Why Garry Steven Davis planned to murder three "perfect" aged-care residents with large doses of insulin remains a complete mystery.
It may have been "simply for the sake of killing", said Justice Robert Allan Hulme in jailing the former NSW senior nursing home worker for at least 30 years.
"In killing two and attempting to kill another vulnerable patient of an aged-care facility the offender acted with extreme callousness," he said on Tuesday.
"It is as if he thought their lives were worthless."
After a judge-alone trial in the Supreme Court in Newcastle, Justice Hulme in September found Davis guilty of murdering Gwen Fowler, 83, and Ryan Kelly, 80.
The 29-year-old was also found guilty of attempting to murder Audrey Manuel, 91, who died of other causes a while later.
Despite there being no medical need, he deliberately injected them with insulin over a 48-hour period in October 2013 at SummitCare aged care home in Newcastle.
A police search of Davis's home found syringes, needles and literature about insulin, including a description of overdosing causing hypoglycaemic effects that could result in death.
"Text messages the offender sent suggested foreknowledge of the impending or prospective demise of Ms Manuel and Mr Kelly" the judge found.
In setting a maximum term of 40 years, he stressed the vulnerability of the victims, the extreme breach of trust by Davis and the tragic and extreme consequences of his conduct.
The residents were "compromised, disempowered and vulnerable".
Their loved-ones were entitled to think they would be treated with dignity and respect - "as people who had lives of value".
The judge said it remained a complete mystery why Davis carried out the terrible crimes and why he chose those particular victims.
Davis told police that they were "not problem residents"; they were "perfect residents", "easy to look after"; and "they weren't really a bother".
"Any mistreatment of elderly people in our community is not to be tolerated," said the judge, who noted Davis still maintained his innocence.
On Friday, former nurse Megan Haines will be sentenced by another judge for murdering two elderly aged-care residents in northern NSW by injecting them with insulin.
And Sydney GP Brian Kenneth Crickitt will face a sentence hearing in February after being found guilty last week of murdering his wife with a lethal dose of insulin.
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