, the Warren Hospital, Charlie was dismissed after suspicion fell on him for a patient’s death. This was shortly after he had been apprehended by law enforcers for breaking into the house of a fellow staff member (Graeber, 2012). After his stint at Warren Hospital, he was employed at Morristown where again he was accused of neglecting patients under his care and not cleaning their rooms. For the second time, Charlie again attempted to take his own life and was then again admitted to the Greystone Psychiatric Hospital. Afterwards, Charlie got another job at the Liberty nursing home where he was again suspected of being involved in the mysterious deaths of two persons. In the first death, the nurse that was fired filed a lawsuit against the institution and named Charlie as the perpetrator. Charlie departed from Liberty and obtained a job at Lehigh Valley Hospital where he orchestrated the deaths of numerous patients including that of a young burn patient. Charlie then again attempted to kill himself unsuccessfully and was dismissed from Lehigh Valley Hospital. He got employment at St Luke after his ordeal at Lehigh. At St Luke’s he was accused of stealing medication and throwing away perfectly good medication. Charlie then, for over one year, was employed at the Somerset Medical Center, where he met and became very close friends with Amy Loughren. However, Amy did not know that Charlie was murdering patients using drug overdoses, more often in mixtures. The Somerset used a system that monitored drug use called the Pyxis and this made Charlie become slyer in the ways that he obtained the drugs that he used in his illicit ways. In the wake of Reverend Gall’s death, Charlie was nearly caught in the investigations but had a lucky escape when the investigations stalled. During the investigations to unearth the cause of death of Reverend Gall, a worker at the pharmacy invited the Center for Poison Control to help in the on-going investigations. The Center for Poison Control’s head raised alarm and advised the hospital to engage the police on the matter – advice that went unheeded. The hospital rather opted to engage the Department of Health who did nothing regarding the matter. It was until five months had passed that the police were brought into the matter. Charlie was then relentlessly and thoroughly investigated by Danny Baldwin and Tim Braun but they faced a lot of hardship comprehending the nature of the information that they came across as they were mostly medical. Amy however noticed, after observing Charlie’s records of Pyxis that he was up to something mischievous and then volunteered to help the police investigate. Amy made a number of calls that the police recorded and after a while, the police had gotten enough evidence from the calls to place Charlie under arrest. After being arrested, Charlie confessed his crimes and was convicted for thirteen murders including those in previous hospitals where he had committed his atrocities. He assisted the police in reviewing medical data to determine other victims in the following three years. He was then sentenced to life in prison. Ironically, at some stage, Charlie managed to perform a life saving gesture by donating a kidney to the brother of one of his previous lovers (Graeber, 2012). Strengths The author of the book, Graeber Charles, is quite an exceptional writer. The book far transcends a mere tale of a mad murderous nurse but further depicts how contemporary medical institutions have become corrupt and lost their morals and values. The author produces a brilliant book by daring to compare the greed and money minded orientations of hospitals (who attempt to shield themselves from shame by concealing the deeds of the nurse and therefore put the lives of several other innocent patients at risk) to the gory deeds of the nurse (Tao, 2006). The nurse in the book who in his own twisted way was driven by the desire to protect his parents is less criminal when contrasted to the shocking actions of the hospital staff that deceived the whole world and the law keepers on the matter so as to save their names. This book, as with all great books, highlights all the relationships and worlds that the story undergoes. Special recognition goes to the author’s captivating illustration of the investigation by the police, his depiction of the tormented nurse, the family that caused his instability, and the heroes of the narration who include the police and the hospital staff who put their employments and livelihoods in danger to halt the murders against their superiors who could easily terminate their employments and suffer their livelihoods. The book basically goes beyond the crime itself and offers a compelling picture of the world of health institutions, the entire society, its villains and the heroes who step out and risk their welfare for the sake of others (Hille, 1964). Weaknesses In as much as the book is a thoroughly compelling read and a decent one too, I found the piece rather too lengthy with the plot developing at a snail’s pace (Hille, 1964). There are a plethora of unnecessary, redundant and meaningless footnotes that disturb the flow of narration. In addition, with much respect, I found the narration quite disjointed and the writing very florid. Furthermore, I am a huge fan of picture accompaniments in books, which this particular piece lacks. Also, after reading the book, I find the heading of the book rather disrespectful and