The community ledger

Build ID 923033

Nurse Harrow / Build guide

Milkers

In-game community build · v120 favouritesUpdated 10/25/2026

This hero is actually a tank/initiator. Once you hit mid to mid-late game you should have max level ult. At this point you need to be comming with your team about going. Dive a squishy in their backline, pop vapors when damage starts coming in and loop it with echo shard for 12.8s of invulnerability. Follow up with unstop and ult to take none of the damage from specter crash and roll the enemy team. This is 100% getting nerfed into the ground, enjoy it while you can.

4.8k Gun Spike Options

Highest priority to ensure you have threat, nothing sucks more than people not caring about your M1 on this hero

Intensifying Magazine

Sharpshooter

Opening Rounds

Personal Preference, your milage may vary but I think it's a very strong item on this hero. Helps with applying heals, bullet velocity.

Titanic Magazine

You really can't skip this item, it's way too much value.

Long Range

Greedy Item, replace recharging rush with this and grab sharpshooter fairly early for huge M1 damage. Sharpshooter is the most cost effective gun damage item in the game beyond 15m.

Intensifying Magazine

If my lane partner is a coward or trash you can skip recharging rush but you will probably need it later. This is less useful if you empty mag super fast. More of a shit-lane item.

Sharpshooter

70% weapon damage beyond 15m. It is the most cost effective weapon damage item in the game and synergizes with many elements of this hero's kit.

4.8k Green Spike OptionsOptional

(Get your 4.8k spike IF you need it, if you are doing fine I wouldn't bother with anything to the right of debuff reducer.I would go straight to unstop if possible.)

Extra Regen

Mo regen

Healing Booster

Buy, Buy, Buy, Buy, Buy, stupid value, stupid value (if you aren't getting leeches delay this a bit and rush 4.8k gun spike and mystic regen for threat)

Debuff Reducer

Unstop is non-negotiable on this hero later on, this is actually a really good buy on this hero.

Healing Rite

One rough ass lane if you need this... lol

4.8k Spirit Spike Options

I would generally suggest simply going Radiant Regen and Duration but you may need utility in certain games.

Mystic Regeneration

Nice sustain with leeches on top of her already insane regen. Just left mouse harder.

Duration Extender

You're going to get extender duration eventually, entirely up to you, nice for leeches and is good spend towards 4.8k spike.

Extra Charge

You shouldn't need this but it can be nice if your lane partner is eating shit.

Suppressor

Double M1 lane, kind of meh otherwise.

Slowing Hex

If you must..... But if you need to, don't skimp on it, seriously...

Spirit Sap

Lots of spirit damage and you have the initiative, if they are choosing when to fight you, do not buy this item. They will probably dump damage into you before it lands.

Mid/Late Game

Echo Shard

Absolutely monstrous power spike, this item with duration will allow you to self-vapor twice for up to 12.8s of invulnerability. Follow up with max level ult and take no damage

Unstoppable

You 100% need this item, it is not optional or you will be taken out of ult and specter crash WILL kill you.

Berserker

You're going to be taking an insane amount of damage, this is amazing value. This item and sharpshooter are 140% weapon damage.

Refresher

I'M FUCKING INVINCIBLE!!!!!!!

Siphon Bullets

It's just good.

Healing Tempo

Can be nice but its not something you rush, build finishing item. Plays off of siphon bullets.

Curse

Cheat Death

Counter for curse if they are trying to get you out of vapors early. Will afford you a chance to ult and if they just burned curse then they cannot remove cheat death unless they want to buy another.

Situational Buys

Crippling Headshot

Maybe buy this for a victor, pretty situational though.

Weighted Shots

Applies extremely quickly, is good weapon damage and provides debuff resist which lowers the chance of you being locked down by cc before you can ult.

Blood Tribute

If the enemy has an insane amount of cc this can be very valuable with weighted shots. I would advise against this generally though. You want weapon damage, not fire rate.

Armor Piercer

Haze or Mirage are dumpstering your team. No other reason to buy this and I would honestly consider other items before picking this up probably. Cost too much.

Counterspell

Rem/Lash/Whoever Ult... you know the drill.

Dispel Magic

Remove da deboof. THIS DOES NOT REMOVE SPECTER CRASH, DON'T TRY IT... lol

Greater Expansion

Great value on ult and sticking leeches. I don't think this plays on her leech retrieval range but I could be wrong. Haven't bothered testing.

Boundless Spirit

Kind of blingy, really shouldn't need it but it exists.

Glass Cannon

Your M1 is dogshit...

Indomitable

Alternative to cheat death if they buy curse, I would rather go cheat though, this can easily be popped by other skills at which point the curse is going to remove vapors AND this barrier.

Rapid Recharge

I find that I have way more charges than I need once I am initiating fights, maybe if you really need it earlier in the game but otherwise skip.

Ricochet

You really shouldn't, trust me. It's not as good as you would think it is, especially since you're initiating/tanking. The fire rate is totally unnecessary on this hero.

Ethereal Shift

Not sure about this item, could see some use but I think it's largely a skip. You don't generate threat or damage with this item.

Mystic Vulnerability

See escalating exposure note.

Escalating Exposure

I'm playin with my slugggg. (I don't actually think you want this item but maybe in games where m1 isn't reliable I would lean into this with boundless)

Majestic Leap

Don't try to pop ult off of this, this is a tool to get you in on their backline reliably so you can vapor -> ult combo. Purely a positioning tool. Very Niche.

