There are numerous psychiatric illnesses and conditions that not only prevent people from living their lives as they want but also make them do terrible things to other individuals. It is proven that “some types of severe mental illness increase the risk that a person will perpetrate a violent crime,” and other additional conditions or addictions may also impact the patient’s behavior (Kopel, 2015, para. 3). In some cases, there are relatively strong connections between the patients’ previous traumatic experiences or damaged psyche and the terrible things they do. One such criminal is Charles Cullen, also known as The Killer Nurse, who was convicted of the murder of twenty-nine to forty people and is also suspected of killing several hundred others.
Unfortunately, Charles Cullen’s childhood was quite miserable, and probably if not for the awful experiences he had to go through while living with his father, he would not develop his mental illnesses and get other issues. He was the youngest of eight children, and their family was deeply religious (Oakley, 2021). However, it did not prevent Cullen’s father from being an abuser, and he raped his son as a kid. At the age of nine, Charles tried to kill himself by drinking poisonous chemicals, and it was his first of about twenty attempts to commit suicide (Oakley, 2021). For example, years later, he jabbed scissors through his head but was saved by medics.
When the patient was seventeen years old, his mother died in a car accident, and this event devastated Charles Cullen. Not being able to cope with stress and past traumas, he enlisted in the U.S. Navy and served there for some time. However, Charles was discharged because he did not stop his attempts to commit suicide and was already showing signs of mental instability (Oakley, 2021). After that, he found a job as a nurse and got married (the couple had two daughters), which may be considered false signs that everything in his life finally became great and his mental health returned to normal.
Chares Cullen has been killing his patients from 1984 to 2003. Working as a nurse, he had access to various medications; however, being an intelligent person, he did not use strictly regulated drugs like Vicodin, OxyContin, or morphine to murder his victims (Oakley, 2021). Instead, he used those considered safe medications, including digoxin, and injected them into patients in large enough doses. Of course, not all victims died. Still, Cullen hid his crimes for almost twenty years and got people killed in nine hospitals. His motives and the way to choose his victims are still unknown.
Diagnosis and Medications
Indeed, it is wrong to say that Cullen’s traumatic childhood justifies his actions, but it is necessary to consider what his father did to him decades ago. Charles Cullen’s actions and medical history allow talking about his diagnosis and appropriate nursing interventions. First of all, one of the illnesses the patient has is schizophrenia. Cullen’s symptoms of this chronic brain disorder include trouble thinking, making faces at random people, talking to himself, chasing and killing animals, and specific delusions (Correll & Schooler, 2020). It is possible to suggest that the patient was initially prone to this mental disease, and the abusive environment he lived in and other traumatic experiences triggered the development of schizophrenia (Correll & Schooler, 2020). Specific medications probably could have prevented Cullen from deciding to kill the patients and seeing his actions as a good deed.
Another disorder that influenced Cullen’s actions is depression. He was addicted to alcohol, probably because it helped him escape reality, and this addiction is a symptom of depression (Mayo Clinic Staff, 2018). Moreover, as mentioned above, he had numerous attempts at suicide, which is another sign of this mental disorder. Finally, apart from trying to kill himself, Charles had frequent thoughts of death. For instance, when he served in the U.S. Navy, he imagined stealing medications and chemicals and taking them to die. According to researchers, “traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one” can trigger depression (Mayo Clinic Staff, 2018). As stated in the previous paragraphs, this is precisely what happened to Charles Cullen.
Possible Interventions and Nursing Diagnosis
Both mental disorders that Cullen is diagnosed with are treated with specific medications and practices. First of all, Phenothiazine is quite effective in treating and controlling schizophrenia, presumably by blocking the action of dopamine in the brain (Ogbru, 2021). Therefore, it is possible to give the patient these drugs and change them to others if their effectiveness is not noticed. Additionally, Cullen requires careful handling and care so as not to provoke anxiety and anger outbursts.
As for depression, selective serotonin reuptake inhibitors are known for causing fewer side effects and being the safest for patients. If there are no positive changes in Charles’s mental condition, it is possible to try other medications, including serotonin-norepinephrine reuptake inhibitors and atypical or tricyclic antidepressants (Mayo Clinic Staff, 2018). Additionally, it is recommended for Cullen to see a therapist who specializes in schizophrenia and depression and can offer cognitive-behavioral or interpersonal therapy to relieve the symptoms and treat both conditions. Finally, the nursing diagnoses for schizophrenia are impaired social interaction and disturbed thought processing, and the one for depression is suicidal attempts and thoughts.
Correll, C. U., & Schooler, N. R. (2020). Negative symptoms in schizophrenia: A review and clinical guide for recognition, assessment, and treatment. Neuropsychiatric Disease and Treatment, 16, 519-534.
Kopel, D. (2015). Facts about mental illness and crime. The Washington Post. Web.
Mayo Clinic Staff. (2018). Depression (major depressive disorder). Mayo Clinic. Web.
Oakley, B. (2021). Charles Cullen: The Killer Nurse. Web.
Ogbru, O. (2021). Phenothiazine antipsychotics. MedicineNet. Web.