Genene Jones started working as a licensed vocational nurse, or LVN, at Bexar County Hospital in San Antonio's Medical Center in late 1978.
About a year later, the number of deaths occurring during the 3 to 11 p.m. shift started increasing. It became known as "The Death Shift."
In his book of the same name, author Peter Elkind recalls how the troubling pattern emerged.
"There was already a very clear pattern that kids under Genene Jones were having surprising emergencies, were taking a turn for the worse and dying when they weren’t expected to die… She seemed to be excited and drawn to the excitement and crisis of a medical emergency," Elkind said.
Pendergraft was one of the first people to meet Jones when she was working at Bexar County Hospital, and she said she also picked up on the pattern.
“In the beginning when I first met her, I was the charge nurse on the 11-7 shift. I was an RN, she was an LVN. She was hired, and I was tasked with orienting her to the pediatric ICU.
She was a very intense person. She had a fun side, too, but she was very intense and very intense with her patients... The thing about it was she seemed to be in the middle of a crisis. She always wanted the most intensive patients. It was always dramatic with her in her patient care and the patients she wanted. If she was challenged in any way, she would react very strongly," Pendergraft said.
At the time Jones and Pendergraft worked in the PICU, the nursing staff was broken down into three shifts: 7 a.m. to 3 p.m., known as the day shift, 3 p.m. to 11 p.m., or the evening shift and 11 p.m. to 7 a.m., the night shift.
While she said she had no reason to suspect there would be any trouble with Jones when she first started, Pendergraft witnessed incidents at the hospital that raised red flags for her.
“The very first bizarre incident that I can recall when I was orienting her was the first night she was there in the ICU. A little preemie was admitted. It was very sick. I ended up taking care of it, but it did end up dying on the shift. [Jones] started crying, and she asked if she could hold the baby. I thought that was kind of odd because [Jones was] not attached to this baby in any way. So, she sat in a rocking chair that we had in the unit and just sobbed over this baby. I thought wow, that’s kind of weird because she had no time to form any type of attachment. That was the very first incident that kind of caught me off guard,” Pendergraft said.
As these strange and unexpected incidents loomed over the ICU, Pendergraft said Genene Jones had other ways of causing tension at work.
"The other thing I noticed about her that I didn’t really like, or it didn’t really appeal to me, was she had a potty mouth," Pendergraft said.
Jones' former fiancé, Ron English, agreed, and said this behavior bothered him as well.
"If there was a sexual joke, I mean Genene knew it, and she could tell it very well. She made sex into a very vile and dirty thing. She was very foul-mouthed," English said.
Pendergraft said Jones was known as a skilled nurse, and for that reason, their supervisors at the time respected her, even as Jones’ actions rattled other staff members.
“I went to the head nurse about it, saying that we had noticed this trend and saying it was disconcerting. I think we might have mentioned Genene’s name at the time, I’m not sure about that conversation, but [the head nurse] did say that ‘this is something that happens cyclically. I don’t think it’s anything to worry about.’ She resented the fact that Genene’s name was mentioned.
I had mentioned her name on another occasion when I went to [the head nurse]. I don’t know if it was before or after that, but she got really incensed. She was very fond of Genene. Genene was a very intelligent nurse. She knew a lot, more than most LVN’s knew. She was very good at patient care,” Pendergraft said.
Former Kerr County DA Ron Sutton, who prosecuted Jones' 1984 murder trial, backed up this claim.
"I made a remark at some point to the press that she could put an IV in a fly," Sutton said.