They appear similar to their film counterpart, the Dark Nurses, with very deformed and rather featureless faces, short, revealing dresses made of skin, and feet marked by pointed toe white heels. As well, the nurses engage in twitchy movements and an attraction to any source of light or a considerable level of sound, remaining frozen until alerted.
Nurses are usually rather easy enemies to overcome, and can be defeated using melee combos with the knife. Later in the game, however, they get significantly more dangerous, being able to use incredibly quick slashes in rapid succession which makes approaching or even escaping them difficult. Turning off the flashlight will lower the chance of being attacked by a nurse, however, this also hinders Alex as he is often plunged into complete darkness without it. Normally, they are found in groups of three or more.
If the Nurse is stunned and Alex is wielding his knife, the finishing move shows Alex stabbing her twice in her breast and throwing her down to a pool of her own blood.
They may represent Alex's institutionalization in the mental hospital for four years, and his possible suppressed libido.
In Alex's diary, Alex writes that he believed that the nurses in the military were sexualized to comfort the wounded soldiers. However, because Alex was never actually in the military, these nurses are likely his wishful fantasies to help him cope with his predicament.
|“|| The food here is terrible. My bed is stiff. There's only one thing that makes it bearable: The nurses. These girls are incredible. They have these pristine white uniforms cut right above the knee, their breasts spilling out from their shirts. Look, I don't want to sound like a dirtbag or anything, I'm just saying I appreciate the military providing us with this one thing to brighten our days. Maybe it's sort of like payback for getting us stuck in this place to begin with. I don't know. All I can say is, "thank you."
The fetuses they carry inside could also symbolize Joshua's birth. Whenever Alex kills a nurse, he is also killing the fetus inside. This may be a subconscious foreshadowing of the repressed memories of Alex killing his brother.
- When the player kills the first nurse on the Xbox 360 version in the hospital, they will receive the achievement "Alchemilla's Finest."
- When illuminated by a light source (not the flashlight), a fetus can be seen growing inside their wombs.
- Their appearance is inspired by the Dark Nurses in the film, which borrowed elements from the Bubble Head Nurse.
- This nurse also made an appearance in Anne's Story, representing Anne Marie Cunningham's refusal to put her father Frank Coleridge in a nursing home after he wound up in a persistent vegetative state.