An “angel of mercy” nurse who saw herself as putting patients out of their misery by hastening their deaths further damages the already fragile reputation of nursing homes, a long-time nursing director said Friday.
Human resources personnel also need better tools and to be more diligent in vetting prospective workers, an employment attorney told McKnight’s Long-Term Care News. Meanwhile, a Pennsylvania nursing home exec lamented that providers couldn’t warn future employers of problematic employees even if they wanted to, and is supporting legislative change.
Their comments come in response to the multiple new charges leveled against a former nurse accused of murder and causing the deaths of at least 17 nursing home patients. On Thursday, the Pennsylvania Attorney General announced dozens of new charges against Heather Pressdee, including two counts of first-degree murder and 17 counts of attempted murder.
“There’s a high probability that in the court of public opinion, everyone will blame the nursing home for hiring a killer nurse, despite having done everything right,” said Jacqueline Vance, RNC, CDONA/LTC, a former national Director of Nursing of the Year and senior director of Clinical Innovation and Education for Mission Health Communities, LLC.
Before Thursday’s announcements, McKnight’s had previously reported that Pressdee either quit or was fired from 11 nursing facilities since 2018 and at the time of her arrest in May, her nursing license showed that it was in good standing. She also had been disciplined for “abusive behavior toward patients or staff.” Seven of the 11 facilities Pressdee worked at in western Pennsylvania over 11 years were nursing homes.
McKnight’s reported that Pressdee had been disciplined for “abusive behavior toward patients or staff” at several facilities, which led to her quitting or being fired from 11 facilities since 2018. Pressdee told law enforcement officials that she “felt bad” for patients’ quality of life and “had hoped they would just slip into a coma and pass away.”
Vance said there is a “big flaw” in the process that licensing boards can disclose only whether an individual’s license has been suspended or revoked, and not whether someone has been required to take part in probationary programs due to workplace transgressions such as diverting drugs or inappropriately administering medications. She added that when she oversaw hiring at past employers, she would call previous employers to ask whether an individual was eligible for rehire.
While that strategy worked well at the time, Jeffrey M. Daitz, co-chair of the Labor and Employment law practice for Hall Booth Smith, said HR offices are now advised to provide only neutral references about dates worked and salary history. When asked whether a person would be rehired, Daitz said he tells clients to say that it’s a matter of policy not to answer such questions.
“Employers are somewhat hesitant to give an accurate and true statement in terms of why someone is leaving because they’re concerned about a negative reference and being brought into a lawsuit,” Daitz told McKnight’s Friday.
He added that nursing facilities “are doing everything they can” to attract employees, which can mean that the intensive vetting that should be done is not always happening.
“Unfortunately, they’re letting their guard down because they need a body to staff the building to meet [staffing] regulations,” Daitz said.
In addition to in-person interviews, HR staff should be checking with licensing boards, state ombudsman offices, and public databases to learn if a prospective employee has been involved in lawsuits against previous workplaces, Daitz noted. Facilities must also monitor a person during their probationary period to verify their work quality and determine their fit as a caregiver, he said, adding that nursing staff who come from staffing agencies should be given an extra look into why they are not employed in a nursing home.
“Sometimes, agency employees have lesser qualifications,” Daitz said. “You’re [hiring] someone who may otherwise not have been able to get a job in a nursing home.”
Pressdee’s case bears similarities to a New Jersey nurse who admitted to killing 29 patients in hospitals by injecting fatal doses of drugs in IV bags and through other methods. In response to that, New Jersey now has The Health Care Professional Responsibility and Reporting Enhancement Act — also known as the Cullen law — that requires healthcare professionals or entities to notify the state’s Division of Consumer Affairs with information about any healthcare professional who may be acting in a way that could harm patients. Daitz said it also allows workplaces to give negative information to prospective employers about former employees. Charles Cullen worked at 11 hospitals and other healthcare facilities over 16 years.
Daitz said that law should be expanded to other states so that healthcare facilities can better vet applicants and be able to give “truthful” information.
Providers want to share ‘red flags’
Count Zach Shamberg, the president of the Pennsylvania Health Care Association, in favor of that effort.
“I think the key ingredient here and what was missed was that employers weren’t able to share their red flags that they saw with new prospective employers,” Shamberg told local ABC broadcast outlet WTAE.
Pressdee held positions at 12 healthcare facilities over a five-year span and resigned or was fired from all of them, according to investigators cited in the local report.
“We at the Pennsylvania Health Care Association have been looking to implement some sort of formal registry, some sort of system that could flag caregivers that are not fit to work in a healthcare setting, so we can stop this from ever happening again,” Shamberg said.
Pressdee’s victims range in age from 43 to 104. Charging documents note that she administered the insulin typically during overnight shifts. A lawsuit filed on behalf of one of her victims alleged that facility administrators “not only brushed off concerns among staff about the woman, whom some colleagues called ‘the killer nurse,’ but disciplined co-workers who spoke about how Pressdee cared for residents.”
Vance said that nursing staff and others need to feel they can report inappropriate or questionable behavior without fearing retribution. Anonymous hotlines should be available in every nursing home, she said. Pressdee remains in custody at the Butler County Prison where she is being held without bail. She waived a preliminary hearing on the additional charges on Thursday and it was not clear how she pleaded in court. Her attorney did not respond to a request from McKnight’s for comment on Friday.
