Most of us in healthcare are warm, caring people who are committed to keeping our patients safe and doing no harm, but there are some among us who do the unthinkable and betray our noble profession. On this podcast, we like to shine a light on the good and the bad. Each week I'll be joined by another healthcare professional, and together we'll dive into these stories while chatting about nursing and healthcare along the way. I'm Tina, a registered nurse, and this is Good Nurse Bad Nurse.
Hey everybody. This is Tina again with Good Nurse Bad Nurse. Welcome back to another episode. We've got a really interesting episode planned for you today. I'd like to introduce my guest host, Tammy Undiemi, who is a family nurse practitioner and also a forensic nurse, and she has written a book that is so exciting, so incredibly exciting about forensic nursing and her experience. Welcome to the show, Tammy.
Thank you so much for having me. I'm excited to be here.
Well, I'm excited to get to feature you in the "Good Nurse" portion and get to talk about forensic nursing and your experiences and kind of just talk about writing a book and I mean, that's just, I feel like that's just so amazing. But before we get into that, of course we always start with our "Bad Nurse" story, and this week we unfortunately have another case of a rogue nurse who it's, you know...
What a story it is. What a story it is.
Mm-hmm. Let's look at it this way. There are how many millions and millions and millions of nurses are there in the world? Okay? And yet the percentage, you know, of these things that happen are, it's really astronomical. You know, the number of people who do things like this, that end up coming out and we find out about these horrible things happening.
It is microscopic compared to the number of people that are in, not just nurses, but in healthcare in general, you know, in positions of direct patient care who have the ability to do this sort of thing, have access, you know, to the medications or resources or have that intimacy with a patient.
So if you think about that in terms of just the number of people you know that have been found to have done things like this, the vast, vast, vast majority of people that are in healthcare are wonderful, caring people, as I've said. And so, but at the same time, we can't ignore these things. Cannot ignore it. We have to be aware.
Yeah, and it makes you think, too, how many are out there that we don't know about? How many are not reporting mistakes or reporting what they see? All the ones that are discovered and talked about, there's a lot more that probably aren't.
Yes, exactly. And it's really why we like to talk about these stories because as I say, we like to shine a light in the darkness and talk about it, get it out there, expose these people, expose the details, so that as we are working with patients at the bedside with our colleagues, we can see the red flags that might be there because many, many times in these stories, there were lots of red flags leading all the way up to when they actually did get caught, and there could have been lives
saved, had someone either A, noticed those red flags, but also B had the courage to step up and say something. And then also, C, the people who have actually reported it, the management and people who you know are in a position to be able to do something actually took action. Because oftentimes we find that to be the case.
Right. And I think that sometimes nurses, you know, we're all busy and you see certain things, and then, okay, what happens if I say something? What happens if I don't say something? How do I bring this up to someone? Is anyone gonna believe me? I mean, there's just so, there's so many dynamics that come into it in leadership for a long time. I would always tell my staff, nothing changes if no one says anything. So being able to step up, but some people are like, how do I do that?
How, you know, what are the next steps to take? Or is this something anybody even wants to know about? You find, even though you know, you find yourself questioning, did I really see that?
Yes, exactly. Well, nobody wants to believe that this sort of thing even can happen. I think it's really hard just to even accept it. You want to, you just want to think that someone wouldn't do that, especially someone you know. It's one thing to hear a news story. It's one thing to hear an occasional story or see a movie about something.
It's a whole other thing to have a person that you are working directly with that you know personally, that you maybe, that might even be a friend of yours and have that person come under suspicion. So yeah, I would imagine that would be a really difficult position to be in. Well, you know, I guess we can go ahead and get started with this story and just talk about it.
Yeah. Yeah. You kind of think about that when you see things like this on the news. It's always somewhere else or in a different time, but really, you know, it's not, it's everywhere and it could be anyone, and so I think it's really important to kind of highlight, and I love what you guys do and how you kind of highlight, hey, this is here, this is everywhere, and we can all, you know, stand together against this kinda stuff. So.
Absolutely. Did you know that you don't have to go all across the country to be a travel nurse? You certainly can, but you don't have to. I literally took an assignment that's an hour and a half away from my house. And I love it. I can stay in a hotel room if I want, or I can drive back home. So it's the best of both worlds for me. For my next assignment, we're gonna get a cabin in the mountains that's about two hours from our house, so it'll really be like a little getaway.
Also, one of my really good friends is going with me so we can share expenses. You guys, even if you're just a little curious about travel nursing, go to trustedhealth.com/goodnurse and fill out a profile so you can see what kind of jobs are out there and what they pay. Go to trustedhealth.com/goodnurse and fill out a profile. Are you looking to take your career to the next level? Consider enrolling in the Doctor of Nursing Practice Program at UC Irvine.
The program offers a postmaster's track for MSN prepared nurses and a family nurse practitioner track for those with at least a BSN. Their program, of course, is fully accredited, and their graduates are highly sought after by healthcare organizations across the country. If you're ready to take the next step in your nursing career, I encourage you to explore UCI Irvine's DNP program today. Visit nursing.uci.edu to learn more.
