From the point of view of NurseMind, a user has one of the following roles. The role determines what is visible to that user, and to whom that user's data is visible.
By default, a user has the role of Nurse. To have a different role, the user must be promoted by another user who possesses the capability to make such promotions. Within the context of a given hospital, a Manager could, for example, promote a Nurse to Charge (but only within that hospital).
A central priniciple is that a Nurse's data is his or hers alone and is visible to no one else except to those to whom has been granted that power explicitly by having been promoted.