The Good Nurse: Reality Versus Hollywood

Image: Charles Cullen

Disclaimer: This article contains spoilers about the movie and the following review of the movie does not reflect the opinions of Nurse.Org but rather the opinions of this author. 

There has been a lot of buzz recently about The Good Nurse, a new movie now on Netflix. The movie is based on a true story and the 2013 non-fiction book written by Charles Graeber.  

If you haven’t seen it, you might want to check it out. It’s about a nurse, Charles “Charlie” Cullen, who was found guilty of 29 murders and thought to be responsible for as many as 400 deaths over a 16-year period at nine different hospitals.  

So, how does the movie hold up to the real-life story? 

The Movie 

The movie begins with a scene from St Aloysius Hospital in 1996. From the doorway of a patient’s room, Charles Cullen stands back and watches the code team attempt to revive a patient. The movie then advances to 2003. 

Amy Loughren is a night-shift ICU nurse at Parkfield Memorial Hospital. The hospital is short-staffed, and Amy is under a lot of stress. That sounds all too familiar! Amy begins feeling short of breath and experiencing chest pain. She learns she has cardiomyopathy and needs a heart transplant. Around this time, she befriends a new night shift nurse on the unit, Charlie Cullen. 

Because Amy has not worked at the hospital long enough to qualify for medical insurance, she attempts to keep her illness a secret until her insurance kicks in. Charlie keeps her secret and helps her out at work and home.  They become close friends. 

Both Charlie and Amy are single parents of two daughters. Although Charlie’s children are never seen in the movie because his ex-wife has them, Amy’s two daughters are present. Charlie is closest to Amy’s oldest daughter, Alex. Neither Amy’s ex-husband nor Charlie’s ex-wife plays a role in the movie, but Charlie does tell Amy his ex-wife is crazy and lies to him about abusing their dogs. 

Just before Charlie starts on the unit, Amy takes care of Ana Martinez who was admitted for taking her husband’s amoxicillin which caused an allergic reaction. Charlie assumes care of Mrs. Martinez the night he hires on, and the next day she passes away on the day shift. 

Image: Cast of The Good Nurse

Charlie and Amy learn of Mrs. Martinez’s death when they return to work that night. She is still in her room, and her body has not been properly prepared. As Amy and Charlie are preparing Mrs. Martinez’s body, he tells her his mother died in a hospital and they lost her body for two hours. He says his memory of his mom was lying half-naked in a hospital bed. He tells Amy that caring for the bodies is the important part for him. 

An investigation takes place at Parkfield Memorial Hospital over the unexplained death of Mrs. Martinez. The two detectives investigating the case are Tim Braun and Danny Baldwin. They have a difficult time investigating the case because the hospital only provides them with four pages of information seven weeks after the patient’s death. The patient’s body has also been cremated by the time the information is turned over to investigators.  

In the movie, it is very evident the hospital knows more than they are sharing with the investigators, and they are hiding something. 

Linda Garran, Parkfield Memorial Hospital Risk Manager, and the hospital’s attorney, Duncan Beattie have instructed all staff members not to speak with the detectives unless she is present. At Amy’s interview, Linda steps out of the room for a moment and the detectives show Amy the toxicology report on Ana Martinez. Amy realizes Ana had insulin in her system, but she was not a diabetic. She tells them this is a double medication error. When Linda re-enters the room, they ask Amy about Charlie. She defends him and tells them he is a good nurse and would never make an error like that. 

Later, Amy is working on a code and becomes very exhausted. She goes to the med room to hide and catch her breath. Charlie comes in and opens the Pyxis, takes out an unknown medication, and gives it to Amy to take. She tells him he will be fired for taking the medication. Charlie reassures Amy there is a fault with the Pyxis and that if you cancel the medication late enough the drawer will still open, but it won’t count the medication as taken. It will show canceled.  

Amy returns to the cardiologist and Charlie accompanies her. He encourages her to talk to her oldest daughter, Alex, just in case something happens while she is at home. She agrees and they talk with Alex. Alex and Amy have a turbulent relationship because Alex feels like Amy works too much and doesn’t spend enough time with her and her younger sister, Maya. 

