How can you tell if she's the Head Nurse?

Answer:
The only way to know is to ask.

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Is she wearing a nurse outfit like one of the ones on this web page?
http://www.3wishes.com/nurse.asp... (NSFW)

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Generally if you look on the "board" where all of the patient's names are listed as well as the names of all the nurses, there should be a name under the title "Charge". As for him/her. Otherwise, just ask your nurse who the "charge nurse" is. The charge will be the head of the department. If you want to go higher up, ask for the "house supervisor". Hope this helps!

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