UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #23

[esther43]

I think that her note taking was impacted by a variety of factors which she previously testified about.

Was this in all instances or some? Which particular occasions/cases was the unit so busy that she could not take notes properly? If you are not specific it seems like a generalisation.

These would all add additional time pressures to an already tight nursing schedule, including the ability to accurately document notes. And, we also heard how she tried (i.e., apparently) to catch up with incomplete nursing notes, by attending outside her designated hours

Is this evidence of a staffing problem? Were lots of nurses coming in on their days off to write up nursing notes or just LL? This would be important information to have.
If everyone is coming in on their days off to do this then yes, we have a seriously out of control unit that is dysfunctional at every level.
However if it's just LL coming in and doing this, then her being there in her time off could as easily be perceived as something other than dotting the I's and crossing the T's.

Notwithstanding, she did try reaching out to her mentor (e.g., texting Dr V at some points), and discussed submitting a datex.

Dr AV was not LL's mentor but a doctor with whom LL shared a friendship. LL's mentor is 'unnamed'

Which IMO demonstrates that she was aware that she was struggling, and was trying to get additional support.
However, IMO she should have spoken formally with seniors by requesting a meeting, and/ or sent emails as opposed to informal methods such as texting.

Can I ask what makes you think that LL was wanting or hoping that Dr AV was going escalate datix issues on her behalf? If that is indeed the reason she was mentioning it.

However, IMO she should have spoken formally with seniors by requesting a meeting, and/ or sent emails as opposed to informal methods such as texting.

Yes. To escalate it through line management or her mentor would be the way forward.

IMO - I think her biggest mistake in the above scenarios was that she was trying too hard… to be perfect (i.e., d/t an array of possible reasons).

To who? Who did LL want to impress?

Thus, she got overly involved in matters above her defined role (e.g., as a band 5 nurse). Consequently, seemed to be everywhere she shouldn’t have been and attracted extra attention.

Who's attention did she attract? And how did that lead to her being investigated by the police?

Thanks for your thoughts!

 

[GoodDayToYouSir]

My read of the evidence is that she remembers the shift very well.

"Letby says colleague Sophie Ellis was the least experienced member of staff on that shift and "did not have the skills for the job" of looking after small, premature babies in room 1.
"I did not think she was qualified for the job...She did not have the skills for the premature babies [in room 1]."

Recap: Lucy Letby trial, May 18 - prosecution cross-examines Letby

Letby is asked why she can now confirm she was in room 3 of the nursery, having not been able to remember to that in police interview. Letby says she was able to remember being in nursery room 3 after since being made aware of which babies were in room 3 that night.

Recap: Lucy Letby trial, Friday, May 5 - defence continues

It doesn't sound feasible (to me) that she remembers where she was for the reason she has given, because she agrees in cross-examination that she wasn't in room 3, her colleague was doing the feed for her, and LL was texting JJ-K.

"Letby is asked why she let a band 4 nursery nurse look after her designated baby.
Letby says it's "not unusual" for band 4 nurses to assist her in her duties.
LL: "I have no memory of that".
NJ: "Did you have something better to do?"
LL: "No."
Mr Johnson says the text at 11.01pm sent by Letby to Jennifer Jones-Key meant she must not have been in a clinical area, and would not have had time to feed her designated baby in room 3.
LL: "I can't answer that."
Mr Johnson says it took her out of the nursing area. Letby said she would have been "in the doorway" of the unit."

Recap: Lucy Letby trial, May 19 - cross-examination continues

I’m not sure I agree with the idea that she has a good memory of that shift.

My reading of the exchanges is that she remembers general things which would have been going on at the time (ie over weeks or months ) rather than events specific to that shift.

1) LL’s comments about Sophie Ellis not being experienced enough to look after babies in room 1 seems to be a continuing theme in this trial. It wasn’t that the babies in room 1 that night were unusual in that they had really rare , hardly seen conditions which SE hadn’t seen before, thereby meaning she wasn’t experienced enough to care for them: LL’s view was that SE shouldn’t be in room 1 full stop on any given shift. So I don’t think her comments about SE can be seen to demonstrate that she has a very good memory of that particular shift.

2) NJ asks LL why she let a band 4 nurse look after her babies. Again, LL’s response is a general statement about the fact that “it’s not unusual for band 4 nurses to assist her in her duties.” This indicates that again, that night wasn’t anything exceptional . She doesn’t say that she remembers specifically asking a band 4 nurse to look after her babies ; she just says that is something she does , which again doesn’t indicate to me that she has a good memory of the shift.

