‘The Good Nurse’ Ending, Explained: What Happens To Charles Cullen?


“The Good Nurse” is a crime drama film that holds a tight grip on how it unfolds its mystery and often impresses with the performances of its protagonists. Although it does follow the real story of America’s most prolific serial killer (by estimation), the film does not look or feel like the usual work of this kind and is instead more focused on a relationship between two colleagues at the center of these incidents. “The Good Nurse” is nothing spectacular or outstanding, but the efforts it makes to present a crime story through a different lens while also commenting on a major safety flaw in practice make it recommendable for a watch.

Spoilers Ahead

‘The Good Nurse’ Plot Summary: What Is The Film About?

The film begins with a scene from 1996 in Pennsylvania’s St. Aloysius Hospital, where a patient has a sudden emergency situation due to which nurses and doctors run into the ward to provide aid. All their best efforts are made, but the patient cannot be saved, and the sound of the flatlining heart monitor is heard. A young male nurse, who was the first to respond and rush in, looks on helplessly as the patient loses his life.

Seven years later, in 2003, Parkfield Memorial Hospital is a busy local hospital in New Jersey, and it also happens to be the workplace of our protagonist, Amy Loughren. Amy is a nurse with a very good reputation, both among the staff and her colleagues and even more so among the patients. She is compassionate enough to let family members stay on long after visiting hours when the patient is stable and is helpful to everyone around her. However, Amy’s life has many hardships of its own, the primary being that she is a single mother to two young girls who really want to spend more time with their mother. But Amy cannot afford to do so due to her job and has to instead regularly leave her daughters with a nanny, Jackie. Making her situation even more difficult, Amy has also developed a serious heart condition for which she has to get a heart transplant done at the earliest, or she might face death. But Amy is not yet ready to get this transplant done, for she neither has the time nor the money for it yet. She needs to continue with her job for four more months before she can get health insurance, which would allow her to manage the finances, and for this reason, she does not tell anyone at her work about this condition either. Amy is certain that the Parkfield hospital authorities would lay her off if they knew she was working under so much stress in such a deadly health condition, so she keeps it to herself. Amid such a scenario, a new worker joins the hospital staff, a male nurse by the name of Charles Cullen, and Amy makes acquaintance with him. From the very beginning, Charles is extremely kind and helpful, especially towards Amy, and the two quickly become good friends. One night during their shift, Amy falls sick, and Charles finds out about her heart ailment. But to Amy’s delight, Charles understands her situation and promises to never tell anyone about it, and the man also offers to help the woman out for the next four months. However, a couple of deaths in the hospital soon changed the scenario and the relationship between these two friendly colleagues.

See More: Is Netflix Film ‘The Good Nurse’ Based On A True Story? Why Did Charles Cullen Kill The Patients?

What Does Amy Gradually Learn About Her New Friend, Charles?

Some days later, a patient, usually under the supervision of Amy, mysteriously died on a night she was not in charge. Although certain things with respect to the patient’s vitals suggest something unnatural might have happened to her, the matter is not pursued too much by the staff, at least immediately after the death. Amy and Charles, who had attended to the patient earlier, are left shocked by this sudden death but are more overwhelmed by grief than they suspect anything of it. At this point, Charles shares a very personal memory with Amy, remembering how his own mother had died when he was a child and how the hospital had first lost her body for a few hours and then recovered it and kept it lying around unattended. Amy finds an easy friend and companion in Charles gradually, even though the two do not get romantically involved. As part of his promise to help her, Charles starts often visiting Amy’s house to spend time with her daughters while their mother is at work. The man also tells Amy how he had lost custody of his own daughters after his divorce from his wife, and he was also not allowed to meet the girls because the ex-wife had been complaining about him abusing their pet dogs. Amy does not seem to give too much attention to all these things, as she believes everything that Charles says. It is also worth mentioning here that “The Good Nurse” does cast a slow and convincing spell with regards to how Charles is presented during the initial parts of the film, as the man does appear to be an extremely helpful person, with the only possible negative being that he was just too good.

In the meantime, the hospital authorities found out that the patient who had passed away had suffered some unusual reaction to the medications she had been given. For situations like this, it was protocol to contact the police and conduct an investigation into the matter, and the Parkfield authorities did the same rather reluctantly. Any hospital fears being found guilty of some negligence on the part of the nurses and staff or some other major wrongdoing, and in order to cover up any chance of actual investigation, the Parkfield authorities informed the police seven weeks after the death. Their excuse was that an internal investigation took so much time, but in actuality, this delay was to hide any possible evidence. The body of the patient had been cremated by the family, who were not even told of the actual reason for her death by the hospital, and this proved the task of the two investigating police officers all the more difficult. They spoke with each of the nurses and staff at the facility, and through their conversation with Amy, they found out that the patient had been given excessive insulin by someone even though she did not suffer from diabetes, and this was direct proof of negligence. Another medicine by the name of digoxin had also been administered, and this, too, might have had a direct role in the death. The officers soon find out that Charles Cullen had a criminal charge against him in Pennsylvania earlier for trespassing, and talking to the police in that state leads them to a new dangerous theory. Charles Cullen had been appointed as a nurse in about six or so hospitals over the last few years, and none of these hospitals wanted to talk about the man’s record. This immediately pointed to the possibility that Charles was perhaps doing something wrong at all the places, and the hospitals wanted to keep it shut to avoid any consequences themselves. The Parkfield administration also has a similar attitude towards the officers, as they are handed wrong and incomplete reports of the records of medicines withdrawn by the nurses. Neither do they have the body of the patient to conduct any more investigation.

