The nursing shortage has passed the point of being a pipeline problem. It is now a structural one — driven by clinical placement constraints, rising student volumes and a growing gap between what new graduates can do and what hospitals need them to do on day one.
Orbis Education has spent years trying to close that gap from the operational side, partnering with academic nursing programs to build consistent, scalable clinical education infrastructure. One of its longest-standing partnerships is with Concordia University, St. Paul, where Wendy Merchant-Schulte, vice president of nursing services at Orbis, and Dr. Hollie Caldwell, dean of the College of Nursing at Concordia University, St. Paul, have built a joint model spanning campuses in Minnesota, Oregon and Colorado — serving more than 870 nursing students.
Becker’s spoke with Merchant-Schulte and Dr. Caldwell about what it actually takes to build a partnership that holds — and why getting it right has never mattered more.
Editor’s note: Responses have been lightly edited for length and clarity.
Q: The Concordia–Orbis partnership started during COVID. What did it take to get aligned early on?
Dr. Hollie Caldwell: We had to start by clearly defining roles and responsibilities — everyone needs to know what the other group is accountable for. On the university side, we maintained academic authority over the curriculum. On the operations side, Wendy’s team made sure that curriculum could be delivered consistently across every campus. Getting that boundary right, and respecting it, took real discipline.
Wendy Merchant-Schulte: It was a culture shift as much as anything. We kept asking the same three questions as we made decisions: Is it scalable? Is it student-centered? Is it collaborative? If we couldn’t say yes to all three, we went back to the drawing board.
Q: You run a consistent model across three states. How do you standardize without losing flexibility where it matters?
Merchant-Schulte: Operational consistency is what allows academic delivery to stay stable when things go sideways — and in healthcare, something always does. A strike at a clinical site, a low census on a unit. When those things happen, a strong operational foundation is what lets you pivot without losing ground for students.
Dr. Caldwell: We rely heavily on standard operating procedures, but with communication loops so local nuances get surfaced and factored in. Our testing center is a good example — operations manages it through standard SOPs, but there’s flexibility built in so every student completes their exam within the same week without everyone testing on the same day. That took real negotiation. But the result is something both fair to students and operationally sustainable.
Q: How do you decide where standardization is non-negotiable?
Dr. Caldwell: Those decisions go through our shared governance structure — committees where full-time faculty and Orbis team members work through it together. Simulation methodology, for example, is non-negotiable across all campuses. That consistency is part of what helped us earn national endorsements for our simulation centers. When we say something applies to all students at all times, we mean it. But we’re also honest about where there’s legitimate room to adapt.
Q: Clinical placement has become increasingly transactional. What has that shift cost nursing education?
Dr. Caldwell: We’ve lost a lot. We used to get students into interdisciplinary rotations — time with pharmacists, nurse managers, respiratory therapists — so they could see where nursing fits in a broader system. That’s largely gone. Placements come through HR, the numbers are smaller, and the creative collaboration that used to exist between nursing faculty and unit-level staff has been replaced with a form and a slot count.
Merchant-Schulte: And then those same hospitals tell us that new graduates aren’t practice ready. Restrictions keep tightening — students can’t give medications at some facilities, can’t start IVs at others — and then we hear that orientation times are too long. That problem can only be solved through a real conversation, not a transaction. Healthcare facilities and academic programs are in a relationship whether they choose to be or not. The question is whether we’re willing to do that work together.
The programs that rebuild the relational foundation underneath the transactional logistics are the ones that will produce the graduates the system needs. The ones that don’t will keep having the same conversation about workforce shortages without getting any closer to solving them.
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