What would you do if you were Nurse Ratched?

[purple_nomad]

I am in my mental health class and have done a few clinicals already. Out of curiosity, I finally watched "One Flew Over the Cuckoo's Nest," and was taken aback by Nurse Ratched. Not by how terrible she was, but rather how NOT terrible she was. At least, not as terrible as I had imagined her to be, based upon all of these vague references to her in articles about nursing representation in the media.

Granted, she wasn't good in the film, and I'm sure she was even worse in the book. We all know that. But as I was watching the film, I wondered...what would I do if I was in her shoes? Residents being violently disruptive? Residents trashing the ward? A suicide on the ward? Would I ever respond like she did?

If you were faced with the same situations as Nurse Ratched was, what would you do?

[Horseshoe, BSN, RN]

"Sometimes being a high riding ***** is all a woman has to hold on to"

WOW. What an amazing essay, DoGoodThenGo! I wanted to quote parts of it, but I couldn't figure out which sections to leave out without destroying the whole! Such an incredibly insightful, thoughtful response to the question.

Well done!

[mama_d, BSN, RN]

Every time I tell hubby about things at work, if he thinks I need to stop and rethink my perspective, he sats "OK, Nurse Ratched". It either gets him smacked (jokingly!) or else I try to do it better next time.

I think causing a pt to get a lobotomy just because they challenged her authority might be worse than the suicide...I dunno...I'll have to debate that one with hubby.

For those of you who have just seen the movie, read the book. The movie is great (I love Kubrick, aside from "Eyes Wide Shut")m the book is so much better.

[mama_d, BSN, RN]

Wowzers, DoGood, that was awesome. Makes me miss taking lit classes...I love reading great literature and analyzing it. (Yup, total nerd...if I wasn't morally opposed to writing papers for people none of friends in school would ever have to do any, I'd do them for the fun of it.)

[RNperdiem, RN]

That nurse was a woman of her times.

Punishing and shaming were no problem then- ask people over 60 to describe the Dunce caps worn at school by slow students or the lashings kids received at the hands of teachers. One of my nursing instructors said she had scars on her back to show for her schooling.

The movie takes place during the changing times between the old system and the freedom of the late sixties.

[billyboblewis]

We have to remember this is fiction. There are people in life who do mean things. Hopefully a well run institution will find them before they harm a patient. Unfortunately though we are all human including hospital management and cannot be perfect. Make sure you are doing your job properly and scream loudly when you see someone endangering a patient with their actions.

[Psychtrish39, BSN, RN]

We have to remember this is fiction. There are people in life who do mean things. Hopefully a well run institution will find them before they harm a patient. Unfortunately though we are all human including hospital management and cannot be perfect. Make sure you are doing your job properly and scream loudly when you see someone endangering a patient with their actions.

billyboblewis,

I agree and I always have and always will. I think that as nurses we dont just give medications and call docs for orders and do treatments. We advocate for the patient . We take up for those who cant defend themselves and in mental health care most suffers have been abused by the system and other people all their lives. I was taught that by a seasoned nurse who orientated me in my first graduate nurse job. It stuck with me. I imagine she is retired now but she made an impression on a old dog (me) learning new tricks as a new nurse. Its got me in trouble a few times but I dont care.

[DoGoodThenGo]

Yes, OFOTCN was "fiction", but all good forms of that genre often is based on some truth.

It is also very unfair to compare today's nursing practice in any area with standards from over forty years ago. This especially applies to caring for those with "mental illness".

Nurse Ratched probably entered and graduated from nursing school around the 1940's or early 1950's. The world of psychiatric nusing practiced on the wards she entered as a new grad probably hadn't changed that much from the early part of the century.

Lobotomy, introduced in 1942 was seen as a "break through", for until then treatments pretty much was limited to electroconvulsive and hydro-theraphy. NR would have seen the effects of all this on patients and formed her own "best/evidence based" practice theories based upon results. Chlorpromazine and later haloperidol played a huge role treatment of mental illness, but again, NM had her own ideas.

