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Build ID 917476

Nurse Harrow / Build guide

Arson's Harrowed Nurse

In-game community build · v60 favouritesUpdated 10/27/2026

Built off of Kael's "Harrows Nurse" build, now with more shields + annotations! More combat medic/ gun oriented, since her Spirit Scaling is just okay.

Early Game | L > R | Can get your gun spike using any optional damage items, but Titanic Mag and Healing Booster are Mandatory

Extra Regen

Solid lane regen and builds into Healing Booster

Kinetic Dash

Dash jump with healing bullets out to get MORE healing bullets! (Can sell for Spiritual Overflow later)

Swift Striker

Gun Spike! Can swap this out for Blood Tribute if you have lots of leech stacks (aka not dying)

Trophy Collector

Can swap out for Fortitude in 'Optional Greens' if you're not fighting with team a lot/ pocketing someone

Healing Booster

You're a nurse, you heal. This is a no brainer

Arcane Surge

Dash jump and then cast your leeches, or dash jump then cast ult. Both are good! (Sell for slots/ optional items as needed)

Stamina Mastery

Triple horse for actual escapes (Can swap out for Warp Stone/ other optionals as needed)

Mystic Expansion

Imbue it on your 1. Makes it easier to stack

Duration Extender

Longer ult for safer patients

#Citadel_HeroBuilds_MidGame

Core Items, only needs 1 walker

Greater Expansion

Bigger ult for bigger scares

Superior Cooldown

Around the clock care

Superior Duration

Helps most of your abilities + items

Ricochet

BEST T4 ITEM. Helps heal teammates that are close, helps proc anti heal and deal damage! Amazing Item

Late Game | NOT L > R |

Use your head (Though Ricochet + Tempo + Boundless is great)

Transcendent Cooldown

Healing Tempo

Shoot a teammate across lane and they still get buffs. Fantastic item!

Boundless Spirit

Ricochet + Healing Tempo + Boundless are absolutely busted and line up with your Healing Needles T3 upgrade. Nobody dies now.

Unstoppable

For when they keep stunning you out of your ult. (Also good for stealing mid!)

Spiritual Overflow

Fire rate, Spirit Power, and Spirit Lifesteal all in one. Everything you could ever want!

Indomitable

Break in case of Mo, Holliday, or Doorman

Escalating Exposure

Use if you want your ult to absolutely SHRED the enemy in teamfights

Vampiric Burst

HOW ITEM WORKS: Use the item in "Healing Needles" mode. It will increase healing ammo permanently until its used. You can stack it off cooldown, but it's super niche and not 100% usefull all the time.

Transcendent Cooldown

Only buy if you have a lot of active items

Optional Support ItemsOptional

Knockdown

Helps deal with heroes that fly or have abilities that can be CC'd off of (Vindicta, GT, Celeste, Holliday)

Suppressor

Good item vs heavy gun lanes

Disarming Hex

Break in case of fed Haze/ Silver/ Venator

Rescue Beam

Good against CC like Bebop, Lash, and Holliday, but your healing is already nuts so maybe not needed?

Divine Barrier

Break in case of Pocket

Cursed Relic

For problem patients that NEED to be put to sleep

Optional Damage ItemsOptional

Rapid Recharge

For spamming leeches even more! Your leeches do a lot so this isn't terrible tbh

Blood Tribute

Good item, BUT only good if you have lots of Leech stacks. (Otherwise can skip)

Toxic Bullets

Best Nurse Anti Heal Item (Skip if no enemy tanks/ enemy sustain)

Opening Rounds

Very good straight damage, but Nurse's damage is pretty bad anyways so it's impact is just okay

Fleetfoot

Fast strafe shooting in teamfights. Okay I guess?

Recharging Rush

Can help with getting healing needles back faster, but not necessary majority of the time

Optional GreensOptional

Enchanter's Emblem

Early game spirit resistance in lane. Buy if you know what you're doing, but sell later if slots are needed.

Dispel Magic

Against lots of CC/ DoT that slows your work (Slows, Infernis, Shiv Bleed, etc.)

Warp Stone

For when you need to GTFO asap. (Also gives good bullet resist!)

Counterspell

Press F to say no to Lash (Also good against Warden, Knockdown, Seven, etc.)

Metal Skin

Counterspell but for bullets (Use against fed Haze, Drifter, Venator, etc.)

Fortitude

Can swap out for Trophy Collector if you're constantly fixing lanes solo/ farming jungle

Spirit Resilience

When you're being hit by LOTS of consistent spirit damage.

Spellbreaker

Buy if you are EXPLODING to bursty spirit damage (Lash, Mina, Holliday, etc.)

Late Game Situational Items

Niche + specific situations. "Late Game" category is usually better but use your head

Siphon Bullets

In case they have a VERY tanky comp

Cheat Death

For when you're (correctly) hyperfocused in any fight. Buys time for you to get away

Diviner's Kevlar

People aren't lookin at you when ulting so ehh, but reduced Ult cooldown is nice!

Refresher

Double shift to help patient recovery

Plated Armor

If you needed Metal Skin, might be time to buy this too

Lightning Scroll

Very situational, not terribly good on ult overral unless it's Street Brawl maybe

The BinOptional

Questionable Items that require further research

Enduring Speed

okay I guess? You're not building juggernaut so why are you buying this after Tropy Collector?

Juggernaut

You're not a frontliner so why are we buying this?