And of course, we'll put a link on our website and you can access it at goodnursebadnurse.com. So this is the story of Christina Aistrup Hansen, or as she came to be known as the Devil of Death. Christina was born in 1984 in Denmark. Little information is really known about her early formative years, but Christina decided to pursue a career in healthcare as an adult. She enrolled in Herlev Nursing School in the mid-2000s and she completed her final exams in Nykøbing Falster Hospital.
I am sure I'm butchering these words. I don't speak Danish and I don't even pretend to, so I'm just doing the best I can. So I apologize upfront for that. After completing her exams, she became a full-time employee at the same hospital in 2009. So her nursing skills were highly regarded at the hospital. She had a reputation for being committed to her job and for being ambitious, and this is a common thread oftentimes throughout these stories that I see. People who are ambitious.
You know, I think we've all probably had a job where we felt really comfortable and confident. You've been there for a little bit and you feel like you're good at it, and so that's a great feeling to, you know, maybe save someone's life or identify something that could be really bad and intervene before it happens. And that's a really good feeling. And so I can see where there's that sort of fine line be between being good at your job and confident and then crossing that line like she did.
I can kind of see, not really understand what she did obviously, but I can see where she felt sort of empowered by being good at her job.
Yeah, I think, yeah, for sure. I can see how someone who has no regard for human life, who clearly is a sociopath, just sees the whole world as just players in her, you know, their secondary roles in the play that's her life and she's the main character and she's the only one that matters, and everyone else is expendable when it comes to entertaining her or bringing her excitement or whatever it is.
So if you're that kind of person and you kind of are an adrenaline junkie, or you just want to always be doing something exciting, you just can't stand boredom, can't stand monotony, then all of a sudden you get in a role where occasionally something like this will happen and you get that adrenaline pumping and you're doing chest compressions and all the things that go along with a rapid response or a code in a hospital, and then afterwards, you feel that, you know,
kind of sensation of accomplishment if the patient survived, you might even have your colleagues or physicians or upper level, you know, providers that are complimenting you on your abilities, your skills and saying, wow, you really, you caught that. You jumped on CPR so quickly that you're the one that saved this person's life. You know, that sort of thing. And how that could, if you kinda have that personality, it could almost become addictive. And you want more and more and more.
And so you go from someone who just goes into an area of the hospital like ICU or ER, where you're gonna have that excitement happen more often to actually creating those scenarios because they're not happening often enough for you. And it seems like maybe that happens sometimes with these people. Well, she definitely didn't shy away from the spotlight. She welcomed it. While her nursing skills were appreciated, she was not well liked among her peers.
She was known to be controversial and kind of pretentious. She once allegedly put her uninjured arm in a cast, just so others would ask her what happened. You know there's a movie on Netflix about this called The Nurse, 'cause there was The Good Nurse that was about Charles Cullen that came out last October, and this is called The Nurse. This is a recent, it's more of a, I guess, mini series, it's like a, I think four episode.
And in that, you know, sometimes I think they take some creative liberties. So I don't know how accurate this is, but in that she showed up to work one day crying and upset, saying she had a car accident, and her colleague, who was kind of starting to look at her like, you know, maybe with a little bit of suspicion, went and kind of checked out her car and absolutely no damage to the car. So that's the sort of thing, you know, that she would do.
And that's so crazy. If you think about people who do things like this and make up stories that they never even consider the fact that someone might say, oh, hey, what about your car? Or actually notice that the car is not wrecked, or you have a cast on your arm that's terrible. As nurses, we know that's usually like six to eight weeks or something, maybe longer, and, like, okay, how long did she wear it? And it's probably pretty hard to do compressions with that on.
So, and you know, she craves that. And so like, you just think like someone who doesn't think through the process and they still go forward with it because they crave that attention.
Yes. Sounds like someone, you know, maybe kind of impulsive and just not thinking anything through, just living in the moment. It's just what can I do right now in this moment to make my life more exciting and not even thinking about the consequences. Definitely not caring about anybody that you would harm for sure for that.
So some of the nurses on the ward reportedly issued complaints to their supervisor that Christina made them feel uncomfortable and that there was something kind of amiss with her that they really just couldn't quite put their finger on. They weren't able to necessarily put it into words, but they were just like, something is off with her. They just kinda had a bad feeling.
You know, sometimes that happens, especially nurses seem to have this sense, heightened sense of intuition or something, and it's--
Oh, for sure. Yes.
For sure. And I hesitate to even say that just because I don't like it when people refer to nurses as basically who say, you know, that that we have this sixth sense that nurses, they have a feeling, or when really it's less about probably intuition and more about an educated assessment. And you have knowledge in your head, you understand the way things work, the way things are supposed to work, and then when things aren't going right, you're recognizing these things.
Whether you can even put it into words or not, your brain is going, something is wrong, but it's doing that because it's recognizing things. Maybe it's seeing symptoms. Maybe your brain is--
Right, and experience, you know. Yeah. Your experiences, you know, experienced nurses can walk into a room and while the patient looks great on paper, all the monitors look good, you're just, you've got this gut feeling and you're just like, I can't put my finger on it. But that, you know, heightened intuition, I agree, comes from education and experience and, you know, some people are, you know, have more intuition.
