AN NHS nurse alleged to have tried to kill off elderly patients in a ruthless efficiency drive was yesterday described as "professional and caring" by the Clinical Director of Medicine at the hospital where she worked. Dr Maxwell Winson, who has been Leighton Hospital in Crewe for more than 25 years, told Chester Crown Court that Barbara Salisbury "did not suffer fools gladly" and was forthright at times, but that did not detract from her being a good nurse. Salisbury, 47, of Leeswood, North Wales, but originally from Liverpool, denies attempting to murder four patients in 1999 and 2002, either by pumping them full of potentially lethal doses of the painkiller diamorphine or starving them of oxygen as they lay on her ward. Appearing on behalf of the defence in the trial, Dr Winson, a consultant physician and specialist in respiratory medicine, told the jury he had reviewed the medical notes on the case of 92-year-old retired mechanic Frank Owen, of Nantwich, Cheshire, who is alleged to have been left "on the verge of death" by a diamorphine injection. Referring to Mr Owen's last day alive, when Salisbury gave him two injections, he said: "I concluded there was not a problem on that day." He added: "The diamorphine doses were as prescribed, and the frequency between individual doses was as prescribed. They were relatively small doses." Dr Winson was asked by the police to make a statement during the investigation into Salisbury's work at Leighton Hospital. At their request, he looked at Mr Owen's notes. He himself had examined the patient as an emergency admission after a suspected minor stroke on January 3, 2002. The prosecution has also claimed that Salisbury ordered a junior colleague to lay Mr Owen in a position where he would choke to death, saying: "Lie him flat. With any luck his limbs will fill with fluid and he will die." But Dr Winson said: "Some patients who one would think would be more comfortable upright are actually more comfortable lying flat. They tend to find their own positions. "Only yesterday I saw a man with his lungs full of fluid lying comfortably in his bed flat." Dr Winson said he had encountered Salisbury both when she worked in intensive care and then over 11 years when she was a ward sister. He told the jury: "I have encountered her many times and sought from her information about patients under my care. "I always regarded her highly as a ward sister. I always found her to be professional and caring with regard to patients. She relates very well to doctors but is not known to suffer fools gladly. "She is forthright at times in her views but that does not detract from her being a good nurse." Salisbury, a nurse with 20 years' experience, denies trying to murder James Byrne, aged 76, in 1999, and Reuben Thompson, aged 81, Frances May Taylor, aged 88, and Mr Owen, all in 2002. They have all since died. It is alleged Salisbury hastened patients' deaths, and "deliberately and brazenly overstepped the line between humane nursing and callous despatch." In the case of James Byrne, of Davenham, Cheshire, she is said to have boosted a syringe driver administering diamorphine so that it bleeped like a space invader machine, and then said to the patient: "Give in, it's time to go." Dr Ian London, a consultant at Leighton Hospital, told the court that Salisbury "had a good grasp of information" and would update him on patients' conditions as he made his "walk-round" on the wards twice a week. He added: "She was able from her experience and knowledge to prioritise information and make sound judgements." In the case of 81-year-old diabetic Reuben Thompson, who was allegedly denied oxygen by the actions of Salisbury, Dr London said: "I don't remember there was a medical requirement for him to receive oxygen therapy." The case continues. | 
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