This sand ornament honors the nursing profession which provides such important services to others and it makes a perfect gift as well. Nurses do what nobody else will do, a way that nobody else can do, in spite of all you go through; THAT is to be a Nurse, they call the shots!!! Yes . . . . it is made with REAL SAND and is as durable as ceramic. A tag is attached to each ornament indicating that it is “handcrafted with sand” as well as “Made in Florida-USA” Plus . . FREE SHIPPING!!.