VASNHS using VR to prepare nurses for cardiac arrests

VA Southern Nevada Healthcare System (VASNHS) is launching a groundbreaking virtual reality (VR) training program to better prepare non-critical care nurses for cardiac arrest events—high-stakes emergencies that occur infrequently but demand immediate, precise action.

This simulation training is the first of its kind within VA and in southern Nevada. Designed and implemented by Dr. Carissa Hernandez, this initiative uses immersive VR simulation to boost nurse confidence, reinforce adherence to the American Heart Association (AHA) Basic Life Support (BLS) algorithm, and improve documentation accuracy during code blue responses.

“Unlike traditional mock code training, which requires extensive scheduling, staff, and space, VR allows for flexible, on-demand participation without disrupting clinical care,” said Hernandez. “It’s rare to find a solution that improves training quality, saves money, and gives time back to both staff and educators. This one does all three.”

The training is filmed in 360 degrees on the actual medical-surgical unit, using real equipment and coworkers as actors to create a deeply realistic and psychologically safe learning environment. According to Hernandez, this hyper-realistic format creates emotional engagement and immediate relevance to clinical practice. 

Staff reported feeling more confident and connected to the training experience. According to Hernandez, the hyper-realistic format created emotional engagement, immediate relevance to clinical practice, and staff reported feeling more confident and connected to the training experience. 

“This training gives the nurse the ability to work out problems at their own pace without being prompted,” said Cydnie Etterley-Crown, VASNHS Registered Nurse. “And being able to do the training when I had downtime on the unit made it easy to practice without interrupting patient care. I found it to be beneficial as a first step towards VR use in future training”

In FY2024, 31percent of in-hospital cardiac arrests at VASNHS occurred outside of critical care units. The statistics underscore the need for targeted, accessible, and high-impact training for medical-surgical and outpatient nurses. Traditional training methods like mock code drills are also essential but put a strain on resources. Virtual reality training supplements these methods with a scalable, engaging solution that enables frequent, independent skill reinforcement. 

“Ultimately, better trained nurses lead to faster, more coordinated resuscitation efforts, which can mean the difference between life and death for Veterans,” said Hernandez.

This project is the foundation of a broader VR training initiative across VASNHS. Upcoming training modules include:

• Emergency triage simulations for the Emergency Department.
• Code Blue and emergency response for outpatient primary care clinics.
• Crisis response training for VA Police.
• Difficult conversation training to support emotionally challenging interactions.

Each scenario will be filmed on-site with department-specific workflows and actors, ensuring relevance. VR enables standardized training that is adaptable to local context. Rural sites such as Pahrump and Laughlin, Nevada, will also receive the same high-quality training without needing to leave their clinics. This expansion positions VASNHS to create a sustainable, scalable, and equitable training infrastructure that could serve as a model for VA facilities nationwide.

“This isn’t just a local training initiative, it’s a prototype for system-wide innovation,” said Hernandez. “We’re building a model that other VA facilities can adopt and adapt. Our goal is to create a virtual training library that reflects the realities of every department, rooted in the daily experience of our staff and guided by the needs of our Veterans.”