Nurse Ratched's Malpractice in One Flew Over the Cuckoo's Nest

The nurse-patient relationship is one that is built on mutual trust and respect that fosters hope and assists in a harmonious healing process. A nurse has the professional duty to the patient to provide physical, emotional, and spiritual care to avoid injury. Any negligence in rendering care to the patient is direct disregard and may result in malpractice. This is the crux of the problem with Nurse Ratched. In One Flew over the Cuckoo’s Nest, Nurse Ratched is guilty of malpractice as she forced marginalized people in society to conform to societal norms through the cruel medical treatments she practiced, mental anguish she inflicted on the patients, as well as the undue authority she exercised in the hospital.

In One Flew over the Cuckoo’s Nest, Nurse Ratched is the antagonist and her use of cruel medical treatments is the main argument for malpractice. She used daily doses of medication, electroshock therapy, and a lobotomy procedure to “treat” the patients in the ward. “Put your troubled mind at ease, my friend. In all likelihood, you needn't concern yourself with EST. It's almost out of vogue and only used in the extreme cases nothing else seems to reach, like lobotomy”. Nurse Ratched’s treatments were more harmful than helpful. The medication she used was over-prescribed and unnecessary. It just sedated the patients to keep them calm while not actually helping them to cure or to rehabilitate. Nurse Ratched used the medication in order to make the patients adhere to society’s behavioral norms.

In addition to medication, Nurse Ratched used electroshock therapy that had no positive effect on the patients. While it caused injury to the patients, the real intent was to force them to comply with Nurse Ratched’s strict rules. By doing so, Nurse Ratched was stealing her patients’ freedom and their way of expression. This is in direct contrast to what a nurse is supposed to do. Nurses are called upon to care for their patients and their needs, not hurt them. Nurse Ratched also had no qualms about recommending lobotomy procedure for her patients. By doing so, she was responsible for turning them from an acute to a chronic patient. Nurse Ratched prescribed lobotomy for McMurphy simply as revenge for attacking her even though she knew that he was not really crazy and the doctors were even contemplating on sending him back to Paddington Work Farm to complete the remainder of his six-month work prison sentence. This was a totally unnecessary procedure which in itself is a reason for malpractice.

Another reason to consider this as malpractice is because Nurse Ratched did not get consent from McMurphy’s family before deciding on giving him this cruel and medically risky treatment. “Patients were slowed up in thinking and acting, they were dull, at times completely lacking in emotional expression or display and showed a striking reduction in interest and driving energy. Others receiving the same operation were uninhibited and euphoric and they were somewhat restless with a purposeless type of activity”. This research at the time shows that the treatments that were employed by Nurse Ratched had detrimental consequences to her patients. Nurse Ratched used a lobotomy procedure because she thought that the patients are outliers in society, and were beyond repair.

Nurse Ratched was the main source of mental anguish for the patients in the ward. She caused more pain than relief for the patients. “Mrs. Bibbit's always been so proud of your discretion. I know she has. This is going to disturb her terribly. You know how she is when she gets disturbed, Billy; you know how ill the poor woman can become. She's very sensitive. Especially concerning her son. She always spoke so proudly of you”. Nurse Ratched threatened Billy Bibbit to ensure that he does not have a relationship with any woman even though Billy pleaded with her not to tell his mom about his episode with a prostitute. This caused lasting emotional damage to Billy that eventually led to his suicide. Nurse Ratched was trying to suppress his sexual liberation and exploration as it did not fit with society’s traditions. This is unquestionably malpractice by Nurse Ratched. Her role as a nurse in a hospital is to foster an environment where her patients feel safe and protected emotionally. This was not the case with Billy who felt threatened by her. He could not take the threats from Nurse Ratched anymore and believed that the only solution was death.

Nurse Ratched could be described as the main culprit who drove Billy to suicide. The group therapy session meetings conceived by Nurse Ratched were unhealthy by nature and caused mental anguish for the patients. From each patient’s medical records, she learned personal and confidential information about them. Nurse Ratched used this information and manipulated the men in the ward to disclose their secrets to the group through probing questions during the group therapy. “Their mouths opened in unison. Her sweeping eyes stopped on the first man along the wall. His mouth worked. I robbed a cash register in a service station. She moved to the next man. I tried to take my little sister to bed '.

Nurse Ratched pinned all the men against each other, and in doing this, all the men were at odds with each other. This lead to the uncovering of very personal and confidential information that was used by the men in the ward to humiliate each other. Nurse Ratched was trying to use humiliation as a way to get the patients back on “track” with society’s rules. This is evidence for Nurse Ratched’s malpractice, as it was a breach of the nurse-patient confidentiality. “The objective of this confidential relationship is to make patients feel comfortable enough providing any and all relevant information. This helps the doctor to make a correct diagnosis, and ultimately to provide the patient with the best possible medical care”. Nurse Ratched hurt the patients' medical care as they were not emotionally cared for by exposing secrets and humiliating them publically which is a cause for legal action.

Nurse Ratched’s unchecked authority over the hospital led to mishandling of the patients in the ward. She controlled every movement and every person’s actions and thoughts. She made the doctors so miserable when they did not follow her instructions, that they begged to be transferred out of the hospital. “I'm disappointed in you. Even if one hadn't read his history all one should need to do is pay attention to his behavior on the ward to realize how absurd the suggestion is. This man is not only very very sick, but I believe he is definitely a Potential Assaultive”. This quote from the book illustrated how Nurse Ratched controlled her ward. She manipulated people into siding with her regardless of whether or not it was the right decision. This was malpractice by Nurse Ratched because she did not allow the doctors, who were trained to diagnose patients, to do their job properly. Instead, she manipulated the doctors to diagnose the patients incorrectly in order to benefit her interests rather than those of the patients.

Nurse Ratched’s selection of the orderlies further exemplifies her misuse of authority over the hospital which contributed to malpractice. “They are in contact on a high-voltage wavelength of hate, and the black boys are out there performing her bidding before she even thinks it”. Nurse Ratched favored orderlies that conformed to her strict rules than those that were actually trained for the job. Nurse Ratched retained orderlies based on how much they hated and mistreated the patients. The more they hated, the better suited they were for the ward. She wanted them to hate without her having to tell them. This can be construed as malpractice because Nurse Ratched created an environment where the patients were physically threatened by the orderlies. Another aspect to consider as malpractice was that Nurse Ratched was not providing orderlies to the patients who were even qualified for the job. She was using the orderlies to enforce societal norms in the hospital which resulted in malpractice.

Nurse Ratched is guilty of malpractice due to her cruel medical treatments, the mental agony she inflicted on the patients, and the uncontrolled power she ran the hospital with. People who are less fortunate or marginalized in society need to be protected from harsh societal punishments as a result of their different ideologies and sometimes their mental limitations. It is important to recognize the motives, signs, and symptoms of malpractice to make sure that justice is served for all those that are being ill-treated and victimized.

01 February 2021
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