Critical care nurses function in a hierarchy of roles. In this open heart surgery unit, the nurse manager hires and fires the nursing personnel. The nurse manager does not directly care for patients but follows the progress of unusual or long-term patients. On each shift a nurse assumes the role of resource nurse. This person oversees the hour-by-hour functioning of the unit as a whole, such as considering expected admissions and discharges of patients, ascertaining that beds are available for patients in the operating room, and covering sick calls. Resource nurses also take a patient assignment. They are the most experienced of all the staff nurses. The nurse clinician has a separate job description and provides for quality of care by orienting new staff, developing unit policies, and providing direct support where needed, such as assisting in emergency situations. The clinical nurse specialist in this unit is mostly involved with formal teaching in orienting new staff. The nurse manager, nurse clinician, and clinical nurse specialist are the designated experts. They do not take patient assignments. The resource nurse is seen as both a caregiver and a resource to other caregivers. . . . Staff nurses have a hierarchy of seniority. . . . Staff nurses are assigned to patients to provide all their nursing care. (Chase, 1995, p. 156)