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President Brian Sandoval: Welcome back, Wolf Pack Family. I'm your host, Brian Sandoval, a proud graduate and the president of the University of Nevada. Nevada currently faces a nursing workforce shortage. Just to catch up to the national average, not surpass it, Nevada would need nearly 5,000 more registered nurses and over 700 advanced practice nurses. Nursing education programs around the state and the Orvis School of Nursing here at the University have made great strides to help meet the workforce demand. Today, we'll explore the work so far and what is planned for the future.

I'm excited to have two guests joining us on the podcast today from the Orvis School of Nursing. Dr. Charlie Yingling, the dean of the school, and Dr. Shannon Richard, associate dean for undergraduate studies. A national leader in nursing education and workforce policy, Dr. Yingling is advancing initiatives that address Nevada's nursing shortage through academic innovation, community partnerships and rural health engagement. His leadership is driving growth at the Orvis School of Nursing, including the expansion of nursing education at the University's Lake Tahoe campus. A first-generation college graduate, Dr. Yingling completed his Bachelor of Science in Nursing at Loyola University Chicago, followed by a master's degree as a family nurse practitioner and a Doctor of Nursing Practice at the University of Illinois Chicago. His extensive academic experience includes nearly two decades at Carnegie R1 institutions, where he has excelled in leadership roles with a focus on student success, academic excellence and inclusive education.

Dr. Richard leads OSN (Orvis School of Nursing) undergraduate programs and is deeply involved in launching the school's new presence at the Lake Tahoe campus. Her work ensures that nursing graduates are clinically prepared and equipped to serve diverse communities. She earned her Bachelor of Science in Nursing and her Master of Science in Nursing from our University — our great University — and then went on to complete her doctorate in nursing from the University of Nevada, Las Vegas. Dr. Richard has taught various courses on campus since 2012.

It's amazing. Today's podcast is being recorded in @One in the Mathewson-IGT Knowledge Center, right here on campus. Dean Yingling and Dr. Richard — and can I call you Charlie and Shannon?

Charlie Yingling: Would you please?

Shannon Richard: Of course.

Sandoval: I look forward to chatting with you about the importance of nursing education in our state and the exciting plans your school has to meet the workforce demand. So, let's dive right into the topic at hand — the nursing shortage in Nevada. Charlie, what makes Nevada's nursing shortage unique, and how is the Orvis School of Nursing responding?

Yingling: Thanks so much for that question. One of the unique features of our nursing shortage is the extraordinary divide between rural and urban Nevada. As a state with two urban centers, the rest of Nevada is rural and frontier. It's two very, very different kinds of nursing practice, and so the types of practice environments that would attract some nurses are not necessarily present in our state. That really drives the persistent nursing shortage. The other factor is our proximity to California. From a wage perspective, California nurses earn a higher wage than Nevada nurses, and so it is understandable, in pursuit of higher wages, that nurses want to leave the state.

Those are the challenges we are facing, but there are solutions, and those are the solutions we are working toward. One of our key initiatives has been growing enrollment. As you acknowledged, the first phase of that enrollment growth is going to be up at the Lake Tahoe campus, which I am sure we will talk about a little bit further. The other thing we are looking at doing in the very near future is relaunching our accelerated Bachelor of Science in Nursing program. This is a one-year accelerated program for people who already hold a science degree or a degree with the requisite pre-nursing credits. This is a great option for people who are considering nursing as a second career, as it gives them a 12-month pathway to become a registered nurse with the incredible Orvis School of Nursing baccalaureate degree.

We are also working closely with our partners at Nevada Online to expand our presence in the online learning space. All of our advanced practice nursing programs — nurse practitioner, nurse educator, nurse leader — are available fully online throughout the country, as well as our bachelor's completion program. In our Nevada nursing workforce, a large proportion of nurses are prepared at the associate degree level from community colleges, and we have a wonderful program to offer them the [ҹɫ��Ƶ] baccalaureate degree fully online. These are some of the strategies we are using to address workforce issues but also our overall growth strategy.

Sandoval: No, that's incredible. And maybe to follow up a little bit downstream, obviously we want to grow the number of students, have students out there that are eager to engage in healthcare. I'm a novice, so you'll have to help me out with the nomenclature on this, but they have to do their rounds; they have to go to the hospitals to learn and get that in-person learning. Are there enough slots there to be able to handle more students, Shannon?

