UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #10

[marynnu]

Thats really interesting, especially as you have many years of ward experience of this. I just think back to the newborn stage with my children and you basically dont ever want to be more than 1m away from them at all times!

But I guess, even if a relative is only cotside for 6hrs a day, then you would expect, on average, for 25% of the collapses to have happened right in front of them. Yet that doesnt happen. The baby is seemingly usually alone (albeit for LLs presence)

JMO

I definitely think it's something worth looking at. Maybe in addition how often babies collapsed with other staff members when LL wasn't there? Not sure about those figures!
You're right, it's really hard to leave your baby at the best of times, and parents really struggle with it. They do find a way though, all credit to them.

 

[Dotta]

The baby is seemingly usually alone (albeit for LLs presence)

JMO

One must not forget about "FATE" she texted about.

LL and Fate - and, you know

"What Fates impose..."

JMO

 

[Becky53]

One of the doctors told the jury that he saw LL, crying to one of the other nurses, although he couldn’t pinpoint the exact day and time.

But he said LL cried and was saying “It’s always me when it happens, my babies, it’s always …happening to me a lot. "


She sent a sympathy card to the family, Only time she’d ever sent a card…

Snipped by me

The saying “crocodile tears” springs to mind. JMO

 

[Anxala]

Dr Alison Ventress: Hope work wasn’t too bad x

LL: Yeah it was ok. Baby I in 1 with distended abdo. Looks a bit rubbish. Having a chill on sofa in my PJs now.

Dr V: Poor baby I, not again. Sounds like well deserved chill on sofa, I’m doing the same. Let’s go and set up our own neonatal unit with all the other faces that don’t fit who often seem to be the best ones.

rsbm

Interesting.

Clearly an ongoing 'dissatisfaction' with the conditions in which they worked and some of the people they worked with. What do we make of that? The clear implication is that the practices/policies within the unit were not conducive to either a healthy or productive work environment.

And this is a doctor saying that.

 

[sapphireminds]

There have actually been several collapses that have happened with people present in the same room that didn't see anything untoward.

 

[katydid23]

I have to ask! What does Crowne hospital refer to?

Oh yes, I messed up the nickname. I thought the name was COC---Countess of Crowne....oops...

 

[katydid23]

rsbm

Interesting.

Clearly an ongoing 'dissatisfaction' with the conditions in which they worked and some of the people they worked with. What do we make of that? The clear implication is that the practices/policies within the unit were not conducive to either a healthy or productive work environment.

And this is a doctor saying that.

I am not sure that is a clear conclusion, that 'the unit was not conducive to a healthy or productive work environment. '

I think that any stressful environment, like a critical care unit, a school for troubled youth or an emergency clinic, is going to have some employees that feel dissatisfied with work situations and/or their co-workers and supervisors. There are going to be factions or cliques in any stressful working environment because people feel the need to vent. JMO

 

[Dotta]

I am not sure that is a clear conclusion, that 'the unit was not conducive to a healthy or productive work environment. '

I think that any stressful environment, like a critical care unit, a school for troubled youth or an emergency clinic, is going to have some employees that feel dissatisfied with work situations and/or their co-workers and supervisors. There are going to be factions or cliques in any stressful working environment because people feel the need to vent. JMO

Not to mention an alleged maniac hiding in their midst
"Scary, scary nights"
JMO

 

[bbsaz]

There have actually been several collapses that have happened with people present in the same room that didn't see anything untoward.

Yes, but in my mind there is a big difference between clinical staff being in and out of a room, busy doing tasks, then present when the results of an attempt become apparent, to a parent sitting next to the cot doing nothing much other than watching their baby for long stretches.

Most of the methods put forward by the prosecution are not immediate. There is a delayed reaction.

So another employee may well have been in the room when the baby collapses, but doesnt mean they were there when the alleged method of attack was applied as they are in and out and distracted with tasks. Parents/relatives are less so.

 

[Tortoise]

rsbm

Interesting.

Clearly an ongoing 'dissatisfaction' with the conditions in which they worked and some of the people they worked with. What do we make of that? The clear implication is that the practices/policies within the unit were not conducive to either a healthy or productive work environment.

