The novel One Flew Over the Cuckoo's Nest by Ken Kesey talks about the power structure of a psychiatric ward from the point of view of a patient, Bromden. The story is set in 1950s Oregon. Many of the patients admitted to the ward are not necessarily insane, however they do not fit into established social norms and have chosen a life far from these norms. The volunteer men surrendered to the staff and follow them like sheep, however the committed men need to be controlled according to the company, so they were sent to the ward. The head nurse, Nurse Rached, of the department maintains control by using her staff selected through years of meticulous selection. Rached's staff maintains control of patients with cruel acts such as forced labor, intimidation, and separation. Forced labor is very prolific throughout the story and is the hospital's first line of defense in keeping patients under control. From the beginning of the story, the assistants in the department force patients to do menial jobs for all the acute and some of the more mobile chronic patients. Assistants are first shown as the people who do this in the novel's opening scene, when Bromden wakes up: "Put a mop in my hand and wave to the spot where they want me cleaned today, and I'll go" (9) . ). Bromden is bossed around from what was at the time the lowest rung of society (all the assistants are black) even though he is enormous, six feet tall.” would be more active. This forced labor policy is endorsed by Nurse Rached, as shown when McMurphy first arrives addressing one of the attendants, "you may need a month's worth of bedpans... to refresh your assessment of how little... half of paper ......line and having a cold but happy smile allow nurses to at least make patients say things they wouldn't normally say. The power Rached wields in these situations allows her to control patients regarding matters of she wants to talk about. Nurse Rached has a multitude of techniques that she and her staff use to control patients. They use work to keep themselves busy, medical treatments as threats, and separation to calm patients patients are treated in the novel would never have been allowed in modern times. Furthermore, the idea of ​​a power structure dominated by a very powerful woman is still very rare, however in modern times Rached would probably be a doctor with more residents than her. they help. The power structure in this book is very complicated, however the staff has complete control, just like the equivalent people in modern society.