THE HAGUE, Netherlands -- A Dutch nurse was convicted Monday of murdering four patients and sentenced to life in prison, a punishment rarely imposed in the Netherlands.

Judges said Lucy de Berk, 41, had been "calculating and refined" as she plotted to kill three terminally ill children and an elderly woman at two hospitals in The Hague.

Her actions robbed family members of a chance to say goodbye to their loved ones and disgraced the medical profession, said presiding Judge Jeanne Kalk of The Hague district court.

"Apparently she believed she was qualified to hold the power of life and death over these people," Kalk said.

De Berk also was convicted of three attempted murders. She was acquitted of 11 other murder and attempted murder charges.

She pleaded innocent at several court hearings, saying she "had never taken someone's life." Her lawyer said she will appeal the ruling.

Life imprisonment is the harshest possible sentence in the Netherlands, which doesn't have a death penalty.

The three-judge panel said de Berk lied about her deeds and never showed remorse.

"The victims were sick and helpless babies, whose parents entrusted them to the suspect's care as a nurse," Kalk said. "She has gravely shamed the trust that society puts in hospitals and medical personnel."

De Berk threw her hands in the air in frustration after the sentence was read and glanced at the public gallery, packed with family members of the victims.

Outside the courtroom, parents and relatives embraced.

The case has been widely publicized in the Netherlands, and in Canada, where de Berk spent troubled years as a teenager.

The verdict was based in part on the testimony of a statistician, who said the chance it was mere coincidence de Berk was on duty at each of the deaths that occurred on her watch over a four-year period was one in 342 million.

The ruling focused on the case of 6-month-old Amber Zuidewijk in September 2001, whose death led to de Berk's arrest.

Relatives of the young victim cried in court as Kalk described how a doctor found Amber in stable condition one night, but a half-hour later she was discovered alone with de Berk, pulse racing. She turned blue-gray and died soon after.

Forensic experts said Amber's death was likely due to a massive overdose of digoxin, a heart medicine that had not been in Amber's recent regimen.

Judges also cited entries from de Berk's diaries, in which she talked about a "strange compulsion" and a secret she would take with her to her grave. On Nov. 27, 1999, the day an elderly woman died in her care, she wrote that she had "given in" to her compulsion.

"But I make people happy with it! Strange, huh? Well anyhow, I hope I don't get another chance."

De Berk claimed she was referring to a habit of telling patients' fortunes using tarot cards.