The Death Shift
When nurse Genene Jones was on duty in a San Antonio hospital, babies had mysterious emergencies and sometimes died. Then she moved to a Kerrville clinic, and the awful pattern began again.
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At the far end of the sofa was Debbie Sultenfuss. Debbie, 35 and also an LVN, met Genene when they were both working at Bexar County Hospital. Debbie grew up on a farm, where life moved slowly, and Genene’s fast mouth and mind quickly made an impression on her. In January 1980, shortly after they met, Debbie transferred from the pediatric floor the pediatric intensive care unit and began working the three-to-eleven shift with Genene. They became inseparable: Genene the clever teacher, Debbie the eager, if slow, pupil. Debbie began trying to act like Genene, even to dress like Genene. But she was a poor imitation. Genene displayed a sharp mind and a sharper tongue; Debbie, a six-foot, two-hundred-pound giantess, lumbered. When Genene accepted the job with Dr. Holland in Kerrville, Debbie followed and took a job at the local hospital. When Genene got in trouble, Debbie moved her mobile home to San Angelo, and they settled in together. Debbie says she and Genene shared “a sisterly love.” Genene has gone to the trouble of publicly denying that she and Debbie are lesbians, and on this evening she pounced on that subject with an angry wave at her new spouse. “Ask my husband if I’m a les,” she said. “It’s nothing but trash.”
When the six o’clock news showed Genene Jones being taken to jail, viewers saw a broken woman, silent and defeated. It was a misleading picture. Genene Jones is a street fighter. She is articulate and intelligent—alternately friendly and defiant, sincere and threatening. She has an answer for every question, a response for every charge. When she hears that others have contradicted her account of the past few years, she goes on the attack: they are liars, “full of shit,” politically motivated, “a real turd”; she is right, they are wrong. She is quick to slip nasty tidbits about her accusers into the conversation—the RN who had an affair with a married doctor, the parents who made love in a hospital room as nurses walked in and out.
Her court-appointed lawyer, Bill Chenault of San Antonio, had told her not to talk about her case, but on this evening she had too much to say. “I’m sick and tired of being crucified alive and having people think I’m a baby killer,” she said. I haven’t killed a damn soul.” The deaths in San Antonio resulted from the mistakes of lousy doctors, she said, not from anything she had done. “Nobody did a damn thing up there. It’s all so much bull.” She had worked at other hospitals—why weren’t there suspicious deaths there? “I’ve been in nursing since 1977, and Bexar County’s the only place I’ve been killing people?” she demanded. “If you’re going to sit there and say that I killed babies, you’re going to have to tell me that a doctor ordered me to do it.”
No, Genene Jones is not about to shut up. “My mouth got me into this,” she said with a grin, “and my mouth’s going to get me out of it.”
THE MAKING OF A NURSE
GENENE ANN JONES GREW UP IN NORTH-west San Antonio. She was one of four children adopted by Richard Jefferson Jones and his wife, Gladys. Dick Jones was a businessman, a bit of a wheeler-dealer who made a go of several different enterprises. When his children were young, he bought some property on Fredericksburg Road, cleared the site, and built a nightclub with a big dance floor inside and a patio and a pool outside. He called it the Kit Kat Swim Club, and he managed the place while Gladys spun records on the turntable. Genene was close to her father and loved to spend afternoons with him, helping to paint and put up the bill-boards he owned all over town. “We just had a ball together,” she says.
Dick Jones didn’t usually put up with much nonsense. He was an imposing figure-six feet tall, 240 pounds, and bald—and he didn’t believe in mincing words. His daughter developed the same trait. At John Marshall High School, she worked in the library, and when others weren’t working the way she thought they should, Genene would tell them what to do. “She was kind of bossy,” says the high school librarian, now retired. Genene was different from most of the other kids—more serious and less tolerant of teenage games.
One of Genene’s brothers died of cancer; another was killed by the explosion of a bomb he had made; and in January 1968, at the age of 56, Dick Jones died of cancer. June 15, shortly after graduation and a month before her eighteenth birthday, Genene married her high school sweetheart, James Harvey DeLany, Jr. Genene was a housewife for a few months, then enrolled at Mim’s Beauty School, became a beautician, and took a job at the Methodist Hospital beauty parlor. Her husband had been drafted into the Navy, and in 1970 they moved to Georgia, where she gave birth on January 19, 1972, in the town of Albany, to Richard Michael DeLany. They moved back to San Antonio, but by then the marriage had begun to collapse. Genene filed for divorce in Bexar County on August 10, 1972, claiming that her husband was “a man of violent and ungovernable temper and passion” who had been guilty of “unconscionable brutality and physical cruelty” and on several occasions had “struck her with great force.” Genene claimed they had been separated since mid-May, and she won a court order barring her husband from going near her or their baby son. Two months later it wasn’t necessary; the couple had reconciled, and the judge dismissed the suit.
