In the week that celebrated International Nurses Day, senior academic John Field revealed a small but dark side to nursing. He tells Denise Carter about the evil angels who like to kill rather than to cure

It wasn’t Dr John Field’s intention to bring the nursing profession into disrepute – after all, he is a registered nurse – but he couldn’t help where his PhD thesis led him.

His lengthy analysis of nurses who murder their patients, named "Caring to Death" ventures on a topic almost too scary to contemplate.

"I didn’t start off doing that topic," says John, who also holds credentials as a barrister and works as a senior lecturer at James Cook University on Thursday Island.

But research for a paper on "the nursing and law interface" began bringing up side references in professional journals and newspaper articles on killer nurses.

The numbers are small, 50 cases in 25 years, but because over half are in the US, John feels there may be more in other countries, who weren’t detected or reported.

Add to that his thesis only covers those murders reported in the English language and it could be just the tip of a much bigger problem.

"What shocked me was I hadn’t been aware of it," John says.

What further surprised John was the reaction he got from other nurses who eagerly asked about the subject of his studies.

"When I would say murder, they would assume euthanasia and when I said no, they did it with malice and forethought, they reacted with so much surprise," he says.

"They were astonished there could be nurses doing that."

John thinks the fact their colleagues don’t suspect them is part of the reason it’s so hard to catch the errant nightingales.

Because there was such a lack of attention to the subject and no links made between the murders, John says his thesis was begging to be done.

The murderers of 750 patients he found range from enrolled and registered nurses to nurses aides and most were serial killers (38 of 48) with some even being "shuffled around" within the health profession when they were suspected.

A New Jersey registered nurse, Charles Cullen, murdered about 80 patients over 16 years and worked in 10 different health facilities over that time.

Another US nurse, Joseph Dewey, was only charged with one murder, that of Robert J. Price, a patient at Cooper Green Hospital.

He later appealed the case successfully because of a technicality.

But Dewey had also been suspected in about 17 suspicious deaths at North Fulton Regional Hospital in Roswell, Georgia.

Overall, he was involved in almost 100 emergency situations, most of which he is believed to have created.

It was alleged he got a thrill from hearing heart monitors trip alarms and from watching hospital workers race to save patients.

The motives vary from case to case but most of the nurses killed for the pleasure of killing.

"It was the power of life over death," John says.

"They were thrill killers whose crimes were sophisticated and premeditated," he says.

"They were bad but not necessarily mad."

And it wasn’t easy to catch them.

One of the UK serial killers, Benjamin Geen, was caught last year after two murders and 15 attempted murders.

His preference was to poison his patients to induce cardiac arrest so that he could then save them and be deemed a hero.

A French nurse, Christine Malevre, was able to kill 30 patients before she was caught.

She was initially charged with manslaughter because she claimed she was committing mercy-killings.

But the charges were upgraded when psychiatric assessments found she had a morbid fascination with illness and had full knowledge of her actions.

One of the most frightening cases was a team of nurses who went on killing sprees in Lainz Hospital in Vienna, Austria.

"One registered nurse and three assistants in nursing killed possibly a couple of hundred people," John says.

"Initially, they used lethal injections but with patients with pneumonia who already had fluid on the lungs, they would drown them – just hold them and pour water down their necks," he says.

The only reason they were caught was they were overheard celebrating their most recent killing in a local pub.

It’s easy for nurses to kill because they have the power to do so on a daily basis and they have access to the means of death.

Methods of killing John found range from placing pillows over the faces of patients to disconnecting tubes but the most common by far is the use of a lethal injection, particularly containing insulin or potassium.

The victims of the killers range across the full age spectrum.

But John has found society reacts differently to cases where the victims are elderly to when they are very young.

"A blind eye seems to be turned when it’s elderly victims but we’re horrified when it’s babies," he says.

"Then there are books and there is mass publicity."

The UK’s Beverley Allitt was convicted of killing four babies and the attempted murder of nine.

She enjoyed being the centre of attention and so would inject the children to make them arrest so she could be involved in the drama that followed.

Dubbed "the angel of death", she was committed to an institution for the criminally insane because she was thought to have Munchausen Syndrome by proxy.

There was a BBC dramatisation of her story and she was one of the murderers featured in the Manic Street Preacher’s song Archives of Pain.

Another "baby-killer", Dutch woman Lucinda de Berk, killed up to 13 babies.

Australia didn’t escape from John’s findings.

"There was a case in Queensland where there was an allegation of a number of murders in a hospital," John says.

"There were two charges of murder and five exhumations in the case, but the first charge was dropped and the second delayed."

John hopes his thesis will raise awareness that murder can happen in the caring profession and he particularly wants nurses to stay alert and take on board his findings.

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