Richard: Well, it certainly is a challenge that we are facing. We're talking about strategies for this every day. One of the components supported by the Nevada State Board of Nursing is our simulation program and our ability to maximize the simulation so that it counts as high-quality clinical experience. The partnerships that we have with local hospitals and community centers are certainly integral in being able to get our students the clinical hours that are required.

Sandoval: When I talk to people out in the community, and you talk about these numbers, we have such a large shortage. Some may say this is insurmountable, but we can do this. Correct?

Yingling: Yes, we can. And I think, as Shannon alluded, those partnerships are going to be the foundation for how we do that, and we'll talk a little bit more, if time permits regarding partnerships. The one thing I do want to dovetail on from what Shannon said is that, at the baccalaureate level, those clinical experiences are highly supervised. At the graduate level, for nurse practitioner students, those are more experiential learning opportunities. I want to call that out because it is a key differentiator of our nurse practitioner programs compared to many nurse practitioner programs in this country. We will not admit a student into one of our programs unless we can arrange clinical experiences for them, regardless of where they are. There is an unfortunate reality that many nurse practitioner programs admit students and then tell those students to find a place to be a clinical learner. We simply will not do that, and I think that's another key differentiator for our graduate program at [the University]..

Sandoval: Go, Orvis School! No, that's great. That's an amazing service to our students. So, Shannon, obviously, nurses play a major role in healthcare around the country and the world. Can you speak to the role nurses play in addressing the state's biggest health challenges?

Richard: The nurses are on the front lines every day. What really makes nursing so special is their presence with patients, with their families and with their community. Our role is to provide care for, to educate and to promote the best outcomes for those we serve. In Nevada, we face a high prevalence of chronic illnesses such as heart disease, cancer and diabetes. The care for and management of those conditions is led by nurses, whether in acute care, long-term or community settings. Our nurses are concerned about the limited access to care in this state—not only in rural areas, but in urban areas as well. They lobby for increased access to opportunities with legislators and policymakers, and some of us actually write and influence the policies affecting healthcare and its access, no matter which type of nursing they specialize in. Nurses are leaders in combating the mental health crisis in our state. They advocate for suicide awareness and prevention, connect people to resources and promote best practices in the management of depression, anxiety and substance use disorder.

Sandoval: It's overwhelming what they know and what they have to treat, but that's one of the things I'm so proud of our students and graduates from the Orvis School—they're prepared so well in the unfortunate circumstance that we have friends or loved ones that are hospitalized locally. I have the opportunity to chat with some of those nurses in there. They always talk about how proud they are and the good training that they received at the Orvis School. So, Charlie, I'm going to move back to you. You've been here a year now?

Yingling: Ten months, almost we are getting close.

Sandoval: So just now having 10 months in the dean's seat, what are your observations and what do you see happening in the future for the Orvis School?

Yingling: Well, I have to say, 10 months has flown by in a very, very good way in that there is an extraordinary amount of energy and momentum at both the level of the Orvis School of Nursing, but also the University's commitment and investment in our school. I view us as being in a very critical growth stage right now. Developmentally, though we are the oldest school of nursing in Nevada, we're at this point of growing quite a bit in the coming years.

 Just to give you some examples—and I will risk talking about this all day—the spaces we're growing in are very, very exciting: from the teaching side of things, from the research and scholarship side of things, and certainly from the clinical practice perspective. Our Office of Global Engagement was newly formed in November–December of last year. This is led by two of our faculty who have a longstanding commitment to global engagement, one of whom, Dr. Shandell, is about to go as a Fulbright Scholar next semester later this year. But we've been working to expand opportunities for our students to have global learning experiences. Our three nurse practitioner students just came back from Cambodia, where they were working alongside one of our journalism students who recently graduated, in a truly bi-directional learning experience—not simply being a clinical tourist in another country, but bringing our expertise to enrich the nursing workforce at the hospital where they were working, as well as taking learning experiences home with them. 

