In the 21st century, nursing requires an immense amount of knowledge and commitment to an evolving patient population beyond the standard administrative practices outlined in the traditional nursing handbook. This knowledge and commitment to the patient is provided by use of therapeutic communication within the nurse-patient relationship. When therapeutic communication is not proficient, patient safety and positive health outcomes are compromised. In the film, One Flew Over the Cuckoo’s Nest (1975), the lack of therapeutic communication used by the nurses in the psychiatric unit had a negative impact on patient safety and positive health outcomes. These patients were verbally abused, treated with no dignity and had very few rights. The nurses were judgmental of the cognitive impairments and coping difficulties the patients endured …show more content…
The nurse warden, Ms. Ratchet, on the unit, has a difficult time maintaining control of the therapeutic milieu due to his spontaneous outburst. Over the course of the nurse to patient relationship, transference is displayed as McMurphy continues to threaten Ms. Ratchet’s authority over the unit by encouraging the patients to engage in risky behavior. For example, stealing the bus to take the patients on a fishing boat trip. However, Ms. Ratchet engages in countertransference by trying to control the patients by shaming and social punishment when they do not comply with her demands. For example, she scowled a young male patient, Billy, for his engagement in sexual behavior and threaten to expose him to his family on the unit instead of discussing his behavior with him. This form of shaming and disapproval was so impactful to Billy that he committed suicide a few moments later on the unit. Her use of nontherapeutic communication often would add fuel to the group distractions and intimidated the patients into silence and