Murder and Me

Maureen A. O'Reilly, DNP, NNP-BC, MSN

Disclosures

September 03, 2019

I'm a nurse practitioner working in a city where a nurse practitioner was murdered.

On a dark, frigid midwinter morning in Milwaukee, I had just finished getting report on the high-risk mothers who were expected to deliver in the next few hours. Walking rapidly toward my base of operations—the neonatal intensive care unit (NICU)—I mentally went over my to-do list: scrub in, examine infants, write notes, meet with parents, look up pending labs. I passed an empty visitor's lounge with a blaring TV; I heard the words "murder" and "nurse." My progress arrested, I turned back and planted myself in front of the screen.

The Murder of Carlie Beaudin

News reports said that the family dog became restless, and Carlie Beaudin's husband Nick woke early to find her side of the bed empty. He began calling to find out where she could be. The rest of his morning was phone calls, terror, and grief.

Like many nurses, Beaudin worked long shifts and often stayed to take care of patients after her shift was nominally over. Nick told reporters that his wife was incredibly nurturing. She loved to sing and even spent a month in Italy singing opera. She became a nurse practitioner, working in oncology. She'd won a DAISY award, given to extraordinary nurses, in 2012. Testimonials from friends and patients marked her as an outstanding nurse and empathetic person.

Carlie Beaudin

Beaudin left work at 1 AM on a cold Friday morning, January 25, 2019. A snowplow driver working on an upper level of the parking structure at the hospital found Carlie at 3:43 AM. She was bleeding, weak, and still alive, but her skin was frozen to the concrete. The driver called for help. Beaudin was taken to Froedtert hospital where she died at 4:21 AM.

According to news reports, when police reviewed surveillance video of the area, it appeared that a man hiding behind a pillar in the parking lot approached Beaudin. When she walked away, he attacked from behind and knocked her down. The man kicked her in the head at least 40 times, dragged her into the car, and drove her to another area of the parking structure, where he left her after taking her purse. Bleeding and unable to move after blunt force trauma to her head and a possible manual strangulation attempt, Beaudin was left utterly alone in the cold and dark.

I was astonished. I could not move. Other nurses drifted in to listen, perhaps alerted by my utter stillness and rapt attention. Incredulous reactions were repeated each time another person joined our throng to find out what had happened. Stories were shared about leaving work alone, in the dark, at odd hours; of feeling scared, of knowing that security should be called but not doing it because it took too long or they were tied up in the ED...the stories trailed off as some of the nurses began to cry. None of us knew Carlie, but all of us knew a Carlie. Someone young, bright, and dedicated. Someone no one wanted to lose.

Before long, the police arrested a young man who had recently been fired from the hospital's valet service. He may have known and spoken with Beaudin. After his termination, he was alleged to have returned to the hospital that black, cold morning and caught Beaudin alone in the parking structure. He was found in possession of her purse, and he admitted that he had "deliberately and purely murdered her." He has since been ruled incompetent to stand trial.

I spent time over the next few days looking at social media, where the story spread rapidly on nursing-related sites. Nurses expressed anger, grief, and blame. Some wondered whether Beaudin's employer—or their own hospital systems—would do something meaningful to improve employee safety. "Having security walk you out" was seen as a pathetic excuse for safety. FBI data confirmed that parking structures and lots are the third most common site of assaults and murders in the United States. I also learned that the attack had been captured on video cameras in the parking structure, but no one was watching.

Degrees of Separation

Emotionally, I tried to distance myself from Carlie Beaudin. I wasn't blond or 33 years old. I didn't work in oncology. I'd never won a DAISY award. I don't sing, at least not in public. I work 24-hour shifts, so I never enter the parking structure in the middle of the night; I always leave in the morning with a crowd. My first line of defense was that it couldn't possibly happen to me.

Then I read a Facebook post written by nurse entrepreneur Barb Haag-Heitman, PhD, with whom I'd stayed in touch over the years, after she hired me in 2003 as a nurse practitioner. Barb remembered teaching Beaudin during her master's program at the same university where I'd earned mine. The distance between us abruptly shrank. We knew the same people, we studied in the same program, we worked in the same city. We were nurses.