Loathsome as many here may find NR's methods of humiliation, domination, "ordering" of medical treatments, and so forth of the patients, no where is it said she broke any known laws or violated practice acts. Indeed as previously stated, Nurse Ratched's methods produced "results" such as they were, and again she "made the trains run on time and under budget".

Then and now there were plenty of women in nursing, education, and religous life who took the "white woman's burden" quite seriously. Pious, virginal and some would say quite full of themselves females who truly saw what they were doing as being good works for the benefit of those for whom it was required, regardless of any lateral consequences or damages (and there were often many).

Nurse Ratched is only seen as evil because she is cast as a ball busting and frigid tyrant by many who see one of the book's real messages; revolting against authority. But play with the though for a moment of how things are from NR's point of view.

Here you are, the DON of a state mental hospital. Well respected and regarded, your methods *may* not please all, and perhaps there are other ways out there, but that isn't your concern. In comes this common criminal who is not only a loudmouth, but a trouble-maker. Indeed not even truly mentally ill, but sought refuge in a mental ward to escape the harsher conditions of a prison work farm. The plan is for him to ride out his sentence in these "cushy" surroundings, then go free.

Once inside the place however, Randy McMurphy does his level best to turn what was a smooth running ward upside down, and worse sets himself up to take down NR and her authority. His litany of offences culminate with an all night orgy of meds (stolen), booze, trashing the place, and sex with sumuggled in loose women. Now I ask you, even if you weren't a "nurse Ratched" type of gal, clearly this patient had crossed the line and if word got out your job and reputation would be on the line.

Having engaged in relations with a woman for the first time, "Billy" (who by the way initially didn't wish to, but was egged on by Mr. McMurphy), looses his stutter, only to have it return the instant NR mentions "telling his mother" what he had done. There was no such thing as HIPPA then, and Billy as someone "not in his right mind" and confined to an insitution literally had few if any rights at that time. His parents/mother certianly were within their rights to be informed about all aspects of their son's treatment, the fact NR and Billy's mom were friends may have meant the later got the information sooner and in perhaps more detail, but by some local standards nothing was wrong in this.

As for NR "ordering" Randy McMurphy's lobotomy, well she certianly could have given heavy weight to the physicans decision, but as a nurse we all know she did not have direct authority to "order" anything, well not at least as nursing was practiced then. Even if she did, taken in context of Randy physically attacking (trying to kill really), NR along with the long laundry list of other "problems" he caused while committed to the state farm, added to his previous life history the powers that be probably felt it was warranted.

In short, until you've worked several shifts in those starched whites and cap, leave us not judge nurse Ratched too harshly.

[leslie :-D]

Having engaged in relations with a woman for the first time, "Billy" (who by the way initially didn't wish to, but was egged on by Mr. McMurphy), looses his stutter, only to have it return the instant NR mentions "telling his mother" what he had done. There was no such thing as HIPPA then, and Billy as someone "not in his right mind" and confined to an insitution literally had few if any rights at that time. His parents/mother certianly were within their rights to be informed about all aspects of their son's treatment, the fact NR and Billy's mom were friends may have meant the later got the information sooner and in perhaps more detail, but by some local standards nothing was wrong in this.

this is where we disagree.

perhaps ratched had a legal right to tell billy's mom...

but morally speaking, her actions were indefensible.

ratched knew exactly how her threat would affect billy...

except, i'm pretty certain she didn't expect the suicide.

having sex with that woman, was clearly, therapeutic for billy.

it doesn't take an education, nsg or otherwise, to be sensitive or decent.

and rather than "frigid" or "ball busting", i saw her as a complete control freak.

when her control was threatened, she (re)acted accordingly.

and what she did to billy, had little to do with the sign of the times.

she was a heartless, controlling *****.

again, we'll agree to disagree.:)

leslie

[lowprofile]

I think she started a chain of nursing schools.

Certainly plenty of instructors left in her mold.

[billyboblewis]

Ya know it would upset the charge nurse in any hospital if she caught a couple of patients having sex and how about the times you catch a nurse having sex with a patient or two nurses having sex and onward..It all happens

[steelydanfan]

I find this entire thread offensive. Are you people serious?