And this is a doctor saying that.

The shift-leader called to testify about the first allegation of attempted murder (on 26 Sep 2015) of baby H was questioned by Ben Myers KC about at least some of what was going on with the staff -

"Mr Myers asked the witness: “Was there an issue with Lucy Letby being relatively junior compared to others and some debate about her going into Nursery One to look after more poorly babies?”

“Sometimes, yes,” she replied.

Mr Myers said: “And sometimes a bit of an under-the-surface dispute about that, is that correct?”

The witness said: “Yes.”

Lucy Letby: Medics could find no reason why baby ‘suddenly collapsed’

By this time, in the space of 3-4 months, babies A, C, D and E had all died in nursery one, babies B, G and H had suffered several life-threatening collapses in nursery one, and shortly after that date baby I also died in nursery one. It could be linked with some staff thinking LL was not experienced enough, and the whole "face not fitting" could be LL jumping on the bandwagon with other colleagues' gripes, to divert attention away from the real undercurrent. IMO



We have also heard vaguely about other upsets LL was involved in

26th Sep -

LL received a message from the deputy manager YG commending her for all her hard work, after the shift when baby H first collapsed.

"LL showed this message to a colleague and asked her how she should reply. Her colleague expressed surprise. The conversation alluded to a disagreement among the neonatal unit staff regarding a Christening for one of the babies in the unit.

LL to YG: “Thank you. That’s really nice to hear as I gather you are aware of some of the not so positive comments that have been made recently regarding my role which I have found quite upsetting. Our job is a pleasure to do and just hope I do the best for the babies and their family. Thank you to you & [another colleague] for your support x.”

LL to colleague: “I’m still frustrated/upset with what’s gone on but don’t think such rubbish nights & being tired help.”

Colleague: “Good reply as it’s important they know about the bitchiness which is all it is. Yes re tired Anyway you’re a star. You’ve done yourself proud. You’ve given positive memories to the family whatever the outcome. Let’s hope they can tease her in a few yrs about her ‘attention seeking’ ways. Sleep well. xx Always a pleasure to work with you even if we’re a ‘[s***] magnet’ team.”

Lucy Letby: Nurse 'commended' for work during 'stressful situation'


30th Sep - after collapses of baby H on 26 Sep, 27 Sep, and baby I on 30 Sep (she had been off work between 27 Sep and 30 Sep)

"LL messaged Jennifer Jones-Key to say: "I am a bit up and down. Have not had nice shifts and not been feeling supported by some people."

Recap: Lucy Letby trial, Wednesday, January 25


23rd Oct - after the shift when baby I had died (having just been off work on 17th, 18th, 19th, 20th and 21st Oct)

"Court is also shown messages between LL and an unnamed colleague. In these messages she says she spoke to a manager about certain staff 'not pulling their weight' at the hospital. LL said in that conversation that she was told Drs at the hospital 'speak very highly of her' and that she needs to be 'confident' in her role and not feel the need to prove herself."

https://twitter.com/MrDanDonoghue

MOO

Registrar Dr Ventress was quite junior I believe. Her texts come across to me as someone not much older than LL. JMO

 

[marynnu]

I am not sure that is a clear conclusion, that 'the unit was not conducive to a healthy or productive work environment. '

I think that any stressful environment, like a critical care unit, a school for troubled youth or an emergency clinic, is going to have some employees that feel dissatisfied with work situations and/or their co-workers and supervisors. There are going to be factions or cliques in any stressful working environment because people feel the need to vent. JMO

I agree. I used to liken our unit to a big dysfunctional family - bickering, disagreements - but we had a common goal & got on with it.

 

[Tortoise]

Thats really interesting, especially as you have many years of ward experience of this. I just think back to the newborn stage with my children and you basically dont ever want to be more than 1m away from them at all times!

