Serial killer Genene Jones was convicted of five additional murders in 2018.
Serial killer Genene Jones pleaded guilty in 2020 to an additional murder count, ensuring she would not be released from prison. Credit: Courtesy / Peter Elkind

For one chilling period of time in the early 1980s, babies admitted for treatment at Bexar County Hospital, then San Antonio’s “charity hospital,” began to die at an alarming rate while under the care of Genene Jones, a licensed vocational nurse who worked the 3-11 p.m. shift in the hospital’s pediatric intensive care unit (PICU).

Soon enough, PICU physicians and nurses dubbed those hours “the death shift” as Jones became the subject of growing suspicion and scrutiny as the toll climbed. Jones’ supervisors and higher ups, including a future mayor of San Antonio who then served as the hospital’s board chairman, convinced themselves that the inexplicable infant mortality rate was not rooted in the work of a single sociopathic nurse. Unable to otherwise explain the spate of deaths, they failed to alert authorities or take definitive action.

In his newly revised book, The Death Shift: Nurse Genene Jones and the Texas Baby Murders (Diversion Books, 2021), journalist and author Peter Elkind not only tells the horrifying original story of murder and official negligence, but also how decades later, the families victimized by Jones worked with local authorities to win a guilty plea that means Jones will never leave a state prison alive.

No one ever established how many babies died at Jones’ hand. Worse, as babies who should have responded successfully to treatment continued to die in unprecedented numbers, hospital administrators devised a cynical scheme to replace all of the pediatric intensive care unit’s licensed vocational nurses with more highly trained registered nurses, thus ridding the hospital of Jones without singling her out for termination that might provoke an expensive and embarrassing lawsuit.

The Death Shift: Nurse Genene Jones and the Texas Baby Murders by Peter Elkind Credit: Courtesy / Diversion Books

Even then, no attempt was made to contact legal authorities or the families whose babies were victims of Jones’ clandestine use of drugs to induce seizures that often proved fatal as Jones rushed to save the babies. Her behavior was likened to firefighters turned arsonists who turn up to battle fires they themselves set.

Jones, a single mother with a troubled past who had largely abandoned parental responsibility for her own two children, had her defenders on the unit. One of them, a young pediatrician named Kathy Holland, hired Jones to help her launch her new private practice in Kerrville. Within days of opening her clinic, the physician found infants brought to her for routine treatment suffering seizures requiring emergency hospitalization that, in one instance, led to death.

Unlike their counterparts in San Antonio, Kerrville hospital administrators revoked Holland’s hospital privileges and alerted local authorities, which eventually led to Jones’ murder conviction and a belated investigation by Bexar County District Attorney Sam Millsap, whose investigators found themselves following cold leads, dealing with defensive hospital administrators who had destroyed medical records, and exhuming infant corpses in search of evidence Jones had injected them with lethal doses of dangerous drugs.

As Elkind recounts, Jones was convicted only of a single Kerrville murder and injury to a San Antonio child in 1984. Eligible for mandatory parole in 2018, she came disturbingly close to winning her freedom after serving less than one-third of her sentence.

For Bexar County authorities, the success in indicting Jones on five additional murders charges in 2017 demonstrated that improved forensic science and less risk-averse prosecutors can prevail where their predecessors failed. She eventually pleaded guilty to one count — the 1981 death of Joshua Sawyer — in exchange for dismissal of the other murder charges.

Jones proclaimed her innocence and born-again religious faith for decades after her convictions. Her guilty pleas finally confirmed what everyone already believed. Jones herself had played God as she took the lives of infants into her own hands, engaging in life-threatening interventions that caused seizures and gave Jones the opportunity to respond to “Code Blue” emergency alerts on the pediatric unit and miraculously save the children.

Bexar County authorities spent months investigating Jones and the wave of baby fatalities that occurred under her care in the 1980s, but ultimately failed to bring her to trial on any of the dozens of infant deaths that occurred under her care.

Jones was sentenced to 99 years for the murder of Chelsea McClellan, the Kerrville infant girl, and 60 more years for causing bodily harm to Rolando Santos, the San Antonio baby boy. A Texas law intended to address prison crowding, however, meant Jones was eligible for parole by 1990 after serving only seven years of her sentence. She was denied parole on at least nine successive occasions, but by 2018, she would become eligible for mandatory parole.

Elkind, now a senior reporter at Pro Publica, covered the story in the 1980s for Texas Monthly magazine, and wrote The Death Shift in the late 1980s. He returned to the story for the magazine decades later as Jones sought her freedom. The new edition of the book brings the story full circle with his account of how Bexar County District Attorney Nico LaHood and later, Joe Gonzales, who defeated LaHood in a bitter courthouse contest for control of the DA’s office, worked to prevent Jones’ release by securing her indictment in the deaths of five San Antonio babies and, finally, the guilty plea to one count of murder.

San Antonio was a smaller city of 950,000 in the 1980 census, and at the time it was served by three daily newspapers, the San Antonio Express, the San Antonio News, and the San Antonio Light, all notoriously sensational and superficial in their local news coverage. Editors and reporters seemed more focused on shocking headlines than in-depth journalism. Hospital administrators, it’s fair to say, were never held to account. The Bexar County Hospital Board Chairman William Thornton, an oral surgeon, was later elected to serve as mayor in 1995 before losing his bid for a second term.

Robert Rivard, co-founder of the San Antonio Report who retired in 2022, has been a working journalist for 46 years. He is the host of the bigcitysmalltown podcast.