Question

One Flew Over the Cuckoo's Nest ( Nursing: Mental Health) (please answer questions thank you, second part is nursing interventions)

Write a one-page analysis discussing the following questions about this movie:

1. The two main characters are Nurse Ratched and Randle Mcmurphy. Why was Randle on this unit?
2. Describe the relationship between the two characters.
3. Explain how Nurse Ratched related to the rest of the patients on the unit.
4. Explain how Nurse Ratched led groups- was it therapeutic?
5. If you were the nurse on this unit, how would you have changed the milieu therapy?

On a separate sheet of paper: Choose any other patient (not Randle McMurphy) in the movie to answer these questions:

(Character name to discuss will be about Billy Bibbit)

6. What are the two priority nursing diagnoses for this character?
7. Name two short-term goals or this patient, including two nurse interventions for each one goal. How would you measure goal completion?
8. Name two long-term goals for this patient include a time frame.
9. What support group would be available for this patient today?

Answer 1

Randle Mcmurphy who is having a criminal past, once again caught, for statutory rape of a teenager. He wanted to escape the hard labor in the prison farm. So, he pretended to have mental illness and hoped to spend the rest of the days of his sentence in a more relaxed manner in the mental institution. He was sent to the mental institute for psychiatric evaluation and to prove that he is not mentally ill. The psychiatric unit was run by Nurse Ratched who was the cold-hearted, passive-aggressive type.

Randle Mcmurphy and Nurse Ratched didn't get along well. The nurse found the rebellious and lively Randle as a threat to her authority. He was unwilling to follow the hospital routines. They were having frequent conflicts and fights and he was always annoying her. The nurse was treating all the patients without any empathy. She was treating them in an authoritarian and abusive way and not helping them to recover and build self-confidence. She was avoiding the requests and demands of the patients and intimidates them to do her biddings.

Nurse Ratched was tyrannical and wanted to break the spirits of her patients instead of curing them. She was never helping them to cure and return to the outside world. She cowed her patients into institutionalized submission. This was not at all therapeutic. Instead of building their self-confidence to lead a normal life, she was making them more dependent and institutionalized. She was using electroconvulsive therapy as a punishment for misbehaving.

If I was a nurse in this unit, I would have encouraged the patients to get involved in entertainment activities and to help them to make the necessary behavioral changes to improve their functioning and mental health. Patients would be encouraged to take responsibility for themselves. They should be taught that they are responsible for their own well being and are able to take care of themselves and others in the group. Interpersonal relationship between the nurse and each patient would be encouraged and would let them voice out their fears and concerns. Social interactions should be encouraged as much as possible.

Billy Bibbit was a stuttering patient who was not having any self-confidence and was dependent on his mother. He was suicidal too. Nursing diagnosis would be

1. Building self-confidence to get involved in the society

2. Ability to talk without the fear of stuttering

Short Term Goals:

1. Address the group and say about his life as a child

Nurses Intervention:

a) Encourage him to relax mentally and physically before the speech

b) Encourage him to practice it in front of the mirror and do deep breathing exercise

Short Term Goals:

2. Speak about the life he wishes to have in the future

a) Encourage him to visualize about himself in the coming years and speak slowly

b) Encourage him to set a goal in life by explaining people who were very successful in spite of their stuttering

Long Term Goals

1. Participate in social activities confidently within 3 months

2. lead a normal life in society within one year

ASHA - American Speech-Language-hearing Association is helping those have stuttering. many other speech associations also available for stuttering patients.