Regarding nurses: modern nursing requires far more knowledge and specialist skills than even 20 years ago, will this be reflected in game? Nurses now can advance to become nurse practitioners and treat patients independently. Perhaps this can be reflected in game as nurses with enough experience and skills becoming able to staff some of the medical rooms/medical roles? This would allow the player to be flexible with their staffing choices and skill mix, especially in smaller hospitals/clinics with limited budget/capacity for doctors.