However, right around this time, a second patient dies from an overdose of insulin and digoxin, and although the officers have been banned by the hospital authorities for misbehavior, they get word of it from Amy. The woman is obviously shocked to hear the investigators’ theory about her close friend, but she decides to look for any clues as well. She met with a nurse friend who had worked at one of Charles’ previous hospitals and spoke to her about the matter. The friend does indeed confirm that there had been a rumor that Charles was killing patients by overdose because the number of unexpected deaths in the hospital was very high when the man worked there. Amy then looks for clues at Parkfield and finally finds what she has been looking for—the bags of IV fluids that are regularly given to the patients show signs of tampering. Later on, when she goes through the records of the medicine disposal system that the nurses used, she finds Charles having used a hack trick to take out multiple doses of insulin and digoxin from the system. Charles had himself shown her this trick, in which canceling the request to get the drugs after a particular point of time canceled the request in the records, but the machine disposed of the medicine anyway. She gives all this information to the investigators, but the fact that the request for the drugs was ultimately shown as canceled on the paper meant that Charles’ trick could not be used in court. But these findings make it very evident that Charles Cullen used to tamper the IV fluid bags with insulin and digoxin, killing the patients slowly over hours. The investigators inform Parkfield hospital about all this as well, but the hospital’s reaction is only to immediately fire Charles from his job, citing a minor error in the information he had provided about his earlier employment. It is certain that all the other hospitals where the man had worked had fired him in a similar manner the moment, they doubted he was doing something wrong. Without any care for justice or punishment, the hospitals merely wanted to avoid any accountability since they would come under heavy fire if an employee of theirs was found to be a serial killer. Now that Charles is fired from his job once again, the investigators have no way but to somehow make the man confess his own crimes, and for this, they approach Amy for help.

‘The Good Nurse’ Ending Explained: What Happens To Charles Cullen?

Ever since Amy had heard of and started believing Charles for who he really was, she felt extremely nervous around the man for obvious reasons. But she had to keep up with the pretension of friendship with Charles since she was in a vulnerable spot, especially since he was close to her daughters as well and would visit them regularly. Even on the day that Charles is fired from the hospital, he visits Amy’s house while she is not there, and she is terrified to see him alone with her daughters. Amy still keeps her fears to herself, though, and she helps the investigators by trying to make Charles admit his crimes on record. This does not work, and the man eventually lands a job at another hospital quickly. The investigators realize that this is too dangerous, and they arrest Charles, but they also remain fearful about the fact that he would have to be freed if no confession came in forty-eight hours. Charles Cullen denies having to say anything about his actions and acts rather frenzied by repeatedly shouting out that he cannot say anything. It is finally Amy who decides to help once again, and now she visits Charles at the police station and comforts him with kind words. This works great, as Charles seems ready to talk, and when Amy asks him why he had committed the acts, the man admits to having killed many patients but also says that he did not know why he had done so.

Why exactly Charles committed the murders is something that the film does not get into, and it is still a mostly unanswered question in reality, too, since the case is taken straight from reality. Charles Cullen was actually a nurse arrested in 2003 after he admitted to having killed 29 patients by administering insulin and digoxin overdoses. Experts and researchers have since then claimed the actual figure of his victims to be close to 400 since there was no way of knowing the exact number. Charles himself has at times stated in interviews that he committed the murders to save the patients from the sad plight of being mistreated by the hospital staff, but many of his victims were not even terminally ill. There can be little doubt about the fact that Charles had been affected by the mistreatment that his mother had received in a hospital, and this probably built in him a deep-rooted mistrust and insecurity against hospitals. If it is really to be considered that he believed that he was saving the patients from disgrace, then this experience from his childhood fits in with his delusional belief, and that is perhaps why “The Good Nurse” chooses to highlight this particular experience. Along with this habit of killing, which had turned into an obsession, Charles was also an incredibly lonely person. He had indeed been divorced, and then a restraining order had been filed against him by his ex-wife, who claimed that the man was mentally unstable. Charles’ short relationship with Amy perhaps makes his loneliness all the more apparent, and the film shows this relationship to have perhaps some genuine feelings from his side. As a friend with probable feelings of love for Amy, Charles opens up to her and confesses at the end because she promises to him that she will not judge him no matter what. It is highly unlikely that Amy actually forgave him for the crimes he had committed, but the brave woman proved to be a hugely important piece in bringing the murderer to justice.

“The Good Nurse” ends with information about the real case, about how Charles Cullen was sentenced to eighteen consecutive life terms in prison in 2003 and remains in jail at present. Amy Loughren also successfully got her heart ailment treated by going through a heart transplant and lives in Florida with her daughters and grandchildren. It is Amy, as the film now directly points out, who is the titular good nurse for having done the right things and stepping up for justice even though the negative consequences of doing so could have been scary for her. The film also puts the hospitals and authorities in direct and sharp contrast with brave Amy, for almost all the hospitals where Charles had worked during his sixteen-year career as a nurse had suspicions about him of wrongdoing. However, none of them had done anything to stop him and had only fired him to avoid any suspicion. There can be no doubt that the hospitals were also somewhat responsible for the murders, for letting the murderer walk free every time, but sadly, no consequence has been faced by either of the hospitals for their horrid negligence.

“The Good Nurse” is a 2022 Biography Crime film directed by Tobias Lindholm.

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Sourya Sur Roy
Sourya Sur Roy
Sourya keeps an avid interest in all sorts of films, history, sports, videogames and everything related to New Media. Holding a Master of Arts degree in Film Studies, he is currently working as a teacher of Film Studies at a private school and also remotely as a Research Assistant and Translator on a postdoctoral project at UdK Berlin.

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