3) in relation to the text messages to JJ K, NJ puts it to LL that the evidence points to LL being in a particular place when she sent the text message. LL’s response is that “I would have been in the doorway “. I don’t read that as her saying she specifically remembers standing in a doorway, and sending the text message in question; she is answering in terms of what would have been usual for her to do based on her experiences.

IMO , etc

 

[Sillybilly]

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Thanks !!

 

[Becci]

Hi anyone know what days are scheduled for nxt wk pls?

 

[Anxala]

Hi anyone know what days are scheduled for nxt wk pls?

Back Tue at 10.30am. That's all the known info as far as I can see/google.

Hopefully, for everyone concerned (but mainly us following the trial), it will proceed as normal for the remainder of the week.

 

[katydid23]

JMOO

I think that her note taking was impacted by a variety of factors which she previously testified about.

Including, staffing shortages (e.g., particularly an apparent lack of doctors on the ward); a peak in neonatal collapses requiring BLS etc.; feeling concerned (i.e., perceptual) that some colleagues lacked experience, so performed additional checks on babies she wasn’t designated; attending to family members of deteriorating babies etc.

These would all add additional time pressures to an already tight nursing schedule, including the ability to accurately document notes. And, we also heard how she tried (i.e., apparently) to catch up with incomplete nursing notes, by attending outside her designated hours.

Indeed, in some of the above scenarios she should have sought help and advice from a senior instead of going beyond her designated duties, and outside of her working hours.

Notwithstanding, she did try reaching out to her mentor (e.g., texting Dr V at some points), and discussed submitting a datex. Which IMO demonstrates that she was aware that she was struggling, and was trying to get additional support. However, IMO she should have spoken formally with seniors by requesting a meeting, and/ or sent emails as opposed to informal methods such as texting.

IMO - I think her biggest mistake in the above scenarios was that she was trying too hard… to be perfect (i.e., d/t an array of possible reasons). Thus, she got overly involved in matters above her defined role (e.g., as a band 5 nurse). Consequently, seemed to be everywhere she shouldn’t have been and attracted extra attention.

JMOO.

I think it is silly to assume she was having a hard time keeping up with her work, when we have seen evidence of how much texting she was doing while working. She admits she often did so while in the clinic area and even in the nurseries. She carried on long conversations with multiple people while on shift.

If she had time to do that, then she had the time to finish her observations. She just had different priorities.

And I disagree that she was trying to 'be' a perfect nurse. I think she was trying to 'seem like' a perfect nurse. BIG difference between the two.

 

[Parker Knoll]

Tuesday and Wednesday of next week from reports, not sure if we are ever going to put in a Monday to Friday shift going forward though !

 

[Tortoise]

My reading of the exchanges is that she remembers general things which would have been going on at the time (ie over weeks or months ) rather than events specific to that shift.

1) LL’s comments about Sophie Ellis not being experienced enough to look after babies in room 1 seems to be a continuing theme in this trial. It wasn’t that the babies in room 1 that night were unusual in that they had really rare , hardly seen conditions which SE hadn’t seen before, thereby meaning she wasn’t experienced enough to care for them: LL’s view was that SE shouldn’t be in room 1 full stop on any given shift. So I don’t think her comments about SE can be seen to demonstrate that she has a very good memory of that particular shift.

RSBM

I think it's in relation to that shift.

Here's another reporter - Lucy Letby trial as it happened: Letby's Facebook messages shown in court - as lawyer says she 'cooked the records'

Letby said the nurse designated to care for baby C had recently qualified and "did not have the experience or skills" to care for a premature boy like him.

I haven't seen a continuing theme about Sophie Ellis not being experienced enough to be in room 1, it seems to me to be specific to baby C and that shift.

What other examples do you have?

 

[marynnu]

RSBM

I think it's in relation to that shift.

Here's another reporter - Lucy Letby trial as it happened: Letby's Facebook messages shown in court - as lawyer says she 'cooked the records'

Letby said the nurse designated to care for baby C had recently qualified and "did not have the experience or skills" to care for a premature boy like him.

I haven't seen a continuing theme about Sophie Ellis not being experienced enough to be in room 1, it seems to me to be specific to baby C and that shift.

What other examples do you have?

