diff --git a/.env.example b/.env.example
index 0eed2881..b0844ffd 100644
--- a/.env.example
+++ b/.env.example
@@ -55,8 +55,8 @@ RATE_LIMIT_MACHINE_INGEST=120
 RATE_LIMIT_MACHINE_AGENT=60
 RATE_LIMIT_MOBILE_AUTH=60
 RATE_LIMIT_MOBILE_API=120
-HUMMINGBIRD_PATIENT_CONTEXT_KEY=
-HUMMINGBIRD_PATIENT_CONTEXT_TTL_MINUTES=15
+NIGHTINGALE_CONTEXT_KEY=
+NIGHTINGALE_CONTEXT_TTL_MINUTES=15
 RATE_LIMIT_PATIENT_ENROLLMENT=5
 RATE_LIMIT_PATIENT_CREDENTIAL_EXCHANGE=5
 RATE_LIMIT_PATIENT_AUTH=30
@@ -79,58 +79,58 @@ CARE_PATHWAYS_DEMO_ENABLED=false
 
 # Hummingbird Patient is an independent patient identity/API realm. Every
 # capability remains fail-closed until its explicit deployment gate is enabled.
-HUMMINGBIRD_PATIENT_ENABLED=false
-HUMMINGBIRD_PATIENT_ENROLLMENT_ENABLED=false
-HUMMINGBIRD_PATIENT_TOKEN_EXCHANGE_ENABLED=false
-HUMMINGBIRD_PATIENT_PROFILE_ENABLED=false
-HUMMINGBIRD_PATIENT_SESSION_MANAGEMENT_ENABLED=false
-HUMMINGBIRD_PATIENT_ENCOUNTERS_ENABLED=false
-HUMMINGBIRD_PATIENT_TODAY_ENABLED=false
-HUMMINGBIRD_PATIENT_PATHWAY_ENABLED=false
-HUMMINGBIRD_PATIENT_PATHWAY_HISTORY_DRAFTS_ENABLED=false
-HUMMINGBIRD_PATIENT_PATHWAY_SOURCE_RECONCILIATION_ENABLED=false
-HUMMINGBIRD_PATIENT_PATHWAY_HISTORY_RELEASES_ENABLED=false
-HUMMINGBIRD_PATIENT_PATHWAY_HISTORY_CURRENT_AFTER_MINUTES=30
-HUMMINGBIRD_PATIENT_PATHWAY_HISTORY_STALE_AFTER_MINUTES=240
-HUMMINGBIRD_PATIENT_TEACH_BACK_ENABLED=false
-HUMMINGBIRD_PATIENT_CARE_PREFERENCES_ENABLED=false
-HUMMINGBIRD_PATIENT_GOALS_ENABLED=false
-HUMMINGBIRD_PATIENT_ROUNDS_QUESTIONS_ENABLED=false
-HUMMINGBIRD_PATIENT_ROUNDS_SUMMARY_ENABLED=false
-HUMMINGBIRD_PATIENT_CARE_TEAM_ENABLED=false
-HUMMINGBIRD_PATIENT_MESSAGING_ENABLED=false
+NIGHTINGALE_ENABLED=false
+NIGHTINGALE_ENROLLMENT_ENABLED=false
+NIGHTINGALE_TOKEN_EXCHANGE_ENABLED=false
+NIGHTINGALE_PROFILE_ENABLED=false
+NIGHTINGALE_SESSION_MANAGEMENT_ENABLED=false
+NIGHTINGALE_ENCOUNTERS_ENABLED=false
+NIGHTINGALE_TODAY_ENABLED=false
+NIGHTINGALE_PATHWAY_ENABLED=false
+NIGHTINGALE_PATHWAY_HISTORY_DRAFTS_ENABLED=false
+NIGHTINGALE_PATHWAY_SOURCE_RECONCILIATION_ENABLED=false
+NIGHTINGALE_PATHWAY_HISTORY_RELEASES_ENABLED=false
+NIGHTINGALE_PATHWAY_HISTORY_CURRENT_AFTER_MINUTES=30
+NIGHTINGALE_PATHWAY_HISTORY_STALE_AFTER_MINUTES=240
+NIGHTINGALE_TEACH_BACK_ENABLED=false
+NIGHTINGALE_CARE_PREFERENCES_ENABLED=false
+NIGHTINGALE_GOALS_ENABLED=false
+NIGHTINGALE_ROUNDS_QUESTIONS_ENABLED=false
+NIGHTINGALE_ROUNDS_SUMMARY_ENABLED=false
+NIGHTINGALE_CARE_TEAM_ENABLED=false
+NIGHTINGALE_MESSAGING_ENABLED=false
 # Required before enabling any patient feature outside automated tests. Use an
 # independent random value of at least 32 characters; never reuse APP_KEY.
-HUMMINGBIRD_PATIENT_HMAC_SECRET=
-HUMMINGBIRD_PATIENT_POLICY_VERSION=patient-disclosure-v1-draft
-HUMMINGBIRD_PATIENT_ACCESS_TTL_MINUTES=15
