She’s carrying her woven wicker bag like the ones the Umpqua tribe sells out along the hot August highway, a bag shape of a tool box with a hemp handle. She’s had it all the years I been here. It’s a loose weave and I can see inside it; there’s no compact or lipstick or woman stuff, she’s got that bag full of a thousand parts she aims to use in her duties today—wheels and gears, cogs polished to a hard glitter, tiny pills that gleam like porcelain, needles, forceps, watchmakers’ piers, rolls of copper wire[.]

The reader’s first view of Nurse Ratched, through Bromden’s eyes, reveals a machine-like character. She possesses no trappings of femininity in her bag, but instead—with the exception of medication—she only carries mechanical bits and tools, many of which would have dubious usage at her job on a mental ward and may even cause harm. Bromden’s description aptly reflects the inmates’ view of her as masculine, unemotional, and sadistic.

So after the nurse get her staff, efficiency locks the ward like a watchman’s clock.

Bromden sums up Nurse Ratched’s ward: She’s spent years ensuring the right doctors and aides work with her, underscoring that she holds complete control over her domain. Nurse Ratched picks specific types. She wants doctors who will accede to her control, and she wants aides who will carry out her sadistic wishes seamlessly and without dissent.

“You’re committed, you realize. You are…under the jurisdiction of me…the staff.” She’s holding up a fist, all those red-orange fingernails burning into her palm. “Under jurisdiction and control—

After Nurse Ratched experiences her first rebellion in the ward—McMurphy sits in front of the blank TV screen instead of working—she threatens McMurphy in an attempt to regain her control. Having no experience with his type of behavior, she doesn’t know how to respond. Instead of a recourse to logic with McMurphy, she falls back on emotional threats and assertions of power. She understands that McMurphy poses a threat to her monopoly on power, requiring a new strategy to maintain control through actions, not words.

No. He isn’t extraordinary. He is simply a man and no more, and is subject to all the fears and all the cowardices and the timidity that any other man is subject to. Given a few more days, I have a very strong feeling that he will prove this, to us as well as the rest of the patients.

During the staff meeting, Nurse Ratched presents her analysis of McMurphy’s personality, but she underestimates his strength and tenacity, at the same time overestimating her own power. She believes that she can break him using the same bullying tactics she, no doubt, has used on countless other men. She doesn’t realize that McMurphy is extraordinary and that he fears letting the other patients live in a perpetual state of submission to her.

The nurse was biding her time till another idea came to her that would put her on top again. She knew she’d lost one big round and was losing another, but she wasn’t in any hurry. For one thing, she wasn’t about to recommend release; the fight could go on as long as she wanted, till he made a mistake or till he just gave out, or until she could come up with some new tactic that would put her back on top in everybody’s eyes.

The narrator explains Nurse Ratched’s state of mind after McMurphy breaks the window. She knows that she lost a battle with McMurphy but she still has good odds to win the war. After all, McMurphy lives as an involuntarily committed patient and can only leave the hospital on her say so. She has as much time as she needs to figure out the best way to humiliate McMurphy and reclaim her authority.

The expression on her face was calm and blank as enamel, but the strain was beginning to show in other ways. By the way she jerked the adhesive tight as she could, showing her remote patience wasn’t what it used to be.

The narrator reveals how the battle between McMurphy and Nurse Ratched, exemplified by his continued breaking of the glass window, takes a toll on her. Although Nurse Ratched attempts to retain her cool demeanor, she struggles with how to stop his rebellion. Her tension rises because she faces a wily adversary in McMurphy’s deliberate strategies. She hasn’t yet figured out how to contain him and feels the pressure to do so before his defiance inspires the rest of the men.

[T]he nurse herself brought the problem of Patient McMurphy up in group the next day, said that for some reason he did not seem to be responding to EST at all and that more drastic means might be required to make contact with him[.]

The narrator explains how Nurse Ratched continues to struggle with containing McMurphy and showing her control over him. She already tried to undermine him, by trying to scare men off his fishing trip and turning them against him. She even attempted to quell him through repeated electric shocks. Nothing works with McMurphy. Here she hints at employing more extreme measures to turn him into a compliant patient.

She looked from Billy and the girl to the bunch behind her. The enamel-and-plastic face was caving in. She shut her eyes and strained to calm her trembling, concentrating. She knew this was it, her back to the wall. When her eyes opened again, they were very small and still.

The narrator describes the moment after Nurse Ratched finds Billy with Candy. She knows she has arrived at a make-or-break moment: She must seize control and assert her authority or risk losing her power forever. She decides to shame Billy and terrorize him by threatening to tell his mother. However, she primarily acts for the audience of men, intent on sending them the message that she has the tools to use against them and she is not afraid to use them.

She tried to get her ward back into shape, but it was difficult with McMurphy’s presence still tromping up and down the halls and laughing out loud in the meetings and singing in the latrines. She couldn’t rule with her old power any more, not by writing things on pieces of paper. She was losing her patients one after the other.

The narrator explains how Nurse Ratched has lost control of her ward since McMurphy attacked her. Even though she has physically removed him, his ghost continues to haunt the ward. The men take the intended lesson from his rebellion and realize they don’t have to stand for her domination anymore. Even in his absence, McMurphy undermines Nurse Ratched’s authority, showing that he won the power war between them.

I was only sure of one thing: he wouldn’t have left something like that sit there in the day room with his name tacked on it for twenty or thirty years so the Big Nurse could use it as an example of what can happen if you buck the system.

Bromden comments on the fact that Nurse Ratched ordered McMurphy’s lobotomy mainly to serve as an example to the other men on the ward of what happens to anyone who crosses her. This action shows Nurse Ratched’s pathology. She has taken away another human’s essence simply to exert her own power. This action further calls into question the justice of the psychiatric system that labels a woman like her sane but McMurphy insane.