In GMF, nurses and MD are working in the same note. We have also the same particularities with residents and supervisors.
Usually, the nurse starts the note, save and close the patient file.
Then the MD is taking the same note, and modify it to continue until completion.
We always infor users there are some risks of datas losts if multiple recipients are working AT THE SAME TIME on the SAME NOTE. But it happens sometimes.
It would be safe, if a simple pop up message could be displayed when a user try to MODIFY the note, if someone else is on it in MODIFY too.
Other option : forbid to modify the note until it has been freeed from the other user.