The Good Nurse: A True Story of Medicine, Madness, and Murder

Nonfiction | Biography | Adult | Published in 2013

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Summary

Background

Chapter Summaries & Analyses

Part 1, Chapters 1-7

Part 1, Chapters 8-13

Part 1, Chapters 14-19

Part 1, Chapters 20-25

Part 1-2, Chapters 26-31

Part 2, Chapters 32-38

Part 2, Chapters 39-44

Part 2, Chapters 45-50

Part 2, Chapters 51-57

Part 2, Chapters 58-Post Script

Key Figures

Themes

Index of Terms

Literary Devices

Important Quotes

Essay Topics

Index of Terms

Circumstantial Evidence

As it applies in law, circumstantial evidence is evidence that isn’t drawn from direct observation. For example, a man holding the keys to a stolen car could be circumstantial evidence if he wasn’t observed in the theft and has a reasonable explanation as to why he had the keys (e.g., he found them or they were given to him). Circumstantial evidence can be used in court and can help convict people of crimes, but the pieces of evidence must meet certain standards of proof, and thus it’s more difficult to convict someone using circumstantial evidence. Much of the evidence surrounding Charlie’s case is circumstantial because he’s infrequently seen committing his crimes and masks his administration of overdoses with moments of actual care. Collecting hard evidence to back up the circumstantial evidence is important to ensure that Charlie is incarcerated for his crimes.

Digoxin

A medicine that comes in tablets, capsules, and liquids, Digoxin is used to treat heart failure and arrhythmias. It assists with heart rate control and can also help alleviate heart pain and the effects of heart attack. Charlie abuses digoxin to kill his patients. For a long time, it’s one of his preferred methods of overdose, as he can easily inject it into a patient or the saline solution.

Insulin

A hormone that is naturally produced in the pancreas, insulin is vital in regulating a person’s blood sugar, which comes from the food that a person eats. Insulin moves the glucose from the blood to other cells all over the body, giving them access to the energy needed to perform vital tasks. When a person’s pancreas doesn’t produce enough insulin, glucose instead builds up in the blood, causing a condition called hyperglycemia. A range of conditions impact a body’s ability to produce insulin, and many of these are treated by administering external insulin. Along with digoxin, insulin overdose is one of Charlie’s preferred methods of harming patients. He targets specific patients with insulin injections but also injects the hormone randomly into IV bags in a more arbitrary form of medical violence.

Overdose

An overdose occurs when a living creature takes or is exposed to an excessive and dangerous amount of a drug. Overdoses can be accidental or, in cases of substance abuse or death by suicide, intentional. Charlie often causes overdoses in his patients by exposing them to too much digoxin, insulin, or “drug cocktails.”

Pyxis

The Pyxis MedStation is an automated medication dispensing system. Nurses input their identification information and the patient information and then receive drugs that they order. This allows for secure medication storage and appropriate patient billing—and alerts pharmacies of necessary refills before a medication runs out. Charlie works with an early version of the Pyxis dispensing machine and exploits certain issues with its functionality to access dangerous medicine with minimal detection.

Risk Management

In business, risk management is the process by which people evaluate and forecast risks and then identify procedures to minimize the impact of those risks. Risk management is crucial in economic realms, given that assessment areas include financial, legal, and security risks. In The Good Nurse, the use of the terms “risk management” and “quality assurance” implies that “quality assurance” has replaced “risk management,” but the individuals in those roles function in the same way. However, risk management also involves a process by which Charlie is terminated but doesn’t face legal action, making this an important system in perpetuating his crimes.