The Netflix original film The Good Nurse is a chilling and strangely beautiful depiction of friendship in a profession that needs it most: nursing. Directed by Tobias Lindholm, the biographical crime drama explores the heartfelt friendship between ICU nurse Amy Loughren (Jessica Chastain) and Charles Cullen (Eddie Redmayne), a new nurse in Amy’s unit. Amy is thrilled to have extra help and company during her shifts, but when a number of her patients mysteriously die from random overdoses, she takes matters into her own hands and tries to identify the mastermind behind the sinister crimes. Who is filling the IV bags with the incorrect medication? To her disbelief and utter horror, all the evidence seems to point to her new friend and co-worker, Charles. What makes this thriller even more haunting is the fact that it is based on a true story. Oscar-nominated writer Krysty Wilson-Cairns, who is known for co-writing 1917 with Sam Mendes and Last Night in Soho with Edgar Wright, adapted the screenplay from award-winning journalist Charles Graeber’s book, The Good Nurse: A True Story of Medicine, Madness, and Murder.
The film’s opening scene thrusts the audience into the unpredictable reality of working in a hospital. A patient in St. Aloysius Hospital in 1996 seizes and dies in his bed after a complication with medicine. Charles does his best to help the struggling patient and rushes in doctors, but ultimately, the patient dies. Yes, Charles seems less panicked than his fellow healthcare workers, but his behavior and disposition doesn’t suggest that he would be responsible for any intentional wrongdoing.
The Start of a Beautiful Friendship
The story then jumps to 2003 (the movie’s present day) at New Jersey’s Parkfield Memorial Hospital. The night shift is understaffed, leaving much of the burden to Amy. In addition to being overworked at the hospital, Amy is dealing with cardiomyopathy, a life-threatening heart condition, and is struggling financially to raise her two daughters on her single income. Doctors urge her to take medical leave and get rest so she can live long enough to get a heart transplant. However, Amy insists she can’t because she needs health insurance and doesn’t get paid leave until she’s worked at the hospital for one year. Fortunately, Amy is about to get some help on the job, as the hospital hired a man with “tons of experience” and “great recommendations.” This, of course, is none other than Charles Cullen.
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Amy gives Charles a warm welcome and the two bond over both having two young daughters. Charles, though meek and unassuming, lets his guard down a bit with Amy, often making jokes at his own expense. Things start to take a turn once one of Amy’s patients, Ana Martinez, dies from having too much insulin in her system. This suspicious death prompts a poorly conducted 7-week internal investigation (that only happens because the Department of Health demanded it) that is followed by a more serious investigation with the police. The detectives discover that in 1995 during his time at a hospital in Pennsylvania, Charles was charged with criminal trespassing and harassment for slashing a co-worker’s tires post-breakup. Though the charges were dropped, something still didn’t seem right.
Murder in the Hospital
The hospital doesn’t want to take any of it too seriously and tries to dismiss the death as an “adverse reaction to medication” that was therefore not intentional. In fact, any time Charlie’s name came up at the numerous hospitals he worked at, people kept information close to the vest. Amy explains to the detectives that a double medication error is incredibly rare, and that she doesn’t believe Charlie has anything to do with it for several reasons. Not only would that be out of character, but it would be nearly impossible because Ana died during the day and they worked the night shift. It was also hard for her to believe that someone so loyal and genuinely caring could be capable of such a crime.
When a second patient dies of a double medication error, Amy begins to consider the potential suspects. She meets with a former colleague who also worked with Charlie, and learns that there was once a rumor about Charlie overdosing patients, though no one took any action. After this reveal, Amy checks the IV bags in the storage closet and sees that some of them had tiny pin-pricks and were thus tampered with before going out to the patients. Amy tells the detectives what she discovered and pleads with them not to reveal her name as the source of the new information because she will get fired. “He does it in the storage room before it even goes out. He injects the insulin into the bags and because it enters the bloodstream slowly, it could take hours or even a day to kill someone.” That’s why Ana died during the day and not at night.
Because Ana was cremated, they exhume the body of the second victim and perform an autopsy. Amy sneakily secures paperwork that shows Charlie withdrew the deadly dosages, but that isn’t enough proof. At the same time, Charlie is being questioned by the hospital about the dates he put on his application involving his time at St. Elizabeth’s. A slight date error was enough to be considered a breach of contract, and Charlie was terminated. This minor breach of contract was a convenient way for the hospital (who was withholding information from authorities that would further confirm Charlie's guilt) to get Charlie off their backs. But, if we’ve learned anything, it’s that Charlie would likely have no problem getting another nursing job.
Amy goes to lunch with Charlie and wears a wire, but doesn’t manage to get a confession. She does, however, find out the name of the new hospital he will be working at. The secretly recorded conversation was tense and emotional for Amy and Charlie, as both of them knew the truth though neither wanted to admit it. The two friends leave the meeting with tears in their eyes, and the cops successfully arrest Charlie while he’s on the way to his shift.
Justice Is Served
The Good Nurse reaches its heartbreaking conclusion when the detectives calmly interrogate a handcuffed and quiet Charlie and suggest that maybe he killed these patients because they reminded him of his mother or ex-wife. The typically docile nurse intensely lashes out and repeatedly screams “I can’t” confess. Amy agrees to meet with him and requests his handcuffs be removed. She carefully wraps him in a sweater and holds his hands. She talks like nothing changed and tells him, “I forgot about your goodness.” Amy continues to apologize for going behind his back and making him feel alone, but says that she needs him to tell the truth. “I just did it,” he admits, without having a real reason. With some goading by Amy, he reveals the names of some patients, which includes Amy Martinez. When a tearful Amy asks him why he murdered all of these people, he responds helplessly, “They didn’t stop me.” Even then, Amy still tenderly held his hands.
Before the credits roll, we’re given updates on the real-life Amy Loughren and Charles Cullen. In order to avoid a death sentence, Charles pled guilty to murdering 29 people, though the real number is believed to be closer to 400. He’s currently serving 18 consecutive life sentences and won’t be eligible for parole until 2403. During his 16 years of nursing, several hospitals thought he was suspicious, though no one did anything. To this day, there haven’t been any criminal proceedings against the hospitals he worked at. Amy is living in Florida with her daughters and grandchildren, is enjoying the results of a successful heart surgery, and is, of course, still a good nurse.
