Yeah it hasn't been bad at all, just more challenging. I've yet to die in nightmare with my monk because I've incorporated fleeing into my strategy, something I didn't need to do in normal mode. Definitely utilizing AoE with knockback to keep from being surrounded and wailed on, plus mantra of healing to keep me alive. And my elemental ally has been a mainstay since I got the skill at level 22. He's awesome, almost unfair, like a beefed up companion who you can repeatedly summon. I do miss 7 sided strike but it's less effective than it seems.