Anyway, I think that you're right, nurses have a different level of that when it comes to education and experience because you just, you know, something's wrong and you just can't put your finger on it. And sometimes you're just like, I need a second set of eyes, you know? And you're looking, and before you know it, then whatever is going on, you know, will kind of expand or progress and then you, you know, you have provided the opportunity to maybe intervene and save someone's life. So.
Yeah, absolutely. I always encourage people to listen to that voice. If you have this gut instinct or gut feeling about something, that something is off. And we're, I'm just talking about just in, you know, as you're taking care of your patient, you, as you said, you walk into the room and all the vital signs look okay, or maybe they look similar to the way they have been. Maybe, maybe just a little bit off, but the patient is just not looking so good.
They look labored, they, you know, their skin tone is different, just something-- maybe they, you can kind of tell there's a little bit of extra edema that wasn't there and all these subtle changes are kind of setting off alarms in your head and kind of in your gut. Don't ignore that because I really believe that it is the education and experience that we have in our mind is recognizing that stuff. And you may not be able to say, oh, I, let me assess their lung sounds. I hear crackles.
Oh, I see edema in your low extremities. Oh, I see that you're labored and breathing, you know, 28 times a minute. Maybe you don't immediately pick up on that if you're especially a new nurse, but something is off. Listen to that and then like you said, go get an extra set of eyes. Go get a more experienced nurse. That more experienced nurse may come into the room and say, oh, wait, were they at this swollen like two hours before? Were they breathing like this? No, no, they weren't.
Okay, well, you need to call the provider. Let them know. And then, you know, Lasix gets sorted or, you know, whatever, and the patient improves. And then you learn by listening to that experienced nurse, why those alarm bells were going off in your head. Okay. And that's, I really believe that, I believe that intuition is directly tied to our knowledge and experience that's in her head, that we just aren't able to maybe--
Connect the dots. Yeah.
So in 2014, Christina became a mentor to nurse Pernille Kurzmann... well, nurse Pernille Kurzmann Larsen. A friendship developed between the two, but it wasn't long before Pernille noticed some strange behavior from Christina. Pernille suspected that Christina was responsible for some of the unusual patient deaths that were happening on the night shift.
When Pernille caught Christina red-handed, Pernille and her boyfriend, Dr. Niels Lunden, who worked in the same department, informed the police, this ultimately led to Christina's arrest. This did not happen overnight. This was not something like she started working with this nurse, kind of, you know, right away noticed things were off and then said something to her boyfriend at the time and the two of them started, you know, to look into it, tell the police, and bam, she's arrested.
That is not the way this happened.
No, not at all. Not at all. It was almost watching the series, you're almost like, oh gosh, why didn't you do this? Or why don't you try this? Or what about this? There's all these things that you think it could have been so easy, but I get, you know, it really wasn't, I think during that time. And you know, when we think about simple things that are annoying in some ways, like the Pyxis, you have to go like, or an Omnicell, or any kind of electronic device to get to the drugs that you need.
It sometimes can be a little bit of a hindrance and you don't have time. You know, you think, I don't have time to do this, I don't have time to do this. But watching this show you realize the importance of something like that because there's such a paper trail. Who pulled out what medication, and for what patient and when was it?
And you know, so there's that paper trail that's created and while, you know, sometimes we think, oh gosh, it's so annoying, or I don't have time, it takes too long to get through it, you realize the importance of it and the process is there for a reason. But yeah, you think about, I mean, they were able to just walk into the med room and take whatever drugs they wanted as much as they wanted. There was no tracking anything. What nurse pulled it for what patient, how much did they use?
It was just a free for all. There's no cameras, there's nothing. So it just, you think, oh gosh, why didn't you get a hidden camera? Why didn't you something? But there just wasn't anything. And I don't know what time period this was in and what was available to them, but it was just something that I thought about, like, wow.
All of the times that I was like, oh, I can't get through this Omnicell fast enough, and I needed an RSI kit, or something like that, well, you know, they're there for a reason and they're important.
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Just head to cbdstat.care/healthcare and find your new secret weapon. That's cbdstat.care/healthcare. You know, she started working as a nurse at this hospital in 2009. And so in 2012 there was a 72 year old man who passed away, and he's one of the people that she was apprehended for his death. And in 2015, there were two deaths, an 86 year old woman and a 66 year old man that she was also charged with their death. So think about that.
She started working there in 2009, and you have a death that happened in 2012 and two deaths that happened in 2015, and what happened in between? What happened between 2009 and 2012? What happened in between 2012 and 2015? Oftentimes when in these cases, the police, the prosecutors, the investigators, they focus in on deaths that they feel like they have the most evidence for, that they can make the best case for.
But there are lots of other very highly suspicious deaths that they are pretty sure that person was involved in, but these are the ones that they can focus in on.
Right. Having the evidence to prove it. And I think, did I read this correctly that they were thinking maybe she's probably responsible for at least 23 deaths? Did I read that somewhere I think?
That's what they said and I always feel like how do they know all that she actually did? Because there were many times where she was involved in code situations that the patient did survive, so what about those patients that they went into cardiac arrest, had some kind of a cardiac event, a code was ran, the patient was able to be revived and everything was fine, and nothing ever came of that. How many times did that happen that she was responsible for?