Our Office of Research and Innovation is rolling our research mission exponentially. We are a newly R1 institution, and it's really exciting to have Dr. Alexa Curtis, our associate dean for research and innovation, leading that work to help us contribute to that R1 designation. We're currently in the process of exploring a Ph.D. program launch, another important contribution to our R1 designation. I'm just naming initiatives right now, but one that I'm particularly excited about, because it recently received a substantial investment from a donor, is our Tribal Academy for Nursing. We do not have a nursing workforce that represents the proportion of our state who identify as tribal affiliated or Native American/Indigenous. The Tribal Academy, led by Professor Julie Sawyer, is really working to outreach to tribal communities to present nursing as a viable career pathway and then bring those supports that will help a person—from middle school, high school onward—to be successful in their nursing studies. So, a lot of great work happening. That's just the tip of the iceberg, though. I'll stop there.

Sandoval: No, that is a lot of great work. And one of the things — and either of you can respond to this question — but my understanding is that we get way more applicants than we do have slots. So,there are some really qualified students that, unfortunately, we have to turn away and perhaps they go to other nursing schools and that's great. But do you see some growth in your classes? I'll get to the Lake Tahoe campus next.

Yingling: Absolutely, yes. One of the things I always say is we're root bound right now. We admit the absolute maximum number of students we can seat in a classroom and place clinically. Dr. Richard is working very, very hard at growing those clinical experiences. And if all goes to plan, we will undergo some renovations over the coming year that will expand our admission capacity for the Reno campus. 

Sandoval: And how many students do we accept, Shannon?

Richard: Ninety-six.

Sandoval: Ninety-six. 

Richard: Twice a year.

Sandoval: Twice a year. And then how much growth do you think, if everything fell into place, that we could add to that class?

Richard: We're looking at expanding our programs and opportunities, so looking potentially 150.

Sandoval: Wow, okay. We're going to make a dent in that 700. No, that's great. So, we've been alluding to the Lake Tahoe campus, and I'm really excited to share with our listeners the expansion of the nursing program at our gorgeous, amazing Lake Tahoe campus. So, Shannon, can you share how the world-focused initiative up there will impact nursing education and the communities it serves?

Richard: Absolutely. We are so excited to embark on this initiative. This residential nursing track is unique in that the students live, learn and experience clinical rotations in the Lake Tahoe Basin and then beyond in the rural communities, as well as with the associate dean who oversees this new learning experience. One of the components that I find most comforting and most compelling is our group travel that we can extend into the rural communities. One of the ways that we're able to do this is with the sprinter vans. These vans will safely transport an entire group of clinical students and their faculty through the east and the I-80 corridor and then also to the south in our communities. That is comforting to me because the transport into our rural communities is one of the safety concerns that we considered. That's a wonderful component there.

But these nursing cohorts will also immerse themselves into the nearby communities surrounding Incline Village, and we will be immersed in the hospitals, the community centers and the schools in the Tahoe Basin. When students build this connection to places where they train, they have an increased probability that they will stay and become active members of the community, bringing a positive impact. Our track leader for this Lake Tahoe track, Professor Julie Sawyer, has specialized expertise in rural health nursing. She'll be teaching the rural health theory class and also overseeing the program's activities.

Sandoval: So, when will the program begin? Do you have an idea?

Yingling: We're currently targeting, optimistically, we would love fall of ‘26, but realistically, we're probably going to be admitting our first cohort in spring of ‘27, so that'd be January '27. One of the contingencies there is building out the appropriate instructional and simulation space on campus. So, we're looking late '26 or early '27.

Sandoval: No, and that seems far away, but it's not. I mean, before we know it, it's going to be '26. And just very briefly for our listeners, the University was very grateful for the gift of the campus of Sierra Nevada University in Incline Village, and it is just a stunning campus with wonderful facilities, and we've been trying to find the highest and best use for that. I can't think of a better one than training nurses for rural Nevada. It'll be an excellent place. I don't know if you've socialized this with your students, but I would expect it won't be hard to recruit students to live, learn and work up at Lake Tahoe.

Yingling: If I had been offered a rural community-focused undergraduate program in the mid-'90s, I would've absolutely taken that opportunity. I think there are a lot of people who'll be very excited about this type of academic program.