-HUMMINGBIRD_PATIENT_REFRESH_TTL_DAYS=14
-HUMMINGBIRD_PATIENT_ENROLLMENT_MAX_ATTEMPTS=5
-HUMMINGBIRD_PATIENT_REFERENCE_PROVISIONING_ENABLED=false
-HUMMINGBIRD_PATIENT_REFERENCE_ENCRYPTION_KEY_VERSION=
-HUMMINGBIRD_PATIENT_REFERENCE_CHALLENGE_TTL_MINUTES=10
+NIGHTINGALE_HMAC_SECRET=
+NIGHTINGALE_POLICY_VERSION=patient-disclosure-v1-draft
+NIGHTINGALE_ACCESS_TTL_MINUTES=15
+NIGHTINGALE_REFRESH_TTL_DAYS=14
+NIGHTINGALE_ENROLLMENT_MAX_ATTEMPTS=5
+NIGHTINGALE_REFERENCE_PROVISIONING_ENABLED=false
+NIGHTINGALE_REFERENCE_ENCRYPTION_KEY_VERSION=
+NIGHTINGALE_REFERENCE_CHALLENGE_TTL_MINUTES=10
 # Messaging additionally fails closed until a multidisciplinary-approved local
 # policy supplies urgent-help language, response expectations, and key labels.
-HUMMINGBIRD_PATIENT_MESSAGING_POLICY_STATUS=draft_requires_approval
-HUMMINGBIRD_PATIENT_MESSAGING_POLICY_VERSION=
-HUMMINGBIRD_PATIENT_MESSAGING_URGENT_GUIDANCE_VERSION=
-HUMMINGBIRD_PATIENT_MESSAGING_URGENT_GUIDANCE_TEXT=
-HUMMINGBIRD_PATIENT_MESSAGING_DEFAULT_RESPONSE_WINDOW=
-HUMMINGBIRD_PATIENT_MESSAGING_ENCRYPTION_KEY_VERSION=
-HUMMINGBIRD_PATIENT_MESSAGING_ENCRYPTION_KEY=
+NIGHTINGALE_MESSAGING_POLICY_STATUS=draft_requires_approval
+NIGHTINGALE_MESSAGING_POLICY_VERSION=
+NIGHTINGALE_MESSAGING_URGENT_GUIDANCE_VERSION=
+NIGHTINGALE_MESSAGING_URGENT_GUIDANCE_TEXT=
+NIGHTINGALE_MESSAGING_DEFAULT_RESPONSE_WINDOW=
+NIGHTINGALE_MESSAGING_ENCRYPTION_KEY_VERSION=
+NIGHTINGALE_MESSAGING_ENCRYPTION_KEY=
 # JSON object of version -> base64:... decryption-only keys retained during
 # governed rotation. Load from protected secret storage; never commit values.
-HUMMINGBIRD_PATIENT_MESSAGING_PREVIOUS_ENCRYPTION_KEYS_JSON=
+NIGHTINGALE_MESSAGING_PREVIOUS_ENCRYPTION_KEYS_JSON=
 # Optional override for the fully qualified class implementing
 # PatientMessageHandoffReadiness. The built-in database handoff consumer is the
 # default, but still reports unavailable until its separate staff policy,
 # pilot-unit pools, memberships, and fresh worker heartbeat are all ready.
-HUMMINGBIRD_PATIENT_MESSAGING_HANDOFF_CONSUMER=
-HUMMINGBIRD_PATIENT_STAFF_MESSAGING_ENABLED=false
-HUMMINGBIRD_PATIENT_STAFF_MESSAGING_POLICY_STATUS=draft_requires_approval
-HUMMINGBIRD_PATIENT_STAFF_MESSAGING_PILOT_UNIT_IDS=
-HUMMINGBIRD_PATIENT_STAFF_MESSAGING_HEARTBEAT_TTL_SECONDS=120
-HUMMINGBIRD_PATIENT_STAFF_MESSAGING_BATCH_SIZE=100
+NIGHTINGALE_MESSAGING_HANDOFF_CONSUMER=
+NIGHTINGALE_STAFF_MESSAGING_ENABLED=false
+NIGHTINGALE_STAFF_MESSAGING_POLICY_STATUS=draft_requires_approval
+NIGHTINGALE_STAFF_MESSAGING_PILOT_UNIT_IDS=
+NIGHTINGALE_STAFF_MESSAGING_HEARTBEAT_TTL_SECONDS=120
+NIGHTINGALE_STAFF_MESSAGING_BATCH_SIZE=100
 
 # Browser-origin policy. Same-origin browser requests do not require CORS.
 # List only explicitly approved cross-origin browser clients; never use "*".