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Elizabeth Wettlaufer enters the Provincial courthouse in Woodstock, Ontario on June 1, 2017.Peter Power/The Canadian Press

Helen Matheson was a former school teacher who, in the fall of 2011, was living at the Caressant Care facility in this small town near London because she was 95 and had dementia.

One evening, Ms. Matheson told the nurse on duty, Elizabeth Wettlaufer, that she liked blueberry pie.

During a break, Ms. Wettlaufer went to Wal-Mart and purchased ice cream and blueberry pie for Ms. Matheson, who had a few bites before saying, "That's enough, dear."

Related: Key events in former Woodstock nurse Elizabeth Wettlaufer's case

Read more: A history of nurses charged with killing patients

Later that night, Ms. Wettlaufer injected Ms. Matheson with a lethal dose of insulin.

"I had that feeling that it was her time to go," Ms. Wettlaufer later told police in an videotaped interview that was played in a hushed courtroom Thursday.

"You just had to take her life," the police interviewer said.

"Yeah," Ms. Wettlaufer replied.

Earlier, for more than two hours, two prosecutors took turns reading an agreed statement of facts describing how Ms. Wettlaufer, a former nurse, was a prolific serial killer who used insulin injections to murder eight of her patients and attempt to kill four others.

Ms. Wettlaufer pleaded guilty to eight counts of first-degree murder, four counts of attempted murder and two counts of aggravated assault on Thursday, 10 days before she turns 50.

The Crown and her lawyer made a joint recommendation of concurrent life sentences with no chance to apply for parole for 25 years. But it will be up to Justice Bruce Thomas to decide at a hearing on June 26 and 27, where victims' impact statements will be presented.

Ms. Wettlaufer's plea came seven months after her arrest last fall, in a case that raised questions about why she was allowed to continue working as a nurse for so long, looking after frail patients and having access to medications, despite her personal issues.

Divorced, beset by depression and consuming rye whisky and opioids, she was angry and frustrated with her job and her life and would kill when she felt what she called "the red surge," court heard.

Some of her patients who had dementia were difficult, but she had no bad feelings toward the others. It was just, "God said she's the one," she explained about her choice of victims.

"Afterward, I'd hear a laughter in my head," she said in her video interview.

She eventually quit her final nursing job on Aug. 29, 2016, because she had been assigned to look after diabetic children and she couldn't trust herself not to hurt them, she said in the video.

Pale-faced and wearing a white blouse, she sat in a glass-encased witness box, just a metre from relatives and friends of the victims.

"It tore me apart to hear how she killed my dad," Susan Horvath – whose father, Arpad, was Ms. Wettlaufer's last murder victim – told reporters afterward.

"Can you believe it? She's sitting there, with no expression on her face," Ms. Horvath said.

Court also heard that over the years, Ms. Wettlaufer mentioned to at least 10 people that she was hurting or killing patients.

Her confidants – including a pastor and his wife, a boyfriend, a cousin – didn't call police and later said they had found her remarks too vague and suspected she was being manipulative.

Another person to whom she shared her remorse was a young nursing aide student working at Caressant. The young woman wanted to alert the authorities, but Ms. Wettlaufer said there was no proof and she would deny that the conversation took place.

"She said she'd found God and He had forgiven her," Crown attorney Andre Rajna said.

The 11th person to whom she talked, a Facebook friend, contacted police but by then, last September, Ms. Wettlaufer had checked herself into Toronto's Centre for Addiction and Mental Health (CAMH), where she also talked about the killings and wrote a four-page confession, leading the hospital to contact the Toronto Police Service.

The killings started after she got a job in 2007 at the Caressant Care facility in Woodstock, Ont. While an employee at the Caressant home, she often worked the overnight shift and had sole access to three locked medication carts.

Two of her patients, Clotilde Adriano, 87, and her sister-in-law, Albina Demedeiros, 90, were diabetics, which gave her the idea of overdosing them with insulin.

"She felt no ill will," Mr. Rajna said, explaining that Ms. Wettlaufer told police that she acted because "she felt overwhelmed and angry about her career, responsibilities and her life in general."

The two women survived. The first murder victim was James Silcox, 84, a Second World War veteran, who died on Aug. 12, 2007.

She was angry at him and felt "the urge to kill him," prosecutor Fraser Kelly said, reading from the agreed statement of facts. "It was his time to go."

In the video, Ms. Wettlaufer said she felt shame when she went to bed afterward.

Four months later, she killed Maurice (Moe) Granat, 84, in December, 2007, telling him she was giving him a vitamin shot.

She tried to kill two other Caressant residents, 57-year-old Wayne Hedges ("it was his turn to go," she said) and 63-year-old Michael Priddle ("This must be God. This man is not enjoying his life," was her justification).

Both survived, but she then killed Gladys Millard, 87, Ms. Matheson, 95, and Mary Zurawinski, 96.

"When someone's dying it feels like it takes longer when you're around," she said casually at one point in the interview.

In July of 2013, she killed 90-year-old Helen Young and afterward, hugged and consoled Ms. Young's niece.

"She cried on my shoulder," Ms. Wettlaufer recalled on the video.

The last victim at Caressant was Maureen Pickering, 78, who was killed in March, 2014, just as Ms. Wettlaufer was fired for a string of disciplinary problems related to medication errors.

Later that year, working at a nursing home in London, she gave a fatal insulin dose to Mr. Horvath, 75, and the following fall tried unsuccessfully to kill Sandra Towler, 77, at the Telfer Place Long Term Care in Paris, Ont.

Her last victim was Beverly Bertram, 68, a diabetic woman who was recovering from surgery at her home in Oxford County.

Ms. Wettlaufer had been hired to provide in-home care, giving Ms. Bertram antibiotics by intravenous injection.

Without access to a nursing home's medication cart, Ms. Wettlaufer stole insulin by breaking into another patient's house, because she didn't want to use up Ms. Bertram's own insulin prescription, the Crown said.

After Ms. Bertram got what she thought was antibiotics, she felt dizzy and unwell and decided to skip on her own dose of insulin. That saved her life.

Shortly after, Ms. Wettlaufer quit her job and checked into the CAMH.

"I didn't want to hurt anybody any more," she told police.

The night before leaving for the CAMH, court heard that she used her computer to check online articles with titles such as "5 Killer Nurses Who Preyed On Their Helpless Patients" and "When Nurses Kill." She was also looking up the death notices of her victims.

Her case makes it clear that not enough is being done to protect seniors in long-term care, said an advocacy group for older Canadians. CARP, formerly the Canadian Association of Retired Persons, is calling for a public inquiry into what it calls the "abuse, neglect and untimely deaths," of people who live in nursing homes.

"The murder of these eight elderly residents in their long-term care facility puts a disturbing spotlight on long-term care," Wanda Morris, the vice-president of advocacy for CARP, said in a statement after Ms. Wettlaufer entered her guilty pleas.

As Thursday's hearing stretched into the afternoon with a screening of her video interview, some relatives of the victims started sobbing and comforting each other while Ms. Wettlaufer described one killing after another.

They shook their heads as they heard her on the video say that she eventually realized that, "It wasn't God, it was something wrong with me."