The case of a serial-killer nurse leads to major investigation in Canadian healthcare practices

In 2017, Nurse Elizabeth Wettlaufer pleaded guilty to eight counts of first-degree murder, four counts of attempted murder, and two counts of aggravated assault after quitting her job in 2016 and checking herself into a psychiatric hospital where she eventually confessed.

Her crimes were committed against elderly patients placed under her care between 2007 and 2016. Most of them were perpetrated at Caressant Care nursing home in Woodstock, Ontario. She used heavy amounts of insulin to commit her crimes which usually ended in overdoses.

The 52-year-old Wettlaufer has since been prosecuted and is serving eight concurrent life sentences, with no chance of parole for 25 years, reports CBC.

When she was sentenced, Superior Court Justice Bruce Thomas said, “She was far from an angel of mercy. Instead, she was a shadow of death that passed over [her victims].”

However, while Wettlaufer is behind bars, her case signifies what many are calling “systemic vulnerabilities” within the Canadian healthcare industry, which has allowed for misuse of prescription drugs, medication, and the potential abuse for victims.

As it stands, many believe that had Wettlaufer not begun to feel the weight of guilt and confessed it is unlikely that she would have ever been caught and would have been free to continue killing her elderly patients. This also means that, if oversights in the healthcare industry are not addressed, there’s little stopping someone like Wettlaufer from committing similar crimes in the future.

“According to Wettlauffer’s own testimony, “if there was a way that the insulin was counted, she would not have been able to do what she did without getting caught,” reports CTV News.

Honourable Justice Eileen Gillese was appointed commissioner to compile a four-volume report to address just this issue, ultimately detailing 91 recommendations to assist in improving healthcare and preventing future patient abuses.

Included in her report are the following recommendations:

• The ministry of Long-Term Care should conduct a study to determine adequate staffing levels on day, evening and night shifts—and report on that study by July 31, 2020.
• Increase funding for staffing as determined by that study.
• Increase the number of registered nurses and registered practical nurses in long-term care homes.
• Limit the use of temp-agency nurses, who go into long-term care homes with little knowledge of the residents and procedures, to fill staffing holes.
• Give grants ranging from $50,000 to $200,000 per long-term care home, depending on the size, to improve the infrastructure around medication, including how it is stored and tracked. That could include installing glass doors or windows onto medication rooms, installing security cameras in rooms where medication is stored or hiring a staff pharmacist.
• Give long-term care homes more flexibility to use funds to pay for a broad spectrum of staff, including porters or pharmacists.
• Increase funding for training, education and professional development for everyone who provides care to residents in nursing homes.
• Building a universal reporting system for local health integration networks to adopt, which will include a searchable database for incidents.
• Requiring insulin in homes to only be in limited supply.
• Create a three-year plan through which facilities can apply for a grant of $50,000 to $200,000 to improve oversight of the administration of drugs.
• Directors of nursing at facilities should conduct unannounced spot checks on evening and night shifts, including weekends.
• Homes must maintain a complete discipline history for each employee

Other suggestions centre around improving abuse detection and improving communication between hospital and other healthcare institutions’ staff.

“We cannot assume that because Wettlaufer is behind bars, the threat to the safety and security of those receiving care in the long-term care system has passed,” Gillese said in a public remark.

“People are now worried about whether the long-term care system can safely provide care for their loved ones and for themselves as they age.”

Blyth Festival Theatre artistic director Gil Garrat, who is working on a play to dramatize the aftermath of Wettlaufer’s crimes, shared these sentiments: “We bear a responsibility, as a community and as a society, for what we’ve allowed to occur here.”

“It’s not to say that we’re responsible for the crimes of Elizabeth Wettlaufer,” he added, “she is responsible for those crimes. But we have a responsibility for having allowed (the long-term care) system to become what it has.”

“There is no simple ‘fix’ in terms of avoiding similar tragedies in the future,” Gillese continued.

“The offences were a result of systemic vulnerabilities in the long-term care system and not the failures of any individual or organization within it. Systemic issues demand systemic responses.”

“While the long-term care system is strained, it is not broken,” Gillese said, and continued to advocate for improvements to the regulatory systems which may protect patients in the future, reports CBC.

Gillese also stressed the need to have more robust investigations into the possibility of serial killers within the system, especially following very sudden deaths which may be attributed to the patient’s age as much as the cause.