Bubble Head Nurse

The Bubble Head Nurses are monsters appearing in Silent Hill 2 and the spin-offs Silent Hill: The Escape and Silent Hill: Book of Memories. A manifestation of James Sunderland's subconscious, they were first encountered when James Sunderland entered Brookhaven Hospital after coming to Silent Hill, Maine, in search of his deceased wife. They can be seen both in the hospital and the streets of South Vale.

Character
They emit shrieks and gurgles when approaching him and carry their own melee weapons, usually pipes similar to James's. They are fairly aggressive and will surround James if he encounters more than one in an area. However, if they come in close contact with one another and decide to attack, chances are they will harm one of their own close by.

It is advised to fight them from range either with the handgun or shotgun, as a blow from their pipes can do quite a bit of damage. In the hospital, it is advised to use the shotgun, due to the narrow corridors, and because they tend to travel in groups. Melee is not the best option for fighting them, but if the need arises, the steel pipe is the favored option due to its range.

Silent Hill 2
When James Sunderland reaches Brookhaven Hospital in search of his late wife Mary, he is stalked by the Bubble Head Nurses for the duration of his stay. When the town cycles into the Otherworld, the equivalent of REM-sleep in this reality-state, a more demonic variation of the nurse surfaces, and they continue to stalk him until he reaches the Silent Hill Historical Society and transitions to an even deeper part of the nightmare.

Silent Hill: The Escape
The Bubble Head Nurses appear as recurring enemies in the 2008 iOS mobile shooter Silent Hill: The Escape.

Silent Hill: Book of Memories
In the dungeon crawler spin-off Silent Hill Book of Memories, they are simply called "Nurses" (as opposed to their full name) and are one of the first enemies to be encountered in the game, appearing in the first zone onwards. The player can encounter light, blood, and steel versions of the nurse.

Armed with a steel pipe, they usually attack in groups, are fairly fast, and will attempt to surround the player; however, their attacks only cause a small amount of damage, and they are fairly easy to kill, especially from range. They also have a weakness to the steel pipe, the same weapon which they wield.

If the player has the Expansion Pack, they can also wear Bubble Head Nurse masks, called the "Creature Head".

Silent Hill: Downpour
Bubble Head Nurses only appear in the "Surprise!" ending, attending Murphy Pendleton's surprise birthday party, along with James, Mary, Laura, Heather, and all the other characters from Silent Hill: Downpour.

Guest appearances
The Bubble Head Nurse appears as the Bubble Head Bomber in Super Bomberman R: one of the several monsters who lives in a dilapidated hospital on the barren world of Planet Silent Hill. Although she takes the form of a nurse, her true form is unknown. The Bubble Head Bomber and other inhabitants of the hospital sometimes fall prey to Pyramid Head.

Design and symbolism
"When I worked on designing creatures in Silent Hill 2, I really made them have their each meaning of appearance on the true reason of James's journey. Because they are something like illusions from his subconscious, not only creatures to take the score."

- Masahiro Ito

The Bubble Head Nurse is a female humanoid creature, roughly the same height as Mary Sunderland, that appears in a sexualized low-cut Brookhaven Hospital nurse uniform. Their heads are wrapped in a thin vinyl mask containing a semi-liquid (mixed with thinned blood) covering the surface of their face. The liquid-trapped mask gives the head a swollen appearance reminiscent of Mary's swollen head during her illness and hospitalization. The bottom center of the mask takes the shape of an infant's face, sometimes obscured by a red square covered in dried dirt or blood tied to the save points and the nine red squares that James encounters at the end of the game. The Nurses are seen constantly twitching and jittering, as they suffocate and attempt to shake the liquid-filled masks from their heads.

The baby face symbolizes James and Mary's desire for a child. The suffocation that the Nurses experience is also representative of James's subconscious memory of smothering Mary with a pillow. The nurse uniforms are reflective of James's sexuality, possibly stemming from the time he spent with Mary in the hospital. A dirtier brown-tinted variant of the nurses can be seen in the Otherworld wearing tattered clothing, a mask with spikes driven through it, and a protrusion coming from their back and shoulder. According to creature designer Masahiro Ito, this variant of the Nurse was a last-minute addition to the game, so the symbolism behind it wavers slightly. However, it serves as a metaphor for Mary on her sickbed. Despite fan speculation, the protrusion is in no way connected to the Parasite or Puppet Nurses from the original game. Ito clarified that the design of the nurse reflects James's subconscious and not Mary's feelings.

Trivia

 * At one point in Silent Hill 2's development, the Bubble Head Nurse's face mask was intended to burst like a balloon when taking damage to the head (such as from a gunshot). Their weapon was also going to be a blood transfusion stand. Eventually, it was changed to a steel pipe as an homage to Harry Mason.
 * Despite being a manifestation of James Sunderland's subconscious, similar monsters have appeared in Silent Hill: Origins and Silent Hill: Homecoming.
 * When asked why the Brookhaven Hospital nurses in Silent Hill 2 and Silent Hill 3 are distinct from one another, Masahiro Ito replied, "Because they had different protagonists." However, because the Silent Hill 3 nurses are callbacks to the Puppet Nurses from Alessa Gillespie's nightmare, but with red squares and Brookhaven uniforms, Ito referred to them as "a cross between 1 and 2's nurses".
 * In the E3 trailer for Silent Hill 2, Bubble Head Nurses can be seen in the streets of South Vale during the Fog World segments. This was not present in the final game.
 * The Silent Hill 2 BradyGames strategy guide by Dan Birlew refers to them as "Nurse Demons". However, this should not necessarily be accepted as an official name because it never appears anywhere else, and even the official strategy guides occasionally have errors.
 * Masahiro Ito drew inspiration for the design of the nurses' attire from The Exorcist III, Jacob's Ladder, and bondage outfits.
 * The red boots worn by the Gecco figurine were repurposed from Ito's concept art for the Lying Figure.
 * Similar nurse monsters appear in the Silent Hill film and Silent Hill: Revelation, referred to in the credits as "Dark Nurses". As nurses of Brookhaven Hospital, they take a similar appearance to the Bubble Head Nurse.
 * A Bubble Head Nurse costume could be purchased in the now-defunct PlayStation Home.