These nurses have a more "human"-like appearance in opposition to those of the past two installments. Their hair is all uniformly cut into bob cuts and they share the Bubble Head Nurses' attire, and the Nurses also appear to have purple eyeshadow and lipstick.
They each have an ambiguous, red, square-shaped substance around their mouth, implying that they have either coughed up blood or have been feeding on a bloody carcass. This substance could be blood, paint, or make-up. The Bubble Head Nurses in Silent Hill 2 also have red squares over their mouths, so it may be a reference to this.
They make heavy panting noises and when injured, utter bloodcurdling screams.
Nurses are generally more dangerous than other creatures at the time, particularly those with the revolvers. Those armed with pipes swing away at Heather Mason when she comes close enough, limping towards her until they're in range. They are also capable of jarring the pipes forward, an attack which deals more damage. Those with revolvers should be dealt with immediately, as they can attack from quite a ways away and deal a large amount of damage. They can also pistol-whip Heather if she is in close enough range.
The Nurses are manifestations of Alessa Gillespie's memories of her hospitalization and of Lisa Garland. The Book of Lost Memories says it is also possible these nurses are actual nurses that have been perverted by the power of the Otherworld rather than true manifestations, though the details are unclear.
It's unknown why all of the Nurses have dark hair, but it can be theorized that it relates to Alessa as Alessa had dark hair, and Heather remembers her past life as Alessa.
- Their hair and face structure resemble the Fukuro Lady.
- Some characteristics can link them to the Puppet Nurse from the original Silent Hill game:
- Like the Puppet Nurses, they walk with an arching upper torso, and more closely resemble real people as opposed to disfigured monsters.
- The Nurses' garments are naturally bloodied, but more so toward their upper spine, the same place the Puppet Nurses developed their possessing growths.
- When they are hit, they slowly sway to correct their stance in an awkward manner, almost as if they are being held by invisible puppet strings.
- These Nurses were the base for the ones found in Silent Hill: The Arcade.
- In Silent Hill 4: The Room, a uniform akin to Nurse's can be found in Rachel's apartment room.