The final breakup came on June 3, 1974, three months after Genene had filed again for divorce. But Genene Jones and James DeLany weren’t through with one another. They carried on a court fight for three more years. Genene filed suit against DeLany for failure to pay child support, and in August 1976 she won a contempt citation against him. DeLany asked for increased visitation rights, though Genene claimed he hadn’t been visiting Michael even when he was allowed to. On March 22, 1977, both agreed to drop the legal battle. On July 17 Genene Jones’ second child, Heather, was born. In a sworn deposition, she said the child’s father was named Ron English and that he was deceased. But she later on told Dr. Holland, her boss in Kerrville, that her ex-husband was the girl’s father—that Heather had been conceived out of wedlock during another brief reconciliation.
By the time Heather was born, Genene had moved in with her mother and was enrolled in San Antonio Independent School District’s School of Vocational Nursing. She did well in the one-year program: most of her grades were 90’s. And when she took her licensing exam on October 18, 1977, she scored 559—more than 200 points above the passing grade. She got a job at Methodist Hospital, but she was ushered out in late April 1978, after only eight months. “I had a conflict with a doctor,” she explains. “It was a lack of feeling on the physician’s part toward the patient, and I stood up for the patient, and he didn’t like it. They asked me to resign.” She moved across the sprawling South Texas Medical Center complex in northwest San Antonio to take a job in the obstetrics-gynecology ward at Community Hospital. After three months she resigned to undergo minor surgery, and in October she answered an ad for ICU jobs at Bexar County Hospital. Genene began working in the pediatric intensive care unit on October 30, 1978.
INTENSIVE CARE
GENENE SAYS HER FIRST EMOTION ON starting work in Bexar County Hospital’s pediatric intensive care unit was “stark, raving fear.” But she says her doubts about the switch from adults to children disappeared quickly. “The first baby I ever took care of was a preemie with a dying gut,” she recalls. “I picked that kid up and I knew I was going to stay there.” Cherlyn Pendergraft, the registered nurse who gave Genene her orientation, wasn’t so sure. The infant, a six-day-old boy with an often-fatal intestinal disease called necrotizing enterocolitis, went to surgery, returned to the ICU, and died. Genene had barely cared for the child, but “she just went berserk,” Pendergraft says; she broke into deep, wracking sobs, moved a stool into the dead baby’s cubicle, and sat staring at the body.
The pediatric intensive care unit where Genene Jones worked occupied a rectangular space the size of a two-car garage. During the 41 months she was there, the ICU contained eight beds, in separate cubicles with large glass windows that allowed the nurses to keep an eye on the patients and on the machines that monitored their heartbeats and breathing. In the back of the ICU was a small room where the nurses could sit and relax. It was filled with supplies and equipment for conducting simple lab tests.
While patients in the ICU may range up to sixteen years old, many of them are infants. Newborn children who are gravely ill go to the neonatal ICU, a floor below, where they receive more-specialized care and are isolated from the infection that children who have been outside the hospital may bring in. The pediatric ICU is for kids who have been out in the world. Children are brought there to recover from surgery or to be treated for a disease or an injury.
Because the ICU is in a teaching hospital for the University of Texas’ San Antonio medical school next door, its medical staff consists of a rotating group of residents (most of whom graduated from medical school no more than three years earlier) and attending physicians who are faculty members at UT. The medical school provides the hospital with doctors and supervises the patients’ medical care; the hospital allows the doctors to use its patients in instructing students how to practice medicine. While Genene Jones worked in the ICU, the doctors made rounds in the morning and drifted in and out during the day; none worked there full time.
Therefore, in the pediatric ICU, even more than in most hospital wards, the nurses were an extremely strong presence. A pediatric ICU nurse spends all her time on one or two patients who demand almost constant attention; they are capable of doing nothing for themselves. Not all of them are on the brink of disaster, but many are. It is a situation where the work of a nurse can tip the scales between life and death. Nurses who choose ICU work do so because they like that kind of high-pressure challenge. They are bored with the low-key atmosphere out on the floor; they scoff at it as baby-sitting. ICU nurses pride themselves on their ability to intervene, to step between a disaster and a child like a superhero jumping in front of a speeding bullet; they pride themselves on being aggressive.
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