Sandoval: So ,we've talked about Northern Nevada, Lake Tahoe, Reno, the Reno area, rural Nevada. Whether it's on our main campus here in Reno or at Lake Tahoe, the experience for our nursing students is a positive one. So, Shannon, I'll go to you again. How does Orvis School of Nursing support students from all walks of life to succeed?

Richard: At Orvis, our core values are caring, compassion and inclusion. We use those values to mark everything that we do. We pride ourselves in some pretty high NCLEX (The National Council Licensure Examination) pass rates, but what is not often noted is our low attrition rate. So, first, saying we have an NCLEX pass rate of 95% or higher, that means that also we have about 95% of the students who begin the program end up taking that NCLEX exam. And the way that we're able to do that is through our connection to the students. Now, I mentioned that we have a classroom size of 96, and that makes it challenging to connect with each and every student, but our faculty do the best to engage the students. We have these active learning strategies and ways that the classroom is conducted that promote communication among the students and also with the faculty. And we have our clinical structure that's also supportive of this more intimate experience. There is a ratio of eight students to every one faculty. So, there is that individualized attention that the students get.

There are 12 groups of eight in every cohort. So, then we have 12 faculty that oversee the clinical experience, but then a clinical coordinator that helps direct that. And then also we have a track lead who is instrumental in this process. So, our BSN (Bachelor of Science in Nursing) traditional track lead is Professor Cassandra Padgett. She has the superb organizational and communication skills that she employs to keep our students on track. Another one of the components that we have to support our students is the PASST program. That's our Peer Academic Student Support Network. This is led by Professor Shile Eguen.Students are selected for this program based on their leadership skills and also their academic excellence. They hold study sessions for all the students, especially around exam time. They are voluntary and generally well attended when we discuss student success.

I would be remiss if I didn't highlight more about our simulation program. This has undergone incredible enhancements under the leadership of Professor Haley McNeil. One of her underlying tenets for this program is psychological safety, where students feel safe when they're taking risks and safe to make mistakes without the fear of ridicule. This is truly a learning environment that narrows the education-practice gap and is one of the main reasons why Orvis students stand out as practice-ready.

There are also two other components that I like to touch on. One is about Dean Yingling. When he came to the Orvis School of Nursing, we talked about a number of different components about our school. One was the mental health challenges that our own students face on a daily basis. Through his commitment and emphasis on student well-being, we now have a supplemental service that students can utilize that helps them develop skills from stress management and organizational strategies and a crisis hotline where they can go online and select a specialist to talk to in a moment's notice. These specialists are all licensed in the state of Nevada. This is a completely free service to our students, and it really helps them navigate the stressors in life. Lastly, our new Nu Iota chapter from Sigma Theta Tau, the Nursing Honors Society, has set up a very successful food pantry. This is somewhere where I can see students come in before class, after class, during labs sometimes, and grab a nourishing snack and refuel as they need to be successful in daily life.

Sandoval: No, that's incredible. No wonder we have so many applicants and so much success for our students. We are almost out of time, so quick lightning round. Shannon, I know you've been here around these parts for a very long time. Charlie, you've been here for nine, 10 months. What's your favorite part of living in northern Nevada?

Richard: Purple Mountains Majesty.

Sandoval: All right.

Richard: What I mean by that is a beautiful hue. I didn't even know what that meant when I was singing that as a young kid in school with the song “America the Beautiful.” But when the sun goes down below the hills, that lavender hue that lights up on the mountains is a sense of serenity and peace. The landscape of northern Nevada is one of my favorite things about living here.

Sandoval: Agreed, Charlie.

Yingling: About five years ago, I realized that I didn't just get sad in the winter. I got seasonal affective disorder, and this was the best winter I have ever had in terms of my own mental health. The sunshine, the blue skies — I have to say, I love the dry air. I was back in the Midwest for a vacation a couple of weeks ago and remembered I really, really want to get home to Nevada. Yeah, it's just a beautiful place to live.

Sandoval: Well, thank you. And unfortunately, we are out of time. Home means Nevada, correct? I mean for sure. So, that is all the time we have for this episode of Sagebrushers, and thank you for joining us today, Charlie and Shannon. It really was a great, great episode.

Ladies and gentlemen, join us next time for another episode of Sagebrushers as we continue to tell the stories that make our University special and unique. Until then, I am University President Brian Sandoval – and as always, go Pack!