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Nurse Ratched

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The best thing we can do is go on with our daily routine.
~ Nurse Ratched

Nurse Mildred Ratched is the primary antagonist of the book and movie, One Flew Over the Cuckoo's Nest. She is the head nurse at the mental institution that she works. She is often considered one as of the greatest female villains in movie history, rivalling others popular characters such as Wicked Witch of the West, Alex Forrest, Phyllis Dietrichson and Mrs Danvers. She was named the fifth greatest villain in movie history by The American Film Institute.

Ratched is often considered among the most hated characters in movie history.

Role in the Story

Being head nurse, Ratched has control over medication, therapy, hygiene, recreation, among others. Her superiors esteem her for being one of the best nurses in the facility. Ratched is a firm believer in keeping people orderly, and will revoke any privileges they might have if they act out of line in any way. She keeps the patients in line by using their mental weaknesses, and encourages other patient to act is informants for her so that she can use sensitive information against a patient as she sees fit.

When a criminal named R.P. McMurphy arrives to the ward, he begins to disobey Ratched's schedule and tries his best to annoy and meddle her. As McMurphy's disorder persists, she uses treatment almost as punishments for acting out.

McMurphy arranges a party with alcohol and prostitutes as a way of saying goodbye since he plans on escaping the facility. The next morning, Nurse Ratched eject these intruders and finds one patient, Billy Bibbit, sleeping with a prostitute. The depressed and cowardly Billy is now confident and stands up to Nurse Ratched who tries to sham him for having sex with a prostitute. She uses Billy Bibbit's intense fear of his mother as a tactic for returning him to submission and also as punishment.

Distraught that Ratched will tell his mother about this encounter, Billy commits suicide. Nurse Pilbow informs Ratched of this, and she immediately tells the patients to return to their schedule, since that's the best thing to do. McMurphy becomes enraged and straggles Ratched, breaking her neck, (in the book, McMurphy rips her shirt to expose her breasts). Ratched survives and has to wear a neck brace, while McMurphy is beaten and lobotomized.

Nurse Ratched's influence over her patients is reduced and their no longer fear her. In the book, she has to write on a piece of paper to communicate, and in the film her voice becomes much softer. In the film, the last thing we see of her is her kindly congratulating a patient on a successful procedure.


She is a formalist who strongly believes that the best thing to do is to have patients conform to a schedule. Nothing will make Nurse Ratched stray from schedule and routine, even the death of a patient (which she does to prevent utter chaos amongst other patients). She has no tolerance for rule-breakers, especially people who are openly sexual. Ratched is very calm and uses her knowledge of other's weaknesses to make them submissive and obedient. She initially acts quiet and reassuring, but can turn stern when a disorderly patient persists. She dislikes every form of disorder: from rebellion to untidiness. She wears a black overcoat and a black barrett outside of work. In the book, she is perceived by a paranoid patient (Bromden) as unfeeling, manipulative, and working for an oppressive society ("The Combine").


  • Louise Fletcher (the actress of Ratched) has stated in recent years that she can no longer watch her performance as she feels the character's cruelty is "inhumane".
  • She could be considered similar to Samuel Norton of The Shawshank Redemption, both are cruel and use their authority to make other's submissive.
  • Ratched is sometimes said to represent the cruelty that hospitals once embodied.

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