qw does not require you to add commas yourself. Try this instead:

use base qw/NursingOptions::Nurse NursingOptions::Misc NursingOptions:
+:Certifications/;
[download]

While this might fix your error, do heed dragonchild's advice. Of course, sometimes starting over and doing it "the right way" just isn't practical. In your case, i hope it is. :)

L-LL-L--L-LL-L--L-LL-L--
-R--R-RR-R--R-RR-R--R-RR
B--B--B--B--B--B--B--B--
H---H---H---H---H---H---
(the triplet paradiddle with high-hat)