From James Avery, this charm features:  Caregivers and healers, nurses are the nurturers that live their lives with compassion and dedication every day, pledging to care for the sick in their moment of need. sterling silver approx. 0.56" length Crafted in America using the world's finest materials. Due to the personalized nature of James Avery bracelets, we are unable to attach charms and customize your design at dillards.com. Please visit the nearest James Avery store or the James Avery counter at select Dillard's locations to have your new James Avery charm attached at no extra charge. Most local jewelers will also attach the charms for a small fee.