Charles Cullen said he killed patients to end their pain
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An ex-nurse has told US prosecutors that he killed 30 to 40 hospital patients over a 16-year period.
Charles Cullen, 43, has been charged with one count of murder and attempted murder, but investigators are looking into his other self-confessed crimes.
Mr Cullen appeared in court in New Jersey following his arrest on Friday for the murder of a Catholic priest.
He told investigators that he performed mercy killings to end the suffering of terminally-ill patients.
Mr Cullen, from Bethlehem in Pennsylvania, was arrested and charged with the murder of a Roman Catholic vicar, the Very Rev Florian Gall, who had died of a heart attack at a medical centre in June.
After Mr Gall's death, it emerged that he had been given a lethal dose of the drug digoxin, used in the treatment of heart ailments.
Guilty plea
Mr Cullen was also charged with the attempted murder of a 40-year-old woman at the same hospital.
During a 10-minute court hearing on Monday, he told the judge: "I am going to plead guilty. I don't plan to fight this."
He said he did not want a lawyer to represent him.
Under questioning following his arrest, Mr Cullen said he had killed many others at several hospitals in New Jersey and Pennsylvania during his 16-year career as a nurse.
Investigators are examining medical records at 10 hospitals where he worked in an effort to verify his claims.
Prosecutor Wayne Forrest said: "The evidence that we have indicates that may very well be the case."
Mr Cullen is in custody with bail set at $1m.