Puppet Nurse

Not to be confused with the Bubblehead Nurse which featured in later Silent Hill games, the Puppet Nurse is essentially the corpse of a nurse being driven by a huge parasite which can be seen on the back of the body. It's clear that the human consciousness is long gone as there is not even a flicker of their past selves. Due to the sheer size of the parasite, it tears right through their white dresses and cardigans which causes the host to have a severe hunch. They are all encountered in Otherworld by Harry Mason.

The Puppet Nurses have three slightly different appearances with the human faces and hair colours being different as well as the colour of the cardigans that they wear over their white dresses. The nurse with the green cardigan appears to be the strongest variant, with the brunette nurse wearing a blue cardigan being slightly weaker. The weakest is the blonde-haired nurse wearing a blue cardigan. They all wear old-fashioned nurse hats and white pumps. As they are represented as hospital staff, they have access to tools such as scalpels which they will use to cut their targets. Interestingly, they have also been known to work in tandem with other Puppet Nurses - for example it's possible for one to put Harry into a kind of submission hold and keep him steady whilst another uses the opportunity to stab him repeatedly.

The parasite itself can also take some actions independently of its host if required, indicating that it is in fact simply driving the nurse body. It's also worth noting that they have severe death throes - seemingly showing the parasite losing control of its host and has no alternative but to thrash around. It's also interesting to note that the parasite theoretically has the ability to leave their host if necessary and move onto another but never appears to do this with the Puppet Nurse, most likely because there are no viable hosts nearby.

Also, like their not-so-distant cousins, they react strongly to sound and light. So it's possible for Harry to simply sneak around them if he is quiet and keeps his Flashlight switched off.

Finally, in terms of their symbolism they represent Alessa Gillespie's skewed view of cultism, particularly what she has observed from The Order and the Alchemilla Hospital staff assigned to keep her alive in a basement such as Lisa Garland. Essentially, they were forced to do things they didn't want to do which is essentially what the Parasite does to the Puppet Nurse.