Nurse Ratched uses an extensive system of rules and regulations, as well as an ordered routine, to keep the asylum patients under control. Many of the rules Nurse Ratched has in place are petty; the only point of most rules is for Nurse Ratched to display her control over the patients’ lives. Rules range from music constantly remaining on in the main hangout room, the staff members not being allowed to eat with patients, and the toothpaste being locked away as if it could be used as a weapon or a way of escaping the ward. In this novel, rules are not in place to protect people, but to hold them down. The characters are freed by breaking the rules.
Although the order, routine, and rules on the ward give patients a certain sense of security, they also prevent the men from ever being "cured."
Although Nurse Ratched and the patients pretend that the ward is run "democratically," with patients participating in the process of rule-making, she actually refuses to cede power to the democratic process.