Back at the hospital, Amy is caring for a young mother, Kelly Anderson. Kelly has been in a car accident but is otherwise healthy. She comes in to check on her later in the shift and finds her confused. Kelly codes and passes away. Amy sees that Kelly has insulin in her system even though she is not a diabetic.  

Amy returns home to find the detectives at her house. She thinks they are there about Kelly’s death, but they do not even know about Kelly. They tell her Charlie has been at nine hospitals and none of the hospitals will talk to them. They ask her to help them. She takes their card but tells them she cannot talk because her kids are home. 

Now that Amy is suspicious, she meets with her friend, Lori, who also worked with Charlie at another facility. Lori tells Amy there was a rumor that Charlie was putting insulin in saline bags in the storage room before they ever went out to the patient’s rooms. She tells her they had two or three codes per night, but after he quit, they only had one per month. She tells Amy they didn’t suspect him until after he left, and the codes decreased. 

Amy goes back to the hospital and finds several bags in the ICU storage that have pinpricks in them. The stress from this realization causes her to faint on the floor at the facility. She awakens in the ER. Charlie is at her side. He offers her some water, but she is afraid to drink it. She rips out the IV and leaves AMA, but Charlie insists on driving her home. 

When they make it to her house, Charlie offers to sleep on the couch, but Amy convinces him that she needs sleep, and she doesn’t want to scare the girls. He agrees with her and reminds her she only has one month left until her insurance takes effect. 

Amy immediately goes to the detectives with what she has learned. She tells them how Charlie is committing the murders. She explains, because he is putting the lethal doses of medication in the saline bag which is given slowly through an IV, the patients can die on any shift, not just his. She also informs them that the Pyxis does not delete the patient’s information as they were told by Linda Garran. 

Amy offers to pull Charlie’s Pyxis report on Mrs. Martinez, but the detectives tell her since Mrs. Martinez was cremated, they don’t have a body so it will do no good. 

Amy goes to talk with Kelly Anderson’s husband. He agrees to exhume Kelly’s body so they can perform an autopsy. It shows Kelly died in the early morning hours of the fifteenth from insulin and digoxin. Charlie’s Pyxis report shows he pulled and canceled digoxin and insulin on the fourteenth.  

It’s about this time that Parkfield Memorial Hospital terminates Charlie. Their excuse is he put the wrong dates on his application. It’s apparent they know what he is doing, but they are trying to cover it up. The detectives and Amy find out Charlie has been fired. 

When Amy arrives home, Charlie is there, and he and her daughters have made dinner. She is very nervous and makes the girls go to their room. Alex gets angry with Amy because she likes Charlie. Charlie thinks Amy is upset because he was fired. He tells her he was fired because he wrote the wrong dates on his application. She convinces him to leave so she can again spend time with her daughters, and he does. 

Wearing a wire, Amy meets with Charlie at a restaurant to see if she can get him to talk about what he has been doing. He shows up in scrubs and tells her he is starting a new job in Elmsworth later that evening. As she presses him for information, he tells her he doesn’t want to talk about Parkfield. As she continues to ask about Parkfield, he gets up and leaves abruptly. 

The police stop Charlie on his way to Elmsworth, but they can only hold him for 48 hours. Detectives Braun and Baldwin interrogate him, but he will not admit anything. Amy goes to the police department. She still has compassion for the friend she knew, but she knows she must get him to confess. 

As Charlie is handcuffed to the desk in the interrogation room, Amy sits down beside him. She asks them to uncuff him, and they are reluctant, but they do. Charlie tells her to go away, but she doesn’t. She covers him with her sweater since he is cold and talks about all he did for her. 

She apologizes for going behind his back. She tells him she couldn’t understand how he could kill anyone when he was so good to her. He tells her he just wanted to help her, and she tells him she still needs him to help her by telling the truth. At this point, Charlie confesses! 

