The game is called life and the prize is a feeling of belonging in the world. The patients in the mental ward of Ken Kesey's One Flew Over the Cuckoo's Nest have always lost because the game is rigged against them by the Big Nurse and the "combine" of society. Her tools are pills, intimidation, electroshock therapy and lobotomies. The patients' luck changes when a stranger named McMurphy is brought to the ward and turns the tide. McMurphy is involved in the competition with the Chief and the Big Nurse; in the end the winners are few but obvious.
The Big Nurse has always won at her own game, she likes it that way, she will do anything to keep her patients down and stay satisfied with their complacency even if their submission is only driven by the fear of the outside world. The level of her effort depends on the level of the patient's desire to win the never-ending game.
She gives tranquilizers daily to all patients, electroshock therapy to more spiteful players and as a final resort a lobotomy to the truly talented and determined players. The way she describes her tactics is that she's trying to get the patients "adjusted to surroundings" the way she does this is by getting them so drugged up they are submissive. Once she starts losing the battle she never gains her once-held respect and ends up having an embarrassing loss in the end. She loses by having McMurphy sent for a lobotomy and set out as a reminder to the others, her attempt at success it thwarted by the Chief who kills McMurphy, the way he would want it, and any of her hopes of saving face.
The Chief is at the opposite end of the scale of the Big Nurse.