Well, and in the series too, I found it interesting that as the nurse that she was training started to suspect her more and more, and there was an unexpected code and the nurse said to the doctor, well, you know, would this happen if she got too much diazepam? And he said, well, did you give her diazepam? And the nurse's response was, well, no I didn't. And it was just left at that. And then when the patient crashes, they used the reversal agent and it worked.
And there was no questioning after that. The doctor didn't pursue it. You know, like he didn't say, why'd you ask me that? How did you know that would work? I mean, none of that. There was none of that, and so I just thought there's another missed opportunity there to try to figure things out. And maybe if someone would've asked her, she would've said, well, actually, this is what I think is happening. But there was just none of that.
I guess she did make attempts to go to her manager at one point, and even though she was unliked by some of her coworkers, I think that people in management maybe did like her because she looked like this rockstar nurse who had, who was highly skilled, highly motivated, appeared to be working really hard, high energy.
So I, even though maybe some of her colleagues didn't feel so good about her, if you try to go to management and they don't take it seriously, it would be kinda hard to have anything done. And then you, there's also a level, almost like gaslighting going on here too, where you're like, am I crazy? Like, am I imagining this?
Yeah. What if I do go to management and this becomes a big deal and then it's not like what I think it is. You know, it's so hard.
Well, yeah. I mean, imagine if, what if that doctor had said, why did you give diazepam? And she said no. And then when it happened, then they did give, what is the reverse? Is it Renasep--? What is that? I can't think of-- Romazicon? That sounds right. But they administer it and then it works. The reversal agent works.
Would you not be suspicious, like as the doc-- I would've been looking at the nurse who said that and been like, wait, so you said you didn't give it and yet when we gave the reversal it worked, so I might be suspicious at that person. So it's almost like you'd be afraid you were gonna pull yourself into it and have people looking at you.
Well, and as managers, right? In the ER when you or or any setting really, when you have someone come to you and tell you that they're worried about a coworker. I mean, I think it's a responsibility of leadership to always consider. Could this be happening? Is this happening? Not just discounting it because you don't want your, you know, dirty laundry aired, or, you know, you don't want a bad rap or whatever it may be that you're worried about.
But I think that any leadership position, if someone comes to you or even if someone comes to you with a complaint about yourself. I think you have to consider, do I do that or is this happening in my unit? Could this nurse be doing that? I think you always have to consider what's being said because it's being said for a reason. It could be a misunderstanding, but you do have to consider it. Otherwise, things like this will fall through the cracks and just keep happening.
Yeah, absolutely. So for these three patients in particular that the detectives and prosecution were particularly honing in on, they did have elevated levels of morphine and diazepam, or Valium, that were detected in their bodies, and Christina was the night nurse assigned to the hospital department on each of these occasions. So they were kind of looking at the records, looking at when she was scheduled to see, you know, is there some sort of pattern? And they were definitely seeing a pattern.
They were able to prove that she was present at each time of each patient's death, but they needed to really lay the groundwork for a motive. So when patients experienced cardiac arrest after the injections administered by Christina, she went to great lengths to revive them. She made heroic efforts by administering compressions and advising doctors on the patient's condition, which earned her admiration and recognition from her colleagues, doctors, and superiors.
Even when patients died after receiving the diazepam injection, Christina was commended for her dedication to serving and saving them. She was subjected to a psychological evaluation and was determined to have a histrionic personality disorder, which is primarily characterized as extreme attention-seeking behavior. The evaluation also revealed that she was emotionally driven with deficient self-control and a poor level of introspection and self-awareness.
That's so crazy. You know, and also in there, it talks about how she was dosing her daughter with like overdosing her on sleeping pills. And to me I kind of thought, well, how does that fit into all of this? And in my own brain, I guess the way I made sense of it was, you know, was she doing that because her daughter was a distraction from herself?
You know, was she having to spend time or do things with her daughter or her daughter was sort of interrupting her own, you know, I guess time for herself or something she was interested in, or something she was trying to do, they didn't really go into depth about the daughter, but that's like the one thing, like that's how it made sense to me, or that was sort of how my brain kind of mapped that out.
Yeah, absolutely. So with the results of her psychological evaluation, prosecutors argued that Christina saw herself as I said earlier, the main character and everyone else around her were the extras. Prosecutors proclaimed that Christina injected diazepam into patients to seek thrills and attention, and the thrill aspect was the motive behind her actions. This is a motive usually associated with notorious American serial killers, but rarely seen in Danish criminal history.
Christina's trial was 27 days long and involved more than 70 witnesses. She was convicted on three counts of murder as well as one count of attempted murder. So she was handed a life term only for it to be commuted to 12 years in 2017 because no forensic analysis could prove the patients died as a direct result of her medical abuse. So, how frustrating is that, that she was found guilty, had a life sentence, and then has that-- That's, and I don't understand their whole legal process.
Obviously it's a completely different country, but wow. That sounds, that's just unheard of for me.
Yeah, it's crazy because. Their reasoning was that they couldn't prove that the overdose of medication is actually what caused their deaths. And to me, I think to myself, you know, I mean I have a long history in forensics and I think, okay, this is a totally stable patient who's maybe gonna go home the next day, does not have the medication ordered at all. I don't get that.