Charlie tells Amy he “just did it.” He tells her he can’t remember all the names, but she asks him to tell her who he can remember. He names Douglas Stevenson, Ana Martinez, Kelly Anderson, Jack Adams, and a man at the last hospital with a German name. Amy asks Charlie why he did it, and he simply replied, they didn’t stop me.” 

The movie ends with Alex waking Amy up for school, and Amy tells her they are sleeping in for the day. They both smile at each other and lie back down. 

Movie Versus Reality 

Image: Charles Cullen

It’s true, the real Charles Cullen did inject medication into the saline bags of patients. However, the movie focuses only on insulin and digoxin as the drugs Charlie used to commit the murders. He actually used insulin and a variety of heart medications, not just digoxin. 

In real life, he worked at nine different hospitals in New Jersey and Pennsylvania. All of the hospitals suspected something but never turned him over to the State Board of Nursing.  He committed these crimes against his patients over 16 years. 

Charlie has never revealed his motive for the murders. In the movie, it leads you to believe it had something to do with his mother’s death. All Charlie has ever said is, “I thought that people weren’t suffering anymore. So, in a sense, I thought I was helping.” Do not be deceived though! Charles Cullen may be called the angel of death, but he is no angel! He is a murderer! 

In the movie, Charlie named four victims. During his real-life confession, he initially admitted to killing 12 to 15 patients, and later he told investigators it was probably 30 or 40 patients. He pled guilty to 29 murders, but it is estimated his killing spree could encompass close to 400 murders. 

The patients’ names and the hospital settings were changed in the movie. The movie begins in 1996, but Charlie began his killing frenzy in 1987, shortly after finishing nursing school. 

In the movie, Amy’s daughter Alex is close to Charlie. However, Amy revealed in an interview with People that she talked with Alex before agreeing to work with the detectives, and Alex told her, “Mom, he’s murdering people.” The movie depicts her telling the detectives she cannot talk to them because her kids are home. 

Amy did have a heart condition, and she did receive treatment for her condition. Amy is now a Reiki Master, Hypnotherapist, NLP Practitioner, Mediation Instructor, DreamSculptor Practitioner, Reconnective Healer, Integrative Energy Healer, Past Life Regressionist, Crystal Language Reader, and Medical Intuitive.

 

Image: Amy Loughren

Charlie and Amy were both divorced parents with two daughters. Charlie’s ex-wife did also accuse him of abusing their dogs. 

Charles Cullen is currently serving 18 consecutive life sentences in New Jersey State Prison. He will not be eligible for parole until 2403.  

Conclusion 

Image: The Good Nurse Cast

Overall, I enjoyed the movie. I think it appeals more to people who like movies based on true crime as well as nurses. I think they did a pretty good job of staying close to the true storyline. There are a few deviations to make it more movie appropriate.  

I will say there is one scene in the movie that made me cringe. Amy leaves a code, and she is sitting on the floor in the med room when Charlie comes in. He gives her the medication from the Pyxis, and she takes it…all while still wearing the gloves she had on during the code! Have you seen it already? Did you notice that one? 

As a nurse, I cannot imagine harming any patient. We are supposed to take care of our patients, not play Russian roulette with their lives! As for the facilities that did not stop him, it leaves one to speculate they covered this up to avoid lawsuits. It wasn’t about the patients but about their pocketbooks! 

The Good Nurse on Netflix

Image: The Good Nurse Cast

Cast Members: 

• Amy Loughren – Jessica Chastain 

• Charles Cullen – Eddie Redmayne 

• Tim Braun – Noah Emmerich 

• Danny Baldwin – Nnamdi Asomugha 

• Linda Garran – Kim Dickens 

• Duncan Beattie – David Lavine 

• Alex Loughren – Alix West Lefler 

• Maya Loughren – Devyn McDowell 

• Kelly Anderson – Anjelica Bosboom 

• Lori Lucas – Maria Dizzia 

Director - Tobias Lindholm 

Written for screenplay by Krysty Wilson-Cairns