Nurse (Homecoming)

The Demon Nurse, or simply Nurse, is a nurse-themed monster appearing in Silent Hill: Homecoming and Silent Hill: Downpour - Anne's Story, serving as the first enemy that Alex Shepherd encounters in the Otherworld. They are a counterpart to the Dark Nurse of the Silent Hill film and its sequel, manifesting from the psyches of Shepherd and Anne Marie Cunningham.

The Nurse was featured as a playable monster in the 2021 crossover Dark Deception: Monsters & Mortals - Silent Hill.

Gameplay
Nurses are initially rather easy enemies to overcome and can be defeated using melee combos with the knife; the beginning the Nurses are likely easy to allow the player to get adjusted to the gameplay like a tutorial. Later in the game however, they become significantly more dangerous, being able to use incredibly quick slashes in rapid succession, which makes approaching or even escaping them difficult. If a Nurse is allowed to continue slashing in this manner, they will relentlessly attack until Alex is dead, even if the player has full health at the beginning of this encounter. Utilizing Alex's mobility (namely dodging) makes Nurse encounters easier to deal with and get out of sticky situations. If combat needs to be avoided altogether, turning off the flashlight will lower the chance of being attacked by a nurse provided he moves slowly and maintains a reasonable distance. A drawback of this is that it also hinders Alex, as without the illumination it provides, he is often plunged into complete darkness. Normally, they are found in groups of three or more, making direct confrontation all the more dangerous.

Later in the game namely the Fitch's office and Shepherd Glen's town hall the Nurses are in groups which can prove deadly as they can nearly overwhelm Alex if not careful; fighting with the light off or slowly passing through them in darkness is beneficial. If The player accidentally walks into another Nurse while the light is off they won't attack Alex but running into them will. Once the player does enough damage to the Nurses, if a 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. If with the fire axe, Alex will decapitate her from behind.

Appearance and symbolism
The Demon Nurses are similar in behavior and appearance to the Dark Nurses of the 2006-2012 film universe, which were adapted from the Bubble Head Nurse of Silent Hill 2. They wear short-cut hospital uniforms and high heels; their faces are distorted and featureless. The creature is known for its twitchy spastic movements and attraction to any source of light and sound, remaining frozen until alerted. When illuminated by certain light sources, a fetus can be seen through their translucent stomachs.

The Nurse may represent Alex Shepherd's institutionalization in the mental hospital for four years and his suppressed libido as a result. In his diary, he speculates that the nurses in the military hospital were sexualized to comfort the wounded soldiers. However, because he was never actually in the military, these nurses are likely a delusion of his mind to help him cope with his confinement.

"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.""

Alex also writes that he was once sedated by the nurses, potentially explaining their hostility:

"When I woke up, I was screaming. I wasn't sure if I was awake or not, because I was still in the hospital and it was dark. But then the nurses ran in. I couldn't calm down, so eventually they stuck me with a needle and sedated me. That's why all of this is kind of a blur. I'm still a little loopy from the drugs."

In other media

 * The Nurse appears in Anne's Story, a tie-in comic to Silent Hill: Downpour, as a metaphor for Anne Marie Cunningham's unwillingness to put her father in a nursing home following his cognitive decline.
 * The Nurse was included as a playable character in the crossover Dark Deception: Monsters & Mortals - Silent Hill (2021).

Trivia

 * The Nurse adapts much of its design and mannerisms from the Dark Nurse of the film universe, which in turn shares characteristics with the Bubble Head Nurse of Silent Hill 2.
 * The Nurses are equipped with jiggle physics.
 * When the player kills the first nurse on the Xbox 360 version in the hospital, they will receive the achievement "Alchemilla's Finest".
 * The Nurse is Homecoming director Jason Allen's favorite monster in the game.
 * Alex Shepherd grew up in a religious cult that sacrifices children to a deity, which possibly explains the fetuses in the Nurse's womb. He is also responsible for the death of his younger brother, Joshua.

Creator's comment
"Regardless of individual opinion about the movie, they did a great job on character and set design, we felt it was in our best interest to show those potential game players a connection to the movie, when they may not have played any of the previous games."

- Jason Allen

"The film – if it provided anything – gave us visual references, not story, not characters, but stylistic cues on where to take our own character designs and that’s all. There is a motto I like to live by Take what is useful, discard what is useless, add that which is specifically your own. We haven’t tied the new game to the film. They are their own entities, equally valid but different stories in the same universe."

- Jason Allen

"It’s going to sound perhaps a little ordinary but I really like how the nurse turned out. She has some wonderful detection behaviors, and her staccato movement style is very distinctive. All the characters in the game have their unique styles or behaviors that are appealing and it’s hard to play favorites, but if you pushed me, I’d say the nurse."

- Jason Allen