There's no, there was no indication of any-- I know you can't always predict a heart attack or cardiac arrest or respiratory arrest or whatever it is, but, you know, these were patients that were mostly probably gonna go home the next day and doing very well, and there's just no other explanation. So if there's no other explanation to me, I don't know. I guess I just, that's really frustrating that they sort of downplayed it for what they said they couldn't prove.
I felt like the proof was, I mean, pretty good.
Yeah. And I would think it would be very sad and frustrating for the family members of these, of these victims, you know, it's, I can't imagine how that would feel, you know, going through the process of a trial and seeing the person that did this to your family member at least brought to justice only to have that ripped away. That would just be devastating.
Right, right. And I also wonder too, you know, as the trial's going on and everything's on the news, other people maybe who have had family members that had unexplained deaths or unexpected deaths in that hospital, you know that they're probably thinking, I wonder if, you know, she did the same thing to my family member or my loved one and, and they're...
Mm-hmm. Oh yeah. Absolutely. Especially if you had a family member that was in the hospital, you know, during the time that she worked there and they died under suspicious circumstances or they, you know, that they were getting ready to go home, you know, that they, whatever they had wrong with them was nowhere near something that would cause them to die, especially so quickly. You yeah.
I would think that you would be wondering and probably maybe even sure that she had something to do with it and, wow. I mean, how frustrating that that would be. Fortunately though, they did strip her of her license and also she was convicted of needlessly dosing, as you said, her seven year old daughter with high amounts of sleeping pills. She's incarcerated at a local correctional facility in Denmark where she's expected to remain for another five or so years until the summer of 2028.
So, they, and as far as these deaths, what they did is they actually reduced the charges to attempted manslaughter as opposed to, so it's not that they were saying that they didn't prove that she administered the diazepam, but they're saying that they couldn't prove that the death was directly caused by her administering the diazepam. And so they changed it to manslaughter, which I guess reduced the amount of time that she would spend.
But then she's, you know, so now she's spending time, I guess, for the act of over, you know, dosing her daughter with, with sleeping pills. And as you said, that's. I mean, just the lack of regard for her own daughter, that she would, just because she's an inconvenience to her, give her sleeping pills. And, you know, I have heard of people doing things like this, giving their kids Benadryl and that sort of thing. Oh my goodness. What a horrible thing to start.
That is not something you would ever, I mean, unless for some reason your provider, that your pediatrician is telling you to give your child melatonin or something like that to help with sleep. I don't know why that would ever happen. I've never had a pediatrician tell me that before. But, but unless it is advised by a pediatrician, you should never, ever do something like that.
Anything that is sedating, you have to be really careful with, and you need to, you know, use it for the right reasons at the right times and at the right dose. And I mean, anything other than that if, you know, if you're dosing your kid just because they're an inconvenience and you want them to go to sleep so you don't have to deal with them like there's something wrong. There is something wrong there.
Yes, absolutely. So I have to tell you guys about an experience I had with a nursing student. So, you know, I've been doing travel nursing, well, this hospital where I'm at has a lot of LPN students doing their clinicals there. So one of them was following me around one day and she noticed my stethoscope. And of course, y'all know the EKO technology company that sponsors our podcast.
They teamed up with Littmann to make the stethoscope to beat all stethoscopes, the 3M Littmann Core Digital Stethoscope, and this is the one that I use now. So she said, "Oh my gosh, I've been wanting to try one of those." So of course I let her use it and she just could not stop talking about it for the rest of the shift. It was so cute. She was like, "You know, I can't hear anything with my normal stethoscope because I have tinnitus."
And so she was so excited because she could actually hear what heart sounds were supposed to sound like. She said, "I'm gonna ask for one of these for graduation." And I was like, "Yeah, you definitely should."
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So you can go to ekohealth.com and use the promo code "GNBN" to get $50 off your order. And that's EKO is spelled E-K-O, by the way, so it's ekohealth.com and use the "gnbn" promo code to get $50 off your order. I also wanted to remind you that if you're interested in travel nursing to go to trustedhealth.com/goodnurse and fill out a profile so you can see what kind of jobs are out there, and you can also see what they pay, the stipend, the hourly rate, all of that.
I'm a travel nurse now with Trusted Health and I absolutely love working for them. So go to trustedhealth.com, be sure and put forward slash "goodnurse" so that they'll know that we sent you there and fill out a profile today. The following segment contains disturbing material pertaining to sexual abuse and violence against children. Listener discretion is advised. So I guess that kinda wraps it up for our "Bad Nurse" story. I'd like to get into talking about you and your book, Tammy.
This is so exciting, first of all, your daughter is so sweet because she is the one who reached out to me and she was so proud of you and the book that you've written. And so I was, I thought that was just precious and you're exactly the kind of nurse that I love to feature in this segment.
Someone who clearly enjoys your work and what you do, and also then kind of steps out and does something, you know, a little extra, be above and beyond you kind of, you know, like to obviously stretch yourself and spread the word to other people and try to educate people about this sort of thing. So tell everybody the name of your book.
So the name of the book is Chronicles of an ER Forensic Nurse, and then the subtitle is, "The Silence is Deafening". To me what that means and this book is really about awareness. Many people don't even know what forensic nursing is. Forensic nursing is really just the practice of collecting evidence from the human body, trace evidence collection, forensic photography, that kind of stuff for victims of violent crime. People ask me all the time, you know, what's the worst thing you've ever seen?