Carlie Beaudin's death affected me more than I realized. I became shaky and unsure when parents reacted badly to news about their infants. Were they going to become violent? Did I have to listen when they shouted at me—could I hang up or walk away? When I encountered threatening behavior, I desperately wanted to leave the situation. I noticed a new, distinct autonomic reaction to threats: my face flushing, heart rate increasing, a hollow feeling like hypoglycemia. I used to be able to remain calm in threatening situations, but that ability seemed to have abandoned me.

Six weeks after Beaudin's murder, I experienced these new fear-driven physiologic responses when the father of a baby under my care verbally threatened me. The baby's mother had admitted to polydrug use during her pregnancy, so I ordered umbilical cord toxicology testing and made a social services referral. Both actions are standard practice under these circumstances, but these parents were not happy about it, fearing that their baby could be taken away from them. One afternoon in an empty hospital hallway, the baby's father came close to me and whispered, "I know where you live. I'll be by your car some night, waiting. Watch out for me."

Why Us?

Last year in a Boulder, Colorado, hospital, a psychiatric patient tried to kill a nurse by strangling her with her own stethoscope, just for telling him that he was going to be transferred to a different hospital. And earlier this year, a Baton Rouge, Louisiana, nurse died a few days after being viciously attacked by a patient at the nurses' station where she worked.

Tallied yearly by the Bureau of Labor Statistics, 117 fatal work injuries involving "healthcare and social assistance" workers, a category that includes nurses, occurred in 2016 (the latest data available). Only about one third of those fatalities were due to "violence or other injuries by persons or animals." Gun violence in hospitals is relatively rare.

In spite of these reassuring facts, my fears aren't entirely unwarranted. The risk of being murdered while nursing may be low, but the National Safety Council rates my chances—as a nurse—of encountering workplace violence (including rape and assault) as 5-12 times higher than rates for US workers overall.Spitting, yelling, pushing, shoving, stabbing, holding hostage, slapping, raping, beating—all part of the nursing experience? Statistics say yes.

But why are nurses, who are generally perceived as kind, compassionate, and helpful, targeted for assault? It may be tied to the nature of their work. Nurses have the most "face time" with patients and visitors. Nurses are largely female, and women are more vulnerable to sheer overwhelming physical force. How often do nurses willingly enter a stranger's room, with no sight lines for coworkers to monitor their safety, and shut the door, cutting off any calls for help? Every minute of every day, in thousands of hospitals across the country. Nurses are visible and available at the end of a call button, making them easy targets for frustrated, fearful patients and irate visitors. And in today's environment, patients may have the same service expectations for nursing care that they have in a fast-food outlet. If they don't like the service, they might just lash out at the nurse.

Carlie Beaudin's life in nursing and music was celebrated by a performance of "In Paradisum" by the Bel Canto Chorus in the Basilica of St. Josaphat in Milwaukee on May 17, 2019. I wish I could have attended, but I was working. Beadin's alleged attacker remains in custody, receiving inpatient treatment for mental incompetency.

I'll always feel sad about Carlie Beaudin. I think about her and her attacker, and wonder how the fatal intersection of the two might have been prevented. But if not her, it might have been the next nurse to enter the parking structure that night. I have a renewed motivation to prevent it from happening to me. I follow the rules about "staying safe" at work. I dutifully watch the annual active shooter videos and practice running and hiding. I write detailed notes about disturbing or threatening interactions with parents or visitors, and get social workers and child protective services involved when I should.

I'm not fatalistic, but with the confluence of stressed and anxious parents, the alien atmosphere of the NICU, and the imperfect human communication that takes place there every day, who knows which match will be next to ignite violence against a nurse?

Maureen O'Reilly is a neonatal nurse practitioner with Ascension Wisconsin's St. Francis Hospital. In the Special Care Nursery, she guides patient care, teaches staff, and initiates evidence-based improvement projects.

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