"I am honestly sorry," the 38-year-old said at his trial, where he so far faces three murder charges, adding that he had usually acted on impulse when he injected patients with lethal drug doses.
"Usually the decision to do it was relatively spontaneous," the defendant, who was identified only as Niels H. under Germany's strict court reporting rules, said in his first comments to the court.
He said he knew his actions could not be excused and that he hoped that if he is convicted, the verdict would help the victims' loved ones find peace, national news agency DPA reported.
PHOTO: REUTERS
The ex-nurse went on trial in Oldenburg in northern Germany in September, accused of the murders of three patients and attempted murders of two others, using a heart medication that lowers blood pressure.
A psychiatric expert last month told the trial that the man had admitted to those crimes and that he also claimed to have over-medicated another 90 patients, 30 of whom died.
The court heard his motive was to spark medical emergencies so that he could then demonstrate his resuscitation skills, but that he also acted out of boredom.
According to the prosecution, if the first attempt at resuscitation was a success, he would sometimes make a second attempt, Daily Mail reported.
The nurse, whose full name is withheld under German privacy laws, used Gilurytmal, a medication which should only be used by doctors under strict supervision, it was said.
PHOTO: REUTERS
Side effects include an irregular heartbeat, a drop in blood pressure and uncoordinated functioning of the heart muscle.
The defendant told the court Thursday he was indeed seeking thrills, saying: "There was a tension there, and an expectation of what would happen next."
He said he felt great when he managed to resuscitate a patient, and devastated when he failed.
Each time a patient died, he vowed to never play his lethal game again, but this determination would then slowly fade, he said.
The deaths occurred at Delmenhorst clinic, near Oldenburg, where the accused worked in the intensive care unit between 2003 and 2005.
The ex-nurse denied having killed anyone at his previous jobs in other clinics, at an elderly home and for emergency medical services.
A special commission of police and prosecutors dubbed "Kardio" (Cardio) is currently investigating all deaths that occurred in the defendants' previous work places.
PHOTO: REUTERS
The defendant was caught by a colleague in the act of injecting patients in 2005.
In a first trial in Oldenburg, a district court in 2008 sentenced him to seven and a half years in jail for attempted murder, and he has been in detention since.
A senior doctor who testified in the case said that he was a 'passionate medic' who made a good impression on staff at the clinic.
'I found it strange that he was always on hand when patients were being resuscitated, often helping younger doctors with intubation - inserting a breathing tube into a patient's airways,' he added.
It is unclear why investigators or the hospital did not pick up on the possible extent of the alleged crimes earlier.
The death rate in the Delmenhorst clinic nearly doubled in the time he worked there, and use of the heart medication also increased dramatically.
'No one wants to believe that a colleague would rather kill patients, instead of helping them,' said counsel for the clinic Erich Joester, adding that the increased death rate had been attributed to a number of causes rather than a rogue individual.
The shocking case is not the first of its kind in Germany.
In 2006, German male nurse Stephan Letter, who became known in the media as "the Angel of Death", was sentenced to life in prison for administering lethal injections to 28 mostly elderly patients in what prosecutors called an "assembly line" killing spree.
A year later, a nurse at Berlin's prestigious Charite hospital was sentenced to life in prison for killing five seriously ill patients with drug overdoses.
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