And they're usually asking me because they know that I've worked in the ER for so many years. It's really hard to have an answer for that. The trauma, the, you know, like there's just so much that you see, and for me, you could scrape somebody off the highway and bring them to me. I am, I do not lay awake at night and think about terrible injuries that are gonna change someone's life. What sort of haunts me are what humans do to each other. And it's not like gunshot wounds and stabbings.
It's taking your bare hands and just that intimate, you know, you're creating or you're violating these people in different ways, and it's all age groups. Forensic nurses, you can work in a hospital-based system. You can work for the medical examiner's office. Some forensic nurses even do crime scene collection. But when I talk about this and when I say that it's for awareness, people are always so shocked about the stories and the chronicles and they're just like, you know, that's so crazy.
And they think forensic nursing is cool. And it is, you know, it's a different type of nursing. A lot of people are interested in forensics for different reasons. We're all kind of true crime junkies, I think. You know, we all like you talk about the adrenaline junkies and you know, we're all kind of interested, I think, but I think it's because it seems like it's somewhere else or it is in a different time.
But really, I mean, I've worked across four states in multiple emergency rooms and it is everywhere. And I, you see all these things on the news, but you don't know what's really happening in your own backyard. I was shocked as a new nurse working in the ER when I would see things coming in, and then you don't hear about them on the news. You know, and this is in your local community, and it is everywhere. There's no discrimination.
And so for me, it was probably, it is for awareness, but it was also, I guess, very therapeutic for me to get it out just because there's just so much, and people, you know, they're just so shocked all the time. It just blows my mind how there's so much silence that surrounds violence and I think if people were more aware, I think that they would be more willing to step up and say something and trust themselves.
You know, much like we were talking about with the "Bad Nurse" story, people don't trust their gut, and there's so much of that that sort of falls into some of the stories in my book, just people don't-- I guess we're bad at recognizing the fact that we're victims. I think humans are just bad at that. You always justify it.
I shouldn't have been there, or maybe I had too much to drink, or was I really assaulted, or, you know, we all have different life experience, different coping mechanisms, but across the board I feel that humans are pretty bad at recognizing the fact that we're victims. And I think that's another reason why there's just not enough awareness around these types of crimes.
Can you give us a little example of maybe a story that really stands out in your mind or that you think would be maybe a good example of what people can expect when they read the book?
Yeah. One of the stories that really stands out to me, and sometimes I get a little choked up when I talk about it still, just even thinking about it, but there was an 11 year old female that was brought to me one day when I was working in the emergency room. She was found pimping herself out on Craigslist. And I just thought when I walked in this room, this girl is 11 and she has on clothes that are very inappropriate and do not fit her well.
She's wearing high heels that of course, you know, and I think of like, she probably had like an inch, inch and a half of like room in the back of the shoe. You know, obviously they were way too big and I just thought she looked like a little girl who was playing dress up. Like, that's what it made me think of. And as I am going through the motions and going through the whole forensic exam and the conversations that you're having, to her, it was just a conversation like you and I are talking.
She wasn't upset. She didn't seem scared. She didn't seem like she was, I wouldn't say happy, but like, it was just a normal conversation. And I just thought, wow. What it came down to after, you know, getting all the information, her own mom had been murdered by her pimp about two months before. And so then I realized, okay, so this is the only life she's probably ever known. And her grandmother had custody of her since her mom's death, and her grandmother basically didn't want her.
She almost refused to come to the hospital to even pick her up. And then when, so of course, CPS and law enforcement, everybody's involved, she... the grandmother was told, if you don't want her, you have to give her up for adoption in the appropriate fashion. You cannot abandon her in the ER or you will be arrested.
And so I'm thinking to myself, I have to let this little girl go with this person who does not want her, which also made me think that's probably why the little girl's mom was the way she was, you know? And then I thought, you know, is the CPS, or child protective system, any better? You know, like I feel like that system is so broken and so overwhelmed and a lot of those kids end up maybe in a better situation, maybe not. You know, so it was really tough.
And then I think the thing that really got me the most about that particular case was, you know, we don't treat people for STD exposure because, or I'm sorry, we don't test them because it would be way too soon to know if they were exposed to anything, but we treat them with one-time larger doses to maybe, I guess the expectation is to hopefully maybe kick something if there was an exposure so that it doesn't develop, and part of that at that time was also
Plan B, the morning after pill, and this little girl was willing to take all of all the medication that we wanted her to take or that we recommended unless it was going to harm a potential fetus because she wanted to be pregnant. And she told me, I just wanna have a baby so I have somebody to love me. What do you say to that?
Oh, oh my gosh. Well that's heartbreaking. That is, I mean, of all the stories I have heard of and goodness knows, I do so many of these stories. I've been doing this podcast for five years. That may very well be one of the most disturbing ones that I've heard just because of someone at that age being so neglected. And I think of, I am a trauma survivor myself from childhood abuse.
And so what I understand, as I said, as a survivor, is that you do not, as a child, recognize when you're being abused. You don't feel like a victim. You don't...
It's normalized 'cause you don't know any different, you don't know anything else. Yeah.