DO NOT BUY

YOU HAVE INVULN, WHY ARE YOU BUYING RESISTS? DON'T DO THIS.

Build ID 923033

Nurse Harrow / Build guide

Milkers

In-game community build · v120 favouritesUpdated 10/25/2026

4.8k Gun Spike Options

Highest priority to ensure you have threat, nothing sucks more than people not caring about your M1 on this hero

Intensifying Magazine

Sharpshooter

Opening Rounds

Personal Preference, your milage may vary but I think it's a very strong item on this hero. Helps with applying heals, bullet velocity.

Titanic Magazine

You really can't skip this item, it's way too much value.

Long Range

Greedy Item, replace recharging rush with this and grab sharpshooter fairly early for huge M1 damage. Sharpshooter is the most cost effective gun damage item in the game beyond 15m.

Intensifying Magazine

If my lane partner is a coward or trash you can skip recharging rush but you will probably need it later. This is less useful if you empty mag super fast. More of a shit-lane item.

Sharpshooter

70% weapon damage beyond 15m. It is the most cost effective weapon damage item in the game and synergizes with many elements of this hero's kit.

4.8k Green Spike OptionsOptional

(Get your 4.8k spike IF you need it, if you are doing fine I wouldn't bother with anything to the right of debuff reducer.I would go straight to unstop if possible.)

Extra Regen

Mo regen

Healing Booster

Buy, Buy, Buy, Buy, Buy, stupid value, stupid value (if you aren't getting leeches delay this a bit and rush 4.8k gun spike and mystic regen for threat)

Debuff Reducer

Unstop is non-negotiable on this hero later on, this is actually a really good buy on this hero.

Healing Rite

One rough ass lane if you need this... lol

4.8k Spirit Spike Options

I would generally suggest simply going Radiant Regen and Duration but you may need utility in certain games.

Mystic Regeneration

Nice sustain with leeches on top of her already insane regen. Just left mouse harder.

Duration Extender

You're going to get extender duration eventually, entirely up to you, nice for leeches and is good spend towards 4.8k spike.

Extra Charge

You shouldn't need this but it can be nice if your lane partner is eating shit.

Suppressor

Double M1 lane, kind of meh otherwise.

Slowing Hex

If you must..... But if you need to, don't skimp on it, seriously...

Spirit Sap

Lots of spirit damage and you have the initiative, if they are choosing when to fight you, do not buy this item. They will probably dump damage into you before it lands.

Mid/Late Game

Echo Shard

Absolutely monstrous power spike, this item with duration will allow you to self-vapor twice for up to 12.8s of invulnerability. Follow up with max level ult and take no damage

Unstoppable

You 100% need this item, it is not optional or you will be taken out of ult and specter crash WILL kill you.

Berserker

You're going to be taking an insane amount of damage, this is amazing value. This item and sharpshooter are 140% weapon damage.

Refresher

I'M FUCKING INVINCIBLE!!!!!!!

Siphon Bullets

It's just good.

Healing Tempo

Can be nice but its not something you rush, build finishing item. Plays off of siphon bullets.

Curse

Cheat Death

Counter for curse if they are trying to get you out of vapors early. Will afford you a chance to ult and if they just burned curse then they cannot remove cheat death unless they want to buy another.

Situational Buys

Crippling Headshot

Maybe buy this for a victor, pretty situational though.

Weighted Shots

Applies extremely quickly, is good weapon damage and provides debuff resist which lowers the chance of you being locked down by cc before you can ult.

Blood Tribute

If the enemy has an insane amount of cc this can be very valuable with weighted shots. I would advise against this generally though. You want weapon damage, not fire rate.

Armor Piercer

Haze or Mirage are dumpstering your team. No other reason to buy this and I would honestly consider other items before picking this up probably. Cost too much.

Counterspell

Rem/Lash/Whoever Ult... you know the drill.

Dispel Magic

Remove da deboof. THIS DOES NOT REMOVE SPECTER CRASH, DON'T TRY IT... lol

Greater Expansion

Great value on ult and sticking leeches. I don't think this plays on her leech retrieval range but I could be wrong. Haven't bothered testing.

Boundless Spirit

Kind of blingy, really shouldn't need it but it exists.

Glass Cannon

Your M1 is dogshit...

Indomitable

Alternative to cheat death if they buy curse, I would rather go cheat though, this can easily be popped by other skills at which point the curse is going to remove vapors AND this barrier.

Rapid Recharge

I find that I have way more charges than I need once I am initiating fights, maybe if you really need it earlier in the game but otherwise skip.

Ricochet

You really shouldn't, trust me. It's not as good as you would think it is, especially since you're initiating/tanking. The fire rate is totally unnecessary on this hero.

Ethereal Shift

Not sure about this item, could see some use but I think it's largely a skip. You don't generate threat or damage with this item.

Mystic Vulnerability

See escalating exposure note.

Escalating Exposure

I'm playin with my slugggg. (I don't actually think you want this item but maybe in games where m1 isn't reliable I would lean into this with boundless)

Majestic Leap

Don't try to pop ult off of this, this is a tool to get you in on their backline reliably so you can vapor -> ult combo. Purely a positioning tool. Very Niche.

DO NOT BUY

YOU HAVE INVULN, WHY ARE YOU BUYING RESISTS? DON'T DO THIS.