In the quiet routines of long-term care, death is expected. That assumption became the perfect cover.Beginning in 2007, Elizabeth - a nurse working in eldercare facilities across Ontario - exploited her access to insulin to murder vulnerable patients who trusted her with their lives. Struggling with addiction, deteriorating mental health, and mounting personal crises, she administered lethal overdoses to the elderly, often in plain sight. Early warnings were missed. Confessions were dismissed. Deaths were written off as routine.Over nearly a decade, Elizabeth killed eight people.This book traces how her crimes went undetected for so long - despite repeated confessions to partners, colleagues, clergy, lawyers, and recovery groups. It examines the institutional blind spots that allowed a dangerous individual to continue practising, the culture of silence that discouraged reporting, and the systemic failures in medication oversight that made her crimes possible.Ultimately, it was Elizabeth herself who forced accountability, confessing again and again during a rehabilitation stay until authorities finally listened.A chilling examination of trust abused and safeguards ignored, this is not just the story of one nurse's crimes - it is a stark warning about what happens when warning signs are rationalised away and responsibility is deferred.