Megan Stanford

While looking at Miss Ratched as a character in the novel, I can see that she is the one running the institution even though she is not the highest rank in the hospital. She is the head nurse, however she still has control over the doctors in the hospital. You can see this during the group meeting when the doctor is talking about the ideas that he and McMurphy had for the institution. During the meeting, she says, "but I also believe that an idea like this should be discussed in a staff meeting before a decision is reached" (Kesey 109). By saying this, she really is implying that she does not like that Dr. Spivey saying his ideas to the whole group before she okayed the idea. 

We also know that she has been there for a long time because Chief explains how he was the patient there longest, but she was there before him. This shows that she really does have the highest authority even though she is not the top of the chain. She has this ability because she was friends with the one who was in charge of hiring and firing employees and uses it to her advantage.