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You'd have to look at what she got out of it emotionally. Other hospital killers did it for a combination of "They were a burden", "I was putting them out of their misery" and a sense of godlike power of life and death. Some started doing it for seeming mercy reasons but got so comfortable with doing it that they started killing patients because they annoyed them.
I think you're perhaps ignoring what I said about the content of her entries.
She suffered from her actions, emotionally. A lot. It's quite clear she got nothing positive emotionally from it:
She got something out of it though. No one was forcing her to do it so regardless of her entries at the moment of choice she wanted to do it. She may have felt regret or self-hate after the fact but it is clear that those feelings eventually passed.
Regret or self-hate can just as well turn into driving factors to continue doing harm to others. When you are mentally ill, logic starts completely bending and finally making a 180 degrees turn from normal
There's a whole lot of mental health issues in there.