Layers of failure protected nurse

Even if Elizabeth “Bethe” Wettlaufer hadn’t serially murdered eight patients, she would still have been a fantastically bad nurse. Why was she allowed to remain one after being fired from her first job in 1995, having swallowed so many stolen narcotics that she nearly fell into a washroom garbage can at a hospital in Geraldton?

Wettlaufer, born Elizabeth Tracy Mae Parker, came to work late, took long breaks, made many medication errors, made desperate residents wait for pain medication and even oxygen, exposed herself to a co-worker, taunted residents, once pierced a hematoma with scissors not confirmed as sterile, and forgot a resident’s eye wound.

She worked in many places after the Geraldton incident but most of her victims died at Caressant (French for “tender”) Care in Woodstock, Ont., from 2007 to 2014. She attempted to kill another six residents and it will never be known if she murdered even more. Autopsies of the elderly dead are rare and cremation is popular. Three times, doctors and nurses had recommended autopsies but the coroner refused.

So it unfolded, a door opening in a dark room, and a small moment with a dialed-up insulin pen, followed by seizures and worse. What did Wettlaufer say to them as they died?

Five of the dead were women, three of them killed in 2011 soon after she was reprimanded by Caressant administrator Brenda Van Quaethem. One of the women annoyed her, Wettlaufer wrote in her confession, always saying, “Help me nurse,” so she was made to die.

On the other hand, Wettlaufer, 51, smiled a lot and often brought in pie.

A public inquiry is now studying what kept her at work and killing.

The nurses union protected her, the nursing regulator ignored her, health inspectors failed to note flaws in care, a church pastor didn’t report her confession, and her employers, fearing the union and always seeking cheap nurses at $60,000 a year, let matters slide. Suspicious doctors and nurses had asked for autopsies of two of Wettlaufer’s victims but coroners refused.

That’s six layers of failure. Are there more? What regrets there must be.

The Ontario Nurses Association fought her first dismissal for a year, turning the firing into a resignation for medical reasons, making it easier for her to get another job. And Wettlaufer persisted.

Over the decades, she was given multiple warnings but rarely suspensions as her union would almost always fight them. When Caressant finally fired her in 2014, the ONA got her $2,000 in severance and a letter of recommendation, of all things. I assume it will reimburse Caressant who will reimburse the victims’ families and on and on.

The Ontario College of Nurses knew Caressant had fired her for a medication error but declined to investigate. Wettlaufer later told police that her frequent “errors” were actually failed efforts to kill.

The college says it receives 1,300 firing notices each year and nothing stuck out about this one. If firing a nurse is so difficult, what must those 1,300 nurses have done? The mind boggles.

If only minds would boggle more, if only supervisors had kept a sharp eye out for the strange and the macabre. If only American high schools would search backpacks and keep a closer eye on socially awkward angry loner kids.

Wettlaufer worked nights. There was no one to notice.

Killers head for places with access to victims, especially those where people can go missing without anyone noticing or caring. That would be truck stops, poor parts of town, and residential schools for Indigenous kids. Pedophiles get jobs in schools — especially religious ones where children are taught silent obedience — scout troops, overseas NGOs, athletics, choirs, and yes, hospitals.

Imagine a place where death is already common, where victims are weak and trusting, where a killer could roam alone at night with full access to drugs as weapons.

If you were writing a thriller, you wouldn’t plot it this way. It would be too obvious.

“I’ve given a lot of thought to changes that could have been made where I would not have been able to do this,” Wettlaufer told the inquiry’s lawyers recently. She’s so helpful. Perhaps she would bring pie.

Heather Mallick is a columnist based in Toronto covering current affairs. Follow her on Twitter: @HeatherMallick