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Nurses Who Kill Babies Exploit Systems of Trust

Some nurses with specific insecurities need to harm those in their care.

Key points

  • An ongoing trial in England involves a nurse accused of harming and killing infants.
  • Predatory nurses exploit expectations of care that enable them to kill with little chance of discovery.
  • Studies that identify behavior and motives for health care killers provide guidelines to evaluate potential future offenders.
Drawing by K. Ramsland
Source: Drawing by K. Ramsland

In recent news is a British neonatal nurse who’s been accused of killing seven babies at Countess of Chester Hospital in Chester, England. Allegedly, these shocking incidents occurred between 2015 and 2016. A victim’s mother interrupted one attack when she paid an unexpected visit to her 5-day-old son. Lucy Letby, the nurse assigned to the premature infant’s care, was near the child when the mother saw blood coming from his mouth. Letby said a tube was irritating his throat. “Trust me,” she said. “I’m a nurse.” She sent the mother away. The child died five hours later.

Letby, 32, has been charged with 22 crimes. Allegedly, she killed five boys and two girls, and made attempts on 10 more babies. She denies the charges but she wrote some enigmatic notes. Currently, she’s undergoing a trial at Manchester Crown Court, which is projected to last six months.

Letby is also accused of injecting air into another child’s stomach through his nose tube, causing his heart to stop. She’d been alone in the room with him when she should have been elsewhere. She’d allegedly used this method on other children. In her home, according to news reports on court proceedings, police found Post-it notes with messages like, “I am evil. I did this,” “I don’t deserve to live,” and "I killed them on purpose because I'm not good enough to care for them.” Yet, there was also a phrase, "I haven't done anything wrong and they have no evidence so why have I had to hide away?" Social media records show that directly after some deaths, Letby undertook searches for the infants’ parents.

We’ve seen other cases of nurses who targeted kids. Beverly Allitt, arrested in 1991, attacked 15 children in two months with insulin and air bubbles, killing four. Many were infants. Seriously disturbed since adolescence, Allitt had reported numerous illnesses over the years and had even mutilated herself so often she’d become a notorious patient for area doctors. Her diagnosis was Munchausen syndrome by proxy. It didn’t help her in court. She received 13 life sentences.

A more notorious case is that of licensed vocational nurse, Genene Jones. She’s suspected in the deaths of dozens of infants and young children during the 1970s and 1980s. She was caught while working in a pediatrics clinic in Kerrville, Texas. It wasn’t long after she was hired before several children succumbed to inexplicable seizures. Fifteen-month-old Chelsea McClellan, brought to the clinic for a routine check-up, ended up dead.

A week after the funeral, Chelsea’s mother spotted Jones at the cemetery kneeling at the foot of the grave, wailing the child's name. Mrs. McClellan confronted her, but Jones stared at her, rose, and walked away. Dr. Holland, Jones’ employer, learned that just before Chelsea died, a bottle of succinylcholine, a muscle relaxant with the power to paralyze, had turned up missing. Jones “found” it. Holland saw a needle hole in the rubber top. She tested the contents. The bottle was filled with saline. She fired Jones and called police.

On Oct. 12, 1982, a grand jury considered the evidence. A test of Chelsea’s exhumed remains confirmed the presence of succinylcholine. Another grand jury looked into 47 suspicious deaths of children at Bexar County Medical Center Hospital that occurred while Jones worked there. She was indicted on two counts of murder and several charges of injury to other children.

Jose Antonio Flores, 6 months old, had gone into fatal cardiac arrest while in her care. Testing showed an overdose of heparin, an anticoagulant. No one had ordered it for him. Also under Jones’ care, Rolando Santos, a survivor, had experienced inexplicable cardiac arrest with extensive bleeding.

Jones had requested to be put in charge of the sickest patients, which placed her close to children more likely to die. When they did, colleagues had noticed that Jones seemed to thrive on the emergency. Afterward, she’d ask to take the corpse to the morgue. There, she’d sometimes hold it while rocking in a chair. Some reports said she'd also liked to predict which children would die.

Some people enter health care professions to gain attention or a sense of power. Wolf and Donahue-Smith (2019) ran a qualitative study on nurses who killed patients in health care institutions. Medication poisoning was the most frequent method and dominance/power the most frequent motive. Victims are readily available, the atmosphere of care engenders trust that everyone’s there to heal, and the most vulnerable are those who can’t tell.

A study published in the Journal of Forensic Sciences in 2006 examined 90 cases from 20 countries of criminal prosecutions of health care professionals between 1970 and 2006. Fifty-four defendants had been convicted. Nurses (male and female) comprised 86%.

From several of these studies and additional cases, we now know that nurses who endangered or killed a number of patients had multiple red-flag behaviors (Ramsland, 2007). They might have gained macabre nicknames from patients or staff; were in rooms where unexpected deaths occurred (and weren’t assigned there); were secretive or deceptive about innocuous things; liked to “predict” that a patient would die; were associated with suspicious incidents at different institutions; craved attention; hung around after a death to experience the reactions; lied about credentials; or falsified their work records or medical access reports. They didn't operate fully under the radar. Colleagues noticed them.

At Jones’s= first trial for the murder of Chelsea McClennon, the prosecutor said she had a hero complex: She needed to endanger her patients so she could save them. Jones was convicted. She received 99 years. At a trial for the injury of Rolando Santos, a statistical report was the key evidence: An investigator stated that children were 25% more likely to have a cardiac arrest when Jones was in charge. Jones was found guilty and received 60 more years.

It’s hard to imagine a more unlikely place for serial murder than an infant care ward, but the emergence of predatory health care workers shows the need for vigilance and improved safeguards. They might be rare, but there’s still reason for vigilance.


Ramsland, K. (2007). Inside the minds of healthcare serial killers: Why they kill. ABC-Clio.

Wolf, Z. R., & Donahue-Smith, M. (2019). Nurses who murder or who are accused of murder. International Journal for Human Caring, 23(1) DOI: 10.20467/1091-5710.23.1.51

Yorker, B. C., Kizer, K. W., Lampe, P. et al. (2006). Serial murder by healthcare professionals. Journal of Forensic Sciences, 51(6), 1362–1371.