Mm-hmm. Yeah. I mean, it doesn't matter. You could experience pain, you can experience torture, you can experience extreme discomfort, and you do not recognize yourself as a victim, you just don't. That's not, you don't necessarily feel sorry for yourself. You are not, you don't have self pity. You are just, you're just surviving.
So children are, the coping mechanisms that are just ingrained in us, but then as an adult, so I think of her, you know, 10 years later when she's in her twenties and she's reflecting back, that is when she will realize that she was a victim and it will, you know, and probably before that, as you become an adult and you start to realize this isn't normal, that none of that was normal, you know, you start looking back and you go, wow, that is not the way that my childhood was supposed to be.
And sometimes it takes years to recognize things. Sometimes years later, you're looking back on something someone said to you, the way someone treated you, some circumstance you were in, and you're just like, oh my gosh, that wasn't supposed to happen that way. Something that you saw as normal. And so that's what, just as a survivor myself, when I think about the things that she's gonna go through, I just, her life, the chances are she will end up...
Oh, she's gonna struggle. I can't even...
Yeah, with some coping mechanisms that are unfortunately, as I say, many times incompatible with life because people oftentimes turn to drugs and that sort of thing to shut yourself down.
I think about her all the time, like what happened to her? You know? Did she end up in CPS custody? What did her grandmother, did she just go and start pimping herself? Like, I just think about, you know, there's no resolution. Now, some of you know this book, it's chronicles and so it's, it's an easy read. It's not like a long novel. It's just chronicles. Most of them are forensics.
There's a few crazy ER stories in there that just leave you with some questions, like, I have no idea what happened here. But, you know, it's an easy read, but it is kind of, I don't know if you, maybe the right description is a little bit dark. It's the dark side of humanity, but it exists and it's out there and it's everywhere, and people just for some reason are not aware.
Yeah. Well, I think that everyone's kinda living in their own, their own world and have their own life and their own problems and things going on, and you just, if you try to focus on all the bad things that happen all around you in life, it would be so overwhelming, you wouldn't even be able to live. At the same time, we can't just, yeah, we can't just pretend like it doesn't happen.
And we have to be, our government really needs to be focus, focusing on resources to protect children in these situations. I just recorded an episode where the "Bad Nurse" story focused on child abuse and child sexual abuse, and it was a really difficult story to do. But as I said then, there has got to be changes and that's never gonna come about if our government doesn't take it seriously enough to put funding in place, because we have to have resources to be able to do this.
We have to have social workers who can get to all of the people, the kids that they need to see. Many times social workers are just way over taxed and are just not able, you know?
Too many kids in the system. You know, and that's, there's another... I remember working in a trauma center in the last five years, I've worked in a trauma center where the same patients, drug-addicted females, would come in and deliver drug-addicted premature babies. They would spend months in our nicu and they're doing it over and over and over. I personally know of one patient who delivered six drug-addicted premature babies in our hospital, abandoned all of them, you know, and at what point?
You know, here they are talking about all these abortion control laws and birth control for women and not men. And you know, I mean, there's just so many things, but at what point, you know, is enough enough? I mean, everybody has rights, but so do these babies, you know, and they, it's just terrible that we are, these babies are gonna have lifelong problems, especially because technology is great and we can save a lot of babies, but they are life.
They have lifelong illness and they'll never be, not every baby, but this particular case, I happen to know them and you know, some of these babies won't be functioning members of society on their own at all, ever. And I just feel it's so tragic, you know, that it's, pregnancy is a hundred percent preventable.
And at what point do we, yes, this person's not getting prenatal care, but when they come into the hospital with baby number five, and they already are telling you they don't want it, at what point is it not okay for us to offer them, you know, tying their tubes or something just because they're not our patient? Just because we don't follow them, they're not seeing anybody. You know, why is it wrong if they're alert and oriented and can make their own decisions?
Why is it wrong to offer that service right then and there? We're gonna have to deliver the baby anyway. So I don't know. I just, it's just such a struggle. And you're right. You know, our CPS, or child protective system, is so overwhelmed due to the number of children in the system. You know, sometimes they're being removed from their home. For abuse or neglect and placed in a system where they could also be neglected or abused.
Not every house is like that and the system is great in some aspects, but there are a lot of kids who fall through the cracks and end up being victimized again. And it's just, you know, was the, and I think I even mentioned this in my book, you know, I didn't have a great childhood. My dad was not part of my life by his own choice. My mom struggles and still struggles with drug addiction. She has my whole life. And so, I used to think all the time, where was CPS when I was growing up?
And you're right. I was one of those kids, like, I thought this was normal, you know, where was CPS when I was growing up? But in hindsight, like, I don't know if that would've been any better. You know, my brother and I, my sister kind of did her own thing, but my brother and I kind of raised each other. We both kind of claim it, but. I raised him. That's what I say. So, and we're okay.
You know, but I just, I think about that sometimes, you know, would it have been better if we were placed in custody or not? I don't know.
Yeah. I think that's probably, it's a difficult, there are no good answers to that because clearly the system has a lot of flaws and is made up of people who make mistakes who are clearly, you know, look at the "Bad Nurse" story. There can be people in the system who are bad people, you know, bad foster care parents, and there can be all kinds of problems with the system. So definitely that's not the end all. But you're, I mean, you're never gonna remove these situations.