But I guess, even if a relative is only cotside for 6hrs a day, then you would expect, on average, for 25% of the collapses to have happened right in front of them. Yet that doesnt happen. The baby is seemingly usually alone (albeit for LLs presence)

JMO

Part of baby I's mother's statement read out in the Mail Podcast -

“Our daughter could go from perfectly fine to nearly dying, in seconds, there was no in-between. She was continually being resuscitated. The hospital gave us a room to sleep in but every time we left and started to fall asleep we were woken up by banging on the door telling us to come quickly. It wasn’t once, it was several times. Our daughter seemed to deteriorate when we left her alone and predominantly at night.”

The Trial of Lucy Letby, Episode 14: Baby I, “Our daughter could go from perfectly fine to nearly dying in seconds.".

 

[marynnu]

There have actually been several collapses that have happened with people present in the same room that didn't see anything untoward.

It would be easy to sabotage a baby on a neonatal unit with other people in the room, in my opinion. I'm not saying she did, just that it's possible.

 

[marynnu]

Oh yes, I messed up the nickname. I thought the name was COC---Countess of Crowne....oops...

Fair enough. Just thought I'd missed something!

 

[GoodDayToYouSir]

The shift-leader called to testify about the first allegation of attempted murder (on 26 Sep 2015) of baby H was questioned by Ben Myers KC about at least some of what was going on with the staff -

"Mr Myers asked the witness: “Was there an issue with Lucy Letby being relatively junior compared to others and some debate about her going into Nursery One to look after more poorly babies?”

“Sometimes, yes,” she replied.

Mr Myers said: “And sometimes a bit of an under-the-surface dispute about that, is that correct?”

The witness said: “Yes.”

Lucy Letby: Medics could find no reason why baby ‘suddenly collapsed’

By this time, in the space of 3-4 months, babies A, C, D and E had all died in nursery one, babies B, G and H had suffered several life-threatening collapses in nursery one, and shortly after that date baby I also died in nursery one. It could be linked with some staff thinking LL was not experienced enough, and the whole "face not fitting" could be LL jumping on the bandwagon with other colleagues' gripes, to divert attention away from the real undercurrent. IMO



We have also heard vaguely about other upsets LL was involved in

26th Sep -

LL received a message from the deputy manager YG commending her for all her hard work, after the shift when baby H first collapsed.

"LL showed this message to a colleague and asked her how she should reply. Her colleague expressed surprise. The conversation alluded to a disagreement among the neonatal unit staff regarding a Christening for one of the babies in the unit.

LL to YG: “Thank you. That’s really nice to hear as I gather you are aware of some of the not so positive comments that have been made recently regarding my role which I have found quite upsetting. Our job is a pleasure to do and just hope I do the best for the babies and their family. Thank you to you & [another colleague] for your support x.”

LL to colleague: “I’m still frustrated/upset with what’s gone on but don’t think such rubbish nights & being tired help.”

Colleague: “Good reply as it’s important they know about the bitchiness which is all it is. Yes re tired Anyway you’re a star. You’ve done yourself proud. You’ve given positive memories to the family whatever the outcome. Let’s hope they can tease her in a few yrs about her ‘attention seeking’ ways. Sleep well. xx Always a pleasure to work with you even if we’re a ‘[s***] magnet’ team.”

Lucy Letby: Nurse 'commended' for work during 'stressful situation'


30th Sep - after collapses of baby H on 26 Sep, 27 Sep, and baby I on 30 Sep (she had been off work between 27 Sep and 30 Sep)

"LL messaged Jennifer Jones-Key to say: "I am a bit up and down. Have not had nice shifts and not been feeling supported by some people."

Recap: Lucy Letby trial, Wednesday, January 25


23rd Oct - after the shift when baby I had died (having just been off work on 17th, 18th, 19th, 20th and 21st Oct)

"Court is also shown messages between LL and an unnamed colleague. In these messages she says she spoke to a manager about certain staff 'not pulling their weight' at the hospital. LL said in that conversation that she was told Drs at the hospital 'speak very highly of her' and that she needs to be 'confident' in her role and not feel the need to prove herself."

https://twitter.com/MrDanDonoghue

MOO

Registrar Dr Ventress was quite junior I believe. Her texts come across to me as someone not much older than LL. JMO

I wonder what the nature of the dispute was regarding LL being relatively junior compared to other staff, and working in room one.

