Nurse Ratched - in The Novel and Film

In The Novel and Film

Nurse Ratched is the head administrative nurse at the Salem, Oregon State Hospital, a mental institution where she exercises near-absolute power over the patients' access to medications, privileges, and basic necessities such as food and toiletries. She capriciously revokes these privileges whenever a patient displeases her. Her superiors turn blind eyes because she maintains order, keeping the patients from acting out, either through antipsychotic and anticonvulsant drugs or her own brand of "therapy", which consists mostly of humiliating patients into doing her bidding. Her greatest success is the stuttering, suicidal Billy Bibbit, who is so terrified of her that he does whatever she says.

When Randle McMurphy arrives at the hospital, however, her dictatorial rule is nearly toppled; he flouts her rules with impunity, and inspires other patients to follow. Her attempts to cow him into submission — at first with threats and mild punishments, then with shock therapy — are unsuccessful, serving only to fuel his defiance.

Eventually McMurphy sneaks his prostitute girlfriend into the asylum, and encourages her to relieve Billy of his virginity. Ratched threatens to tell Billy's mother about the transgression. Since Billy fears his mother as much as or more than he fears Ratched, the threat frightens him into committing suicide. Enraged, McMurphy attacks Ratched, and nearly chokes her to death.

In retribution, Ratched has McMurphy lobotomized. Chief Bromden, another patient and the narrator of the book, later smothers McMurphy as a mercy killing. Ratched's cruel voice has been removed, due to McMurphy's permanent damage to her vocal cords - rendering her unable to speak well, and requiring her to often resort to writing notes to communicate - diminishing her control over the other patients.