Varchas: The Dour-Faced Nurse's Approval

 is considered a Varchas Quality in Sunless Sea.

Linked to
The Pilgrimage to Amaradri, The Charitable Hospital

Quality description
"It is hard-earned."

Obtaining
Head to The Charitable Hospital and help out the Dour-Faced Nurse, either using one of your Doctor Officers or a  Hearts Challenge.

Interactions
This is one of the requirements for the The Pilgrimage to Amaradri