Nurse Ratched is a dictator when it comes to deciding how things are going to work in her hospital ward. But she also has this clever way of never seeming like a dictator because she uses false logic to make it seem as though all her judgments are objective. For example, she lets the patients vote on McMurphy's idea to watch a baseball game only because she knows they'll vote against it. So she asks, "How would it be if we had a vote and let the majority rule?" Of course, the patients vote her way and she defeats McMurphy.

When the patients reverse their votes on the second occasion, Ratched still gets her way by saying, "I only count nine votes […] There are eighteen patients on this ward." She isn't acknowledging the fact that only nine of the patients are lucid enough to know what they're voting on.

So whether things go one way or another, Ratched has figured out how to get her way. And whenever the patients get upset about this, she sends them off for electroshock therapy. So in the end, voting in this movie symbolizes a fake sense of freedom – the belief that your vote and your opinion count when they actually don't.