Which baby was it that had been looked after by nursery nurses all weekend? LL was a bit scathing about that if memory serves me right.

 

[Tortoise]

Which baby was it that had been looked after by nursery nurses all weekend? LL was a bit scathing about that if memory serves me right.

Baby G.

 

[Sweeper2000]

three cheers for antidepressants. Hip hip, hooray.
just Been listening to the podcast for baby O. Apologies if it’s already been mentioned. now I remember dr evans stating that the more information he gets the more accurate the diagnosis I’m wondering if he Heard the father testify that he actually witnessed that poor babies belly ”swelling”. obviously not air via ngt if he saw it happen. I was wondering how it was proposed that whatever someone allegedly did was able to bypass the ngt as well, thought it was there to prevent excess gas buildup?

 

[Charlot123]

The difference between the father and nurse L is that the father wasn't being paid to keep accurate records of what went on in the baby's nursery. We expect that LL would have an accurate account so that she wouldn't need to rely upon her memory.

Her memory of events should not be deviating from her notes or other's notes. JMO

As for the father's memory, I don't think he necessarily misremembered anything. He was accurate when he said there was no collapse that night, IMO. And he probably had just left as Dr V came to look at the chest drain. JMO

I used to have average memory, but if you ask me what happened during the year that we were all staying at home due to COVID scare, I’d be barely able to. But I can still remember some events. Other people staying at home with me will remember different events and days.

If one day doesn’t differ from another one, there is nothing for the memory to stick to.

So if that was the night without collapses or any major events, first, what three people remember might be different because for one something might be meaningful and for another person, not, and second, three people might remember very different things.

 

[Flurries]

JMOO

I think that her note taking was impacted by a variety of factors which she previously testified about.

Including, staffing shortages (e.g., particularly an apparent lack of doctors on the ward); a peak in neonatal collapses requiring BLS etc.; feeling concerned (i.e., perceptual) that some colleagues lacked experience, so performed additional checks on babies she wasn’t designated; attending to family members of deteriorating babies etc.

These would all add additional time pressures to an already tight nursing schedule, including the ability to accurately document notes. And, we also heard how she tried (i.e., apparently) to catch up with incomplete nursing notes, by attending outside her designated hours.

Indeed, in some of the above scenarios she should have sought help and advice from a senior instead of going beyond her designated duties, and outside of her working hours.

Notwithstanding, she did try reaching out to her mentor (e.g., texting Dr V at some points), and discussed submitting a datex. Which IMO demonstrates that she was aware that she was struggling, and was trying to get additional support. However, IMO she should have spoken formally with seniors by requesting a meeting, and/ or sent emails as opposed to informal methods such as texting.

IMO - I think her biggest mistake in the above scenarios was that she was trying too hard… to be perfect (i.e., d/t an array of possible reasons). Thus, she got overly involved in matters above her defined role (e.g., as a band 5 nurse). Consequently, seemed to be everywhere she shouldn’t have been and attracted extra attention.

JMOO.

I think her charting was severely affected by her texting and Facebooking during work hours.

 

[Charlot123]

JMOO

I think that her note taking was impacted by a variety of factors which she previously testified about.

Including, staffing shortages (e.g., particularly an apparent lack of doctors on the ward); a peak in neonatal collapses requiring BLS etc.; feeling concerned (i.e., perceptual) that some colleagues lacked experience, so performed additional checks on babies she wasn’t designated; attending to family members of deteriorating babies etc.

These would all add additional time pressures to an already tight nursing schedule, including the ability to accurately document notes. And, we also heard how she tried (i.e., apparently) to catch up with incomplete nursing notes, by attending outside her designated hours.

Indeed, in some of the above scenarios she should have sought help and advice from a senior instead of going beyond her designated duties, and outside of her working hours.

Notwithstanding, she did try reaching out to her mentor (e.g., texting Dr V at some points), and discussed submitting a datex. Which IMO demonstrates that she was aware that she was struggling, and was trying to get additional support. However, IMO she should have spoken formally with seniors by requesting a meeting, and/ or sent emails as opposed to informal methods such as texting.

IMO - I think her biggest mistake in the above scenarios was that she was trying too hard… to be perfect (i.e., d/t an array of possible reasons). Thus, she got overly involved in matters above her defined role (e.g., as a band 5 nurse). Consequently, seemed to be everywhere she shouldn’t have been and attracted extra attention.

JMOO.

