AN ANOREXIC nurse who has admitted killing patients at a new Milan hospital to make herself feel powerful and important kept a diary noting details of their deaths.

Sonia Caleffi, 34, was arrested yesterday over the deaths of five patients in one month but Italian police said that the list of her alleged victims was “almost certainly much longer”. Prosecutors said that Signora Caleffi, who was from the Lake Como area, had admitted using a syringe to inject air into the veins of three women and two men at the 900-bed hospital at Lecco, north of Milan, causing their death s by embolism and respiratory failure. She then recorded the details in a notebook at home.

“I felt so sorry for those people,” she wrote. Anna Maria Delitala, the prosecutor at Lecco, said that four more deaths at the hospital were suspicious.

Staff at the hospital said that in each case Signora Caleffi had cleared the hospital room of family members and other nursing staff, remaining alone with her victim. She would then leave the room “in an extremely agitated state” several minutes later, calling for assistance to help the dying patient.

Corriere della Sera newspaper said that the nurse had a history of depression. She had married at 23, divorced at 27 and had worked at a series of hospitals and nursing homes. She was undergoing psychoanalysis when hired at Lecco in September, police said, but the hospital authorities had noticed nothing strange about her behaviour.

Police said that Signora Caleffi had admitted that she had killed patients in her care. Claudio Rea, her defence lawyer, said that he had asked for a psychiatric assessment of the nurse. He claimed that she injected the air not to kill but to make her patients ill so that she could heroically save them. Instead, they had all died.

Suspicions first arose last month when relatives of a 99-year-old woman admitted for routine treatment made a complaint after she suddenly died. Pietro Caltagirone, the hospital director, said: “Death rates on the ward had inexplicably doubled in an isolated series of cases, so we called the police.” The incriminating notebook was found during a search of Signora Caleffi’s home. Police also found “a small library” of books dealing with euthanasia.

Signora Caleffi’s father, Nicola, 59, a postal worker, said that his daughter had wanted to be a nurse since she was 12. “I don’t believe it,” he said. “I don’t understand who this person is they call the ‘killer nurse’ — it’s not my daughter.”

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