Spirit Burn

You don't have enough spirit burst for this

Magic Carpet

Witchmail

You're not very tanky, so this isn't terribly helpful tbh.

← Nurse Harrow wiki

Build ID 917476

Nurse Harrow / Build guide

Arson's Harrowed Nurse

In-game community build · v60 favouritesUpdated 10/27/2026

Built off of Kael's "Harrows Nurse" build, now with more shields + annotations! More combat medic/ gun oriented, since her Spirit Scaling is just okay.

Early Game | L > R | Can get your gun spike using any optional damage items, but Titanic Mag and Healing Booster are Mandatory

Extra Regen

Solid lane regen and builds into Healing Booster

Kinetic Dash

Dash jump with healing bullets out to get MORE healing bullets! (Can sell for Spiritual Overflow later)

Swift Striker

Gun Spike! Can swap this out for Blood Tribute if you have lots of leech stacks (aka not dying)

Trophy Collector

Can swap out for Fortitude in 'Optional Greens' if you're not fighting with team a lot/ pocketing someone

Healing Booster

You're a nurse, you heal. This is a no brainer

Arcane Surge

Dash jump and then cast your leeches, or dash jump then cast ult. Both are good! (Sell for slots/ optional items as needed)

Stamina Mastery

Triple horse for actual escapes (Can swap out for Warp Stone/ other optionals as needed)

Mystic Expansion

Imbue it on your 1. Makes it easier to stack

Duration Extender

Longer ult for safer patients

#Citadel_HeroBuilds_MidGame

Core Items, only needs 1 walker

Greater Expansion

Bigger ult for bigger scares

Superior Cooldown

Around the clock care

Superior Duration

Helps most of your abilities + items

Ricochet

BEST T4 ITEM. Helps heal teammates that are close, helps proc anti heal and deal damage! Amazing Item

Late Game | NOT L > R |

Use your head (Though Ricochet + Tempo + Boundless is great)

Transcendent Cooldown

Healing Tempo

Shoot a teammate across lane and they still get buffs. Fantastic item!

Boundless Spirit

Ricochet + Healing Tempo + Boundless are absolutely busted and line up with your Healing Needles T3 upgrade. Nobody dies now.

Unstoppable

For when they keep stunning you out of your ult. (Also good for stealing mid!)

Spiritual Overflow

Fire rate, Spirit Power, and Spirit Lifesteal all in one. Everything you could ever want!

Indomitable

Break in case of Mo, Holliday, or Doorman

Escalating Exposure

Use if you want your ult to absolutely SHRED the enemy in teamfights

Vampiric Burst

Transcendent Cooldown

Only buy if you have a lot of active items

Optional Support ItemsOptional

Knockdown

Helps deal with heroes that fly or have abilities that can be CC'd off of (Vindicta, GT, Celeste, Holliday)

Suppressor

Good item vs heavy gun lanes

Disarming Hex

Break in case of fed Haze/ Silver/ Venator

Rescue Beam

Good against CC like Bebop, Lash, and Holliday, but your healing is already nuts so maybe not needed?

Divine Barrier

Break in case of Pocket

Cursed Relic

For problem patients that NEED to be put to sleep

Optional Damage ItemsOptional

Rapid Recharge

For spamming leeches even more! Your leeches do a lot so this isn't terrible tbh

Blood Tribute

Good item, BUT only good if you have lots of Leech stacks. (Otherwise can skip)

Toxic Bullets

Best Nurse Anti Heal Item (Skip if no enemy tanks/ enemy sustain)

Opening Rounds

Very good straight damage, but Nurse's damage is pretty bad anyways so it's impact is just okay

Fleetfoot

Fast strafe shooting in teamfights. Okay I guess?

Recharging Rush

Can help with getting healing needles back faster, but not necessary majority of the time

Optional GreensOptional

Enchanter's Emblem

Early game spirit resistance in lane. Buy if you know what you're doing, but sell later if slots are needed.

Dispel Magic

Against lots of CC/ DoT that slows your work (Slows, Infernis, Shiv Bleed, etc.)

Warp Stone

For when you need to GTFO asap. (Also gives good bullet resist!)

Counterspell

Press F to say no to Lash (Also good against Warden, Knockdown, Seven, etc.)

Metal Skin

Counterspell but for bullets (Use against fed Haze, Drifter, Venator, etc.)

Fortitude

Can swap out for Trophy Collector if you're constantly fixing lanes solo/ farming jungle

Spirit Resilience

When you're being hit by LOTS of consistent spirit damage.

Spellbreaker

Buy if you are EXPLODING to bursty spirit damage (Lash, Mina, Holliday, etc.)

Late Game Situational Items

Niche + specific situations. "Late Game" category is usually better but use your head

Siphon Bullets

In case they have a VERY tanky comp

Cheat Death

For when you're (correctly) hyperfocused in any fight. Buys time for you to get away

Diviner's Kevlar

People aren't lookin at you when ulting so ehh, but reduced Ult cooldown is nice!

Refresher

Double shift to help patient recovery

Plated Armor

If you needed Metal Skin, might be time to buy this too

Lightning Scroll

Very situational, not terribly good on ult overral unless it's Street Brawl maybe

The BinOptional

Questionable Items that require further research

Enduring Speed

okay I guess? You're not building juggernaut so why are you buying this after Tropy Collector?

Juggernaut

You're not a frontliner so why are we buying this?

Spirit Burn

You don't have enough spirit burst for this

Magic Carpet

Witchmail

You're not very tanky, so this isn't terribly helpful tbh.