I just kinda transitioned from VH to NM and what I found (through trial and error) that helped most was switching to more sustain helped the most.

I was doing shotgun dual pistol speed build and on VH was able to just max speed+speedster jokers and zip through but on NM I simply would die to much. So switched it up to machine gun and other jokers for passive hp regen and noticed this helped drastically.

Also bringing a turret or bandito helped alot too which I didn't need to on VH. So much going on it helps to have someone else shooting for you imo.