She carries no compact or lipstick or woman stuff and conceals her breasts. The trade-off for power is the loss of femininity; she is impregnable" (McMahan 118). By concealing her femininity, whilst stripping the men of their dignity, she thrives on their shame to keep them compliant and preserve her own authority. Nurse Ratched, an emotionless machine, dictates her actions to show her oppressiveness and authority. Despite her position as a nurse, Ratched is not an overly feminine one rather she is the opposite. She contradicts the conventional image of a nurturing woman due to her lack of delicacy and matronly qualities. This description of Nurse Ratched introduces the negative representation directed towards the women in the novel. .
In addition, she is able to manipulate the staff to remain in control over the entire institution: "That power goes to the supervisor, and the supervisor is a woman, a dear old friend of Miss Ratched's; they were Army nurses together in the thirties. We are victims of a matriarchy here, my friend, and the doctor is just as helpless against it as we are. He knows that all Ratched has to do is pick up that phone you see at her elbow and mention, oh, say, that the doctor seems to be making a great number of requisitions for Demerol -" (Kesey 59). The matriarchal dominance within the hospital intimidates all individuals and allows Ratched to suppress any threat to her authority. Her abilities of manipulation cause fear within not only the patients, but the staff as well who, in turn, are extremely acquiescent to her orders. This power of insinuation causes the characters in the novel to rely on her approval and prevent any rebellion against her order, keeping her in control. If there is any threat to her authority, Ratched is determined to eliminate it in any way she sees fit. She is extremely persistent in obtaining what she wants and will manipulate everyone in the ward until she has the staff under her control.