There is one deeply illogical aspect in this whole story that I can’t understand.

If a medical provider starts killing patients, they run the risk of eventually ending up without any.

Which in a way is what happened in the COCH; due to excessive deaths, their NICU was downgraded back to level 3. Which probably required less nurses, doctors or overtime payments. Had LL stayed, financially, at the level 3 time, she’d lose, or so I think.

Could it still be so that LL was overwhelmed by her own decision to pick up extra shifts because she wanted to buy a house? I don’t know how British system works. How much can they pay overtime, and are negotiations allowed? What is the maximum overtime the hospital is allowed to pay?

I keep wondering if the statistic correlation between her being in the unit and the deaths had to do with her simply being on the unit too much?

In other words, were she more frankly money-oriented, trying to join budding private care British healthcare system, and less involved in the life of her unit, would she ever be suspected?

 

[katydid23]

There is one deeply illogical aspect in this whole story that I can’t understand.

If a medical provider starts killing patients, they run the risk of eventually ending up without any.

Which in a way is what happened in the COCH; due to excessive deaths, their NICU was downgraded back to level 3. Which probably required less nurses, doctors or overtime payments. Had LL stayed, financially, at the level 3 time, she’d lose, or so I think.

Could it still be so that LL was overwhelmed by her own decision to pick up extra shifts because she wanted to buy a house? I don’t know how British system works. How much can they pay overtime, and are negotiations allowed? What is the maximum overtime the hospital is allowed to pay?

I keep wondering if the statistic correlation between her being in the unit and the deaths had to do with her simply being on the unit too much?

In other words, were she more frankly money-oriented, trying to join budding private care British healthcare system, and less involved in the life of her unit, would she ever be suspected?

I keep wondering if the statistic correlation between her being in the unit and the deaths had to do with her simply being on the unit too much?

I don't think that's the case here. Reason being----She would go on vacation 7 or 8 days at a time, and no unexplained collapses happened during her absences. When she'd return, the collapses would start immediately again. When she switched from night shifts to day shifts, the collapse switched at same time to fit her new schedule. When she was taken off the unit, the collapses stopped.

So if it was just about her being on the unit more, I wouldn't expect to see those changes in the way the collapses happened , to fit her schedule exactly.

 

[Kemug]

She carried on long conversations with multiple people while on shift.

If she had time to do that, then she had the time to finish her observations. She just had different priorities.

Speaking for myself, that much texting would have impacted on my ability to concentrate on my work.

 

[Kemug]

Which baby was it that had been looked after by nursery nurses all weekend? LL was a bit scathing about that if memory serves me right.

Well, the baby survived it, didn't they? LL can't say that about all "her" babies!

 

[marynnu]

There is one deeply illogical aspect in this whole story that I can’t understand.

If a medical provider starts killing patients, they run the risk of eventually ending up without any.

Which in a way is what happened in the COCH; due to excessive deaths, their NICU was downgraded back to level 3. Which probably required less nurses, doctors or overtime payments. Had LL stayed, financially, at the level 3 time, she’d lose, or so I think.

Could it still be so that LL was overwhelmed by her own decision to pick up extra shifts because she wanted to buy a house? I don’t know how British system works. How much can they pay overtime, and are negotiations allowed? What is the maximum overtime the hospital is allowed to pay?

I keep wondering if the statistic correlation between her being in the unit and the deaths had to do with her simply being on the unit too much?

In other words, were she more frankly money-oriented, trying to join budding private care British healthcare system, and less involved in the life of her unit, would she ever be suspected?

All JMO:

I can only tell you that where I worked nurses never got overtime. You had to register on the nurse bank, so extra shifts were paid at the same rate as normal. Everyone gets paid more for nights, bank holidays and weekends.
I don't think the despicable attempts to insinuate private medicine into our health system have anything to do with it.

 

[Dotta]

Re obssessive texting

Interesting that Mr NJ KC alluded to her texting during resus and also while performing a certain procedure (when 2 hands were needed).

I wonder what it was all about?
Time will tell.
Didn't he say "We will return to it"?

 

[katydid23]

Tuesday and Wednesday of next week from reports, not sure if we are ever going to put in a Monday to Friday shift going forward though !

If it is just going to stay at 2 days per week it is going to really drag on. There are still 9 babies to get through, and they haven't asked her about the post it notes yet.

And then defense gets to re-direct, don't they?

Then closings and judges instructions.....