Lucy Letby guilty - part 2

[twoandcooplease]

Thread 1 Lucy Letby guilty www.mumsnet.com/Talk/_chat/4875009-lucy-letby-guilty

Just in case anyone wants to keep the conversation going

I haven't read the whole thread so sorry if it's been covered, but how did she even get hold of insulin?

It's a controlled drug, surely? Wouldn't she have had to sign it out, have access to the store and then wouldn't there be regular stock take checks to ensure compliance?

Just been watching the Panorama episode on this as it's made me really sad. I wasn't sure before but I absolutely think it was the right verdict. I can understand why her friends just can't believe it though, she absolutely doesn't present as someone who could really do anything aberrant.

But I do think there's an oddness to her family dynamic, and looking over the cases and her behaviours: always seeking sympathy and admiration, seeking out the drama of complex cases (or cases where harm would be less apparent?), seemingly never once questioning her own competence while being the obvious common denominator, the excessive "cutesiness" as well, there does seem to be something missing.

The officer (I can't remember his name) said she was hard to read as there was just no real emotion or empathy beyond the surface pleasantness. Very disturbing. I don't think she's emotional about the babies either way because that was almost peripheral to what she was getting out of it. Anyway that's the conclusion I've come to.

It’s not a controlled drug.

I'm probably rather alone in this and feel a little anxious to stick my neck out... but I feel some pity for the managers in this situation.

They clearly made terrible mistakes (and should be accountable to those mistakes) but I can't imagine they were ever trained or prepared for something like this to happen. I get the impression they had decided LL was a victim of harassment / some kind of witch hunt and that cognitive error/bias prevented them from seeing or acting beyond that. So whilst they are accountable I also think it's not enough to just say "sack them", "heads should roll" etc - I'm just not convinced that approach prevents the same thing from happening again. I'd suggest perhaps a better approach (as with clinical medical error) is to ask the question "what system could overcome the human error / bias present in this situation?" and go from there. And that might be, however much a manager may feel concerned about the reputation of the organisation, or the effects of police involvement or the personal effects upon a suspected perpetrator (whom they perceive as innocent) there is a black and white guidance stating your statutory obligation is to involve the police when such and such criteria are met. For there to be something that highlights the "red flags" of a serial killer in the organisation the same way that clinicians have prompts to bring to their attention the red flags of serious conditions such as a sepsis and to mandate certain actions. It's like, it doesn't matter if you've decided they don't have sepsis, if A and B criteria are met you're giving them IV antibiotics - it's protocolised.

I have absolutely zero knowledge of medicine, but I assume just like in the legal profession there ARE already guidelines and obligations to report, but they weren't followed because management said the criteria were not met. That's how people like Letby and "Dr Death" in the US get away with unbelievable acts for such prolonged periods of time.

In Dr Death's case his colleagues (senior consultants) were also trying to ring the alarm and reported him countless times over the course of several years, but they kept getting shut down by hospital management to protect the hospital's reputation, even though it was blatantly obvious that he was killing/crippling patients. It's also still unclear what on Earth possessed him to do it, even less if a motive than in Letby's case. These people are just completely cold psychopaths.

How is that possible?

It's not paracetamol! How is it even accessible to every nurse on duty?

Baffling.

Because we (generally, usually) trust nurses.

It was literally their job to ensure patient safety and why they were being paid a six figure salary. Dr Ravi Jayaram’s post on Facebook explains this well. That more babies died in a month than they would usually expect in one year and that she was the only one present every time… Added to that the consultants explicitly told them what was happening and who was to blame.

Drugs aren’t controlled because they’re dangerous - e.g. insulin - but because they’re desirable, mind-altering and addictive. Opiates, barbiturates, that kind of thing. At my last Trust you didn’t even need two nurses to give a controlled drug. As a CNS visiting wards I was just handed the keys and invited to give my patients morphine/whatever. As it wasn’t what I was used to I always found someone else to check it with me. Protocols vary from Trust to Trust, but nurses are accountable for every single thing they do. We can on the whole be trusted with drugs.

