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The psychological drama series Ratched, which premiered on Netflix last month, serves as an origin story for the callous Nurse Ratched from the 1975 novel-turned-film One Flew Over the Cuckoo’s Nest. In both the film and the series, Nurse Ratched is cold, cruel and manipulative, taking advantage of the vulnerability of her patients: people with mental illness. A current trend on TikTok makes it seem, at first glance, like Nurse Ratcheds are everywhere in psychiatric care today. Hashtags like #psychnurse, #psychward, and #nurselife reveal healthcare professionals mocking their psychiatric patients, making light of their conditions, and enacting fantasy revenge against those who are hard to control.
“I’M FINALLY ON PSYCH WARD TIKTOK,” one user wrote in August, to which another replied “It’s lit.”
In a video posted by @vis4vicious captioned “Life as a psych nurse,” we see her, dressed in scrubs, nervously mouthing along to a voice-over of someone panting and saying, “I can’t.” The second frame reveals her transformed: her hair is a mess, her eyes wander, a blanket is draped over her head and her body, and a tampon hangs out of her nose. A caption reads, “SCHIZO PATIENT.” The “patient” — @vis4vicious’s imitation of a schizophrenic person — looks confused and angry, scratching her head and yelling nonsense at the nurse.
A video by @leener43 shows her in scrubs alongside the words “When your naked psych patient picks up a chair and threatens to kill you with it …” She mouths the lyrics to a song playing: “I think you know where this about to go.” She brings a syringe to the camera as the words “B52 time” appear. The video is captioned “A nurse’s favorite kind of cocktail … Benadryl, Haldol, Ativan.” It garnered 14.8K likes.
But it might also have scared off people who actually need to seek psychiatric help. “And this ladies and gentlemen,” one commenter wrote, “is the reason I pretended to be ok so I wouldn’t get hospitalized.”
Whether @vis4vicious or @leener43 or another couple dozen users who have posted troubling videos like these worry about such possibilities, they wouldn’t say: they did not respond to my queries. But another nurse, @e.squared, whose video showing her holding her jaw and complaining about a combative patient who struck her, apologetically told me that her TikToks are meant to be light-hearted for other healthcare professionals who share these experiences. She then deleted the clip.
A psychiatric ward is a highly stressful environment, and research by Alison Rowe and Cheryl Regehr shows that the use of dark humor can be a beneficial coping mechanism for individuals who work in a field where they confront traumatic situations constantly. James E. Johnson, a Professor of Sociology at Northwestern University whose area of expertise includes humor and scandal, told me that psychiatric nurses sometimes use humor to build allegiance, and this form of what he called “folklore” helps them get through the day as a team. But there are lines that should not be crossed, he added. Rowe and Regehr demonstrate that when humor begins to dehumanize patients and incorporate “negative social comparison and victim blaming,” it crosses them.
Professor Johnson made another crucial point: “What becomes particularly problematic is when these in-group affiliative comments reach an out-group, when it breaks through the subcultural wall.” Those who are not in the psychiatric nursing world may take the TikTok clips at face value and store in our belief systems impressions of mentally ill people as threatening and monstrous.
In contrast, many healthcare professionals on TikTok are using the platform to cultivate a healthy conversation about mental illness. One of them is Jenny Helms, currently a licensed clinical marriage and family therapist based in Wichita, KS, who worked in a psychiatric hospital for nearly a year. Her TikTok videos, like “How to Respond to a Loved One’s Anxiety” and “Statements that Help You Cope with Trauma,” have gained tens of thousands of views. Regarding the negative videos, Helms expressed her concern about patients being misunderstood and mistreated. No one is entirely defined by their mental illness, she said: Their illness is not “who they are at their core.”
As Professor Johnson noted, nurses “need an outlet, and humor with the group of nurses is that outlet because everyone knows what is going on.” One might assume that the nurses who posted the satirical videos perform their jobs well and sympathetically, but it’s also possible that the mocking attitude of the videos permeates their work. One thing is clear: by sharing these jokes to the rest of the world they are perpetuating a harmful stigma.