Was it that there was a sort of pecking order in that the most experienced nurses expected to be assigned to room one in preference to a more Junior nurse, regardless of how good the more junior college is at the job? Or was the dispute more about whether LL was experienced enough to be able to properly care for the babies in room one?

 

[Tortoise]

Dr Alison Ventress: Hope work wasn’t too bad x

LL: Yeah it was ok. Baby I in 1 with distended abdo. Looks a bit rubbish. Having a chill on sofa in my PJs now.

Dr V: Poor baby I, not again. Sounds like well deserved chill on sofa, I’m doing the same. Let’s go and set up our own neonatal unit with all the other faces that don’t fit who often seem to be the best ones. <snipped for focus>

(Mail Podcast)The Trial of Lucy Letby, Episode 14: Baby I, “Our daughter could go from perfectly fine to nearly dying in seconds." - The Mail.

30 Sep 2015:

Dr V :"Hope work wasn't too bad"

LL: "Yeah it was ok. I in 1 with distended abdo. Looks a bit rubbish. Having a chill on sofa in my PJs now."

I in 1 with distended abdo. reads like a multiple choice answer for an exam paper - or a Cluedo answer 'Colonel Mustard in the kitchen with the lead pipe'. There is no feeling in it whatsoever, or characterisation, not even 'little'. It shows disconnection IMO. And work was "ok"!

Baby I had vomited her milk feed, stopped breathing, and been resuscitated twice on LL's shift that day. She'd had 4 minutes of CPR. She was in distress. Her diaphragm was splinted. She'd been moved to intensive care in critical condition just before LL clocked off.

Dr V's reply shows more connection, IMO, and she hadn't been there.


I think it might seem as if LL didn't want to tell her, because Dr V might think it sounded like the other recent collapses. JMO

7 Sep 2015 - Baby G projectile vomited with distended abdomen. Dr V was crash called and baby G collapsed 6 times on that shift, requiring ventilation and transfer out. After the shift LL texted JJ-K asking who had told her. She discovered Dr V had told her.

26 Sep 2015 - Baby H collapsed. Dr V was crash called, gave 3 doses of adrenaline and 20 minutes of CPR.

27 Sep 2015 - Baby H collapsed again, and had 6 minutes of CPR. A different registrar attended.

LL texted her right after the shift :

LL: “[H] had resus again but not as bad/long-lasting as with us. Went to Arrowe.”

Dr.V: “Oh crap. Do they know why she did it this time? I’m glad she’s been transferred! How are you? Really rough set of nights for you. Xx”

LL: “No did exactly what she did for us, desat then didn’t pick up & dropped heartrate. Looked fine again after though but made decision to transfer which I think was sensible! X”

Dr.V: "Try to think of all the babies you’ve saved and have gone home happily with their parents. You’re a fab nurse. Hope you manage some sleep xx”

LL: “Thanks Ali Xx”



JMO

 

[Tortoise]

These nursing notes cover the same handover.

Letby's notes, written in retrospect at 8.26pm, record: 'At 1930 [Child I] became apnoeic - abdomen distended++ and firm. Bradycardia and desaturation followed, SHO in attendance and registrar called...
'Nil by mouth. NG tube on free drainage. Cannula inserted but tissued during saline bolus (5mls given).
'Colour appears pale but improved from earlier in shift. Abdomen appears full and distended. Veins more prominent. Not further vomits. Responsive but quiet on handling.'
For the family communications: 'Mummy present when reviewed by Drs. Had left unit when [Child I] had large vomit and transferred to nursery 1. [Mother] up to date with current plan...'


Nurse Bernadette Butterworth, who took over care of Child I for the night shift, records: 'During handover [Child I] abdo became more distended and hard she had become apnoeic and bradycardiac and sats had dropped. IPPV given and despite a good seal with Neopuff there was still no chest movement...'
'The NGT was aspirated and produced 'air+++ and 2mls of milk', after which Child I improved.