Nurses have to know the correct dose of every drug in case it’s been wrongly prescribed or dispensed, because we are accountable for our actions and cannot blame the prescribing doctor or dispensing pharmacist - we gave it when we shouldn’t have, entirely our fault. We have to know the side-effects and contraindications of every drug we give, and its reactions with other drugs. And of course many nurses themselves are now prescribers following specialist training.

There are dozens of different drugs on the average medical ward drug trolley. Most/many of them would kill a person at a high enough dose, or in the right (wrong) combination. Nurses could easily kill themselves, colleagues or patients whenever they felt like it, but the overwhelming majority wouldn’t dream of it. I hate having to reassure people of this. The Letbys and Allitts are anomalies, incredibly rare, and always shocking.

I’m still intrigued as to how the three top executives who backed Letby all swiftly and quietly disappeared within weeks of her arrest. Those far higher up in the NHS have known what was coming and no doubt gone all out to protect their backs.

A couple have now said they believe Letby tried to kill their daughter on the unit in 2012. The mother decided she wanted to check on her baby at 3am and found Letby standing over the cot. She (Letby) walked away and a few minutes later all hell broke loose as the child collapsed. She was rushed to another hospital where she almost died but they managed to stabilise her. Who knows how long it had been going on?

It’s called FII - Fictional or Induced Illness.

I’m not a psychologist but I’d pondered the exact same theory. It’s hard to believe that her own birth and ensuing admiration for nurses played no part. It suggests to me, too, that beneath her apparent confidence she had very low self-esteem as well as extreme narcissism.

In my opinion, this is not just a bit over invested, it is disrespectful.

I'm halfway through. About to finish it.

When asked about if the insulin had been flagged earlier he looked absolutely broken when he said yes.

Essex** I'm all for reading alternative view points but that science link you attached has an j correct opening statement "the consultants only accused LL after a damning report over the deaths" (paraphrased).

How can we trust that over the evidence given in court? I think it's right to always question evidence but if they can't correctly open the piece with factual narrative people (well I am) are questioning the validity of the rest.

As an ex police officer and a midwife I’d say that the police and nhs frontline work attract very different types of people.

Not completely, but there is a tendency for the police to attract the macho, power trip types. Even so I don’t think that a murdering type of police officer like Wayne Cousins would cause others to start murdering. However the WhatsApp type groups which were uncovered about this time full of racism and misogyny, etc between police did not surprise me.

Nursing definitely attracts more caring types who I suspect would be less likely to become “a bad apple” themselves. Certainly the NMC decree that recruitment for nursing and midwifery courses is a “values based” recruitment process. So questions in the interviews for the courses are written to try and ensure that people who are caring, compassionate, etc score highest.

99% of ward drugs aren’t paracetamol. Only a handful of drugs on my ward (certainly less than ten, nearer 5) are controlled drugs. You can’t make everything controlled and you can kill someone with pretty much anything in the right dose. Even air! Which she did.

I hadn't followed case until yesterday.There's more info on evidence on you tube, especially the mail podcast. Trigger warning though.
I initially wondered how a conviction was secured with circumstantial evidence, although thought she was most likely to be guilty.The sheer volume of circumstantial evidence procured the conviction. Also crimes had been committed and who else could have done it?
Odd behaviour was sometimes witnessed at the hospital as well. She would work with babies she hadn't been assigned to. Constantly popping up with grieving parents. One baby took 5 hours to die and rallied for a few minutes whilst with the parents. LL tried to take to the baby from them even though still alive.
Initially had doubts. Now think she is definitely guilty.

.

Disrespectful to who? They're public records.

When LL was removed from the neonatal unit the incidents stopped happening. Delays caused other babies to die despite senior managers being warned of the risk.
There were independent external reports that explicitly stated that further investigation of each death was necessary - this wasn’t done until the police became involved.
One report had an addendum about LL that was redacted; the chief exec and medical director chose to run an extraordinary board meeting about the incidents with the redacted version so the Trust board were not fully informed and were persuaded not to involve the police.
I cannot imagine how the medical staff coped with the gaslighting from LL and their own managers. They are dedicated to paediatric care yet were expected to apologise to a suspected killer and let her back on to the neonatal unit - this could’ve been far worse.

Absolutely.

I'd love to hear the answer to that.