You're never gonna stop all bad things from happening to people. But I think we can do more. I think we can do a whole lot better than we're doing.
I agree. And it's not just with kids, it's with adults too. I mean, it's just, you know, I don't watch the news a lot anymore, but it's all tragic, right? I don't know. I'm always, I have never been the person that, like, I will not be the person standing on the side of the road with my cell phone out recording something. I am gonna step in and help somebody if I can.
Like, even if it doesn't end up well, I'm not, you know, I just think we all have a responsibility to help each other and not just stand on the sidelines.
Absolutely. For sure. You know, if there are nurses out there listening to this, if they're interested, what would you recommend they do to get into forensic nursing?
Sure. So every state has different requirements. Some require certification, some do not. Some offer a state certification. There's a national certification, but the first thing is, across the board you have to be a registered nurse for at least two years. And then if you reach out to your state's Office of the Attorney General, typically you are able to find some sort of, it'll say SANE, which stands for Sexual Assault Nurse Examiner.
Some of them will say SAFE, which is Sexual Assault Forensic Examiner, they all kind of have their own name. If you just search like sexual assault on the Office of the Attorney General website for your state, usually you'll be led to a few links that can give you the information on what the requirements are for that state. Another thing that you could do is every state also has a sexual assault coalition.
So whatever state you're in, you can just Google Sexual Assault Coalition and put your state's name and that will also bring up all of the requirements, the certified or recognized programs for each state. Some of them are hospital-based and some of them are based o out of the Office of the Attorney General. Usually it's a one week course for adults, one week course for pediatric patients. Not everyone has to do both. You know, it's hard.
I think that when you first get into it or when you first think about it and start looking it up, it's exciting and you think it's gonna be cool, but, and it is and it's great. And you can help so many people this way. And there's such a need. There's such a need for trained forensic nurses, but it's not for everyone. And sometimes you don't know that until you try. And that's okay, too. Once you go through that training, then you work with another forensic nurse.
For, you know, a certain number of cases before you can apply for your own certification. There is a international certification through the International Association of Forensic Nurses. That's another resource too that offers the classes. They offer an online class actually. You are also expected to do some courtroom observation because you will be considered an expert witness in a court of law. I think that kind of scares a lot of people, but there's so much training out there.
I mean, you can only testify to the evidence you collect. You can never say, yes, this person was assaulted, or no they weren't. You can only testify to the evidence you collect, and so don't let that scare you off. There's some training out there for that, and it's not as scary as it sounds. A lot of people are very intimidated by that. I work with a lot of pediatricians and they want nothing to do with any of it because they're afraid of going to court, but it's not as scary as it sounds.
There's a lot of training out there for that. So definitely a need. There is such a need there. I believe one of the states I worked in and I kind of refrain from naming those states just because, but 440,000 registered nurses in the state and there were only 336 certified forensic nurses. Yeah. Such a need for sure.
Well, Tammy, thank you so much for coming on the podcast and spending time talking about these things. Remind everybody again the title of your book and then let them know where they can find it.
Sure. Chronicles of an ER Forensic Nurse. You can find it on Amazon. It is available in like Barnes and Nobles and many other platforms. It's available both ebook and paperback and working on an audiobook, but the fastest and easiest way. And on also, I don't get to set the prices for all this stuff, but the less expensive is Amazon. Amazon. It's usually pretty fast, and the printing quality is great and it's a little bit less expensive there. So, I appreciate you so much having me on.
A lot of people are excited to hear this podcast and they've been introduced to your podcast, so they had no idea that it was out there. So they're really excited about the whole "Good Nurse"/"Bad Nurse" portion.
Well, thank you. I appreciate that. I always get, you know, people are like, hey, I just came across your podcast. I didn't even know this was out there. I've been doing it for five years and there are so many millions of nurses out there, and it's not just nurses that listen to it, that I can imagine, the few people that actually listen, you know, to the podcast are such a small amount of percentage of the people out there who you know are in healthcare, maybe somehow pertains to it.
It's sort of a different kind of podcast because it's not necessarily a true crime podcast. And I think there's some people who are, they really love true crime, so they come across it thinking that it's gonna be a true, like a traditional true crime podcast. And then they don't like it, and they'll, you know, give me a bad review and just be like, this is terrible.
They're the, you know, they just don't like the way that we talk a lot in chitchat, but the whole point of it is to use the stories to talk about issues with healthcare, talk about issues in the system, to try to learn something from it.
Yeah, and I think too, you know, healthcare providers are gonna appreciate it a lot more because they've been there. They understand it. They understand where we're coming from and why it's so important. There's a lot of people out there who will also think it's important, even that are not in healthcare. And sometimes too when you know you're looking through podcasts, there's so many out there, it's hard to find the right ones.
But when you come across it, this is a great podcast and I love what you guys do. I think it's awesome to highlight both sides of it. Often you, it's either one or the other and you guys do both, which I think is great.
Thank you. I appreciate that. Well, you guys know you can reach out to me at tina@goodnursebadnurse.com. I love hearing from you. You can find us on our website at goodnursebadnurse.com and we're on social media @goodnursebadnurse. And of course I have to remind you that even if you're a bad girl or a bad boy, be a good nurse.