Recap: Lucy Letby trial, Wednesday, January 25
--

Testimony of BB, designated nurse for the night shift:

"The defendant, who was Child I's designated nurse on the shift, handed over her care to night-shift nurse Bernadette Butterworth in the early evening, when the youngster deteriorated once more.

The oxygen facemask was used again but no chest wall movement was detected, the court heard.

Miss Butterworth noted Child I's swollen tummy and asked Letby to aspirate her nasogastric feeding tube, which obtained a 'fair amount of air' and 2ml of milk."

Nurse gives evidence over child's death at trial of Lucy Letby


Perhaps nurses here can help out - is there any notable discrepancy here, between one nursing note recording tube on free drainage, and another nursing note recording aspirates? LL made no record of the air and milk.

 

[marynnu]

These nursing notes cover the same handover.

Letby's notes, written in retrospect at 8.26pm, record: 'At 1930 [Child I] became apnoeic - abdomen distended++ and firm. Bradycardia and desaturation followed, SHO in attendance and registrar called...
'Nil by mouth. NG tube on free drainage. Cannula inserted but tissued during saline bolus (5mls given).
'Colour appears pale but improved from earlier in shift. Abdomen appears full and distended. Veins more prominent. Not further vomits. Responsive but quiet on handling.'
For the family communications: 'Mummy present when reviewed by Drs. Had left unit when [Child I] had large vomit and transferred to nursery 1. [Mother] up to date with current plan...'


Nurse Bernadette Butterworth, who took over care of Child I for the night shift, records: 'During handover [Child I] abdo became more distended and hard she had become apnoeic and bradycardiac and sats had dropped. IPPV given and despite a good seal with Neopuff there was still no chest movement...'
'The NGT was aspirated and produced 'air+++ and 2mls of milk', after which Child I improved.

Recap: Lucy Letby trial, Wednesday, January 25
--

Testimony of BB, designated nurse for the night shift:

"The defendant, who was Child I's designated nurse on the shift, handed over her care to night-shift nurse Bernadette Butterworth in the early evening, when the youngster deteriorated once more.

The oxygen facemask was used again but no chest wall movement was detected, the court heard.

Miss Butterworth noted Child I's swollen tummy and asked Letby to aspirate her nasogastric feeding tube, which obtained a 'fair amount of air' and 2ml of milk."

Nurse gives evidence over child's death at trial of Lucy Letby


Perhaps nurses here can help out - is there any notable discrepancy here, between one nursing note recording tube on free drainage, and another nursing note recording aspirates? LL made no record of the air and milk.

Re. free drainage/aspirates, I don't think that's there is a discrepancy. The former just means the gastric tube is left open, the latter refers to what you get if you use a syringe, or what drains out spontaneously.

 

[hedgetog]

Something I thought of last night...with all the hours parents spend at their newborns bedside (eg Baby Is parents are there for approx 12hrs a day) isnt it odd that none of these 25 incidents occured when the parents were sat next to the cot?

If nothing unnatural occured here, what would be the odds of that right?! If most parents do a 12hr cotside stint each day, 50% of the collapses should have occured whilst the family were present. But, by my calculations, none did.

JMO

That is an interesting point that I hadn't considered actually. Most NICUs allow parents to be present for 24 hours a day, whilst for various reasons many aren't present all day every day, surely the likelihood of none happening when they were present given this could be anytime must be low? I wonder if they record visiting times and have done all sorts of clever data and probability stuff.

 

[Tortoise]

That is an interesting point that I hadn't considered actually. Most NICUs allow parents to be present for 24 hours a day, whilst for various reasons many aren't present all day every day, surely the likelihood of none happening when they were present given this could be anytime must be low? I wonder if they record visiting times and have done all sorts of clever data and probability stuff.

I don't think visiting is recorded, except where it's mentioned in the nursing notes. Trial has relied on a mixture of parents' memories and nursing notes.

In baby I's case the mother had a daily routine of dropping her children at school, going straight to the hospital, and leaving around 3pm. The father would visit in the evenings after work. According to the mother's statement.