offensive towards nurses who are the core figures in healthcare and demand more respect and awe. Nursing as a profession is one of the noblest and respectable, and to therefore label the murderous and scandalous Charlie Cullen a good nurse is an insult of apocalyptic proportions. Graeber Charles ought to have conjured a better title for this otherwise insightful and amazing piece. Applications and Conclusion As the author puts it, “the culpability of the hospitals, what they knew, when they knew, what they should have done, and certainly laws have changed in the wake of this.” There are numerous lessons that can be picked from the piece and equally numerous applications that stem forth after an analytical read. One of the causes of the difficulties in precisely stating Cullen’s crimes stem from the human error and death that are common occurrences in the hospital set-up. (Edwards, 2008) It is equally cumbersome, for the errors concerning medication, to state which were deliberate and which simply normal mistakes were. The medical center and healthcare system’s failure to effectively deal with Charlie Cullen is a sad reminder of theses institutions’ weakness in halting one of their own from abusing the patients who had come seeking help and care. This is complete failure of the medical institutions and systems in the state and larger nation in offering protection to unknowing patients. Patients under Charlie Cullen’s care mysteriously crashed and died after he injected drugs in the IV bags using microderm needles to prevent detection. Instead of suspecting foul play from one of the hospital staff, Barnibas, the first hospital ST wrongly judged that the deaths were doings of malicious relatives who harbored vengeance against the perishing patients. Even so, no action was taken when Charlie’s name came up when the nurses were cross-indexed. There is equally disturbing failure on the police department who when approached by the hospital concerning the deadly findings, term the matter an internal dispute as the chief of police returns the case back to the hospital. Also, of note is that when moving from one hospital to the next, Charlie obtains good letters of reference even from such hospitals that had fired him. Warren’s hospital, the second hospital he works for, even failed to do a background check on his previous employments. He was dismissed from his maiden job at the start of January and then got employment towards the end of the same month and so Warren’s hospital wrongly assumed that he was merely seeking to change jobs. Medical institutions were not required to conduct background checks. In addition, nurse shortage across the nations enabled him to easily get new jobs. There was a huge need for nurses at the time which is never good for the medical field as we witness in the book (no thorough vetting of employment aspirants, just haphazard employment). Charlie was caught on two occasions at St Luke and San Barnibas but on both instances was never reported to the authorities but rather urged to resign and then given a letter of neutrality. Instead of informing law keepers of their findings, they simply sent their lawyers to confront him. Time after time, Charlie was issued with reference letters from his previous employers including those who dismissed him on suspicions of stealing hospital drugs that he would later use to murder patients. It is only towards the end of the book where he is caught in serious offense of murder that hospitals begin to alert one another and warn against employing him. Furthermore, these medical facilities failed to report about the dead patients but the big issue remains who and what to report about. These medical centers showed very little concern for patients and those potentially at risk but rather opted to attempt to conceal themselves and avoid fines that would arise from such cases. They hurt the on-going investigations with blatant lies such as by failing to report Charlie Cullen and his suspicious dealings and altering the truth regarding the dispense system of the pyxis medication. Before his deeds were discovered, there were increased incidences of deaths arising from digoxin. Because digoxin was an anti-arithmetic drug, the hospital management inquired from the resident nurse what amount was necessary for medication such as digoxin and others to be administered to lethal levels. The nurse summoned the poison control crew of New Jersey and made further inquiries on the matter. After careful consideration of the facts, the poison crew stated that this was a case of serial murder and recommended prosecution of Charlie Cullen. In the current world, the procedural work in hospitals has remained quite slow, as has been in the past ages too. For instance, in cases where a hospital employee is being scrutinized for possible offence, this is done by committees that often take time to constitute and also take a lengthier time conducting investigations. In the meantime, healthcare provision is direly compromised (Edwards, 2008). References Edwards, M. (2008). The informed practice nurse (2nd ed.). Chichester, England: John Wiley & Sons. Graeber, C. (2012). The good nurse: A true story of medicine, madness, and murder. Hille, E. (1964). Analysis. New York: Blaisdell Pub. Sellman, D. (2011). What makes a good nurse why the virtues are important for nurses. London: Jessica Kingsley. Tao, T. (2006). Analysis. New Delhi: Hindustan Book Agency. Read More