Why Is There A Nursing Shortage?

Demand for healthcare is at an all-time high, and the workforce cannot keep pace. The American Nurses Association estimates that more than a million new nurses need to enter the field over the next several years to head off a critical shortage. For anyone considering nursing or looking to advance in healthcare, the math works in your favor: the shortage means an unusual number of openings across the country.

The Numbers

• By 2035, ten states are projected to have a shortage of registered nurses.
• Washington is projected to have the largest gap, around 26%.
• The median age of RNs is 50, and a large share are nearing retirement.
• In 2023, U.S. nursing schools turned away nearly 66,000 qualified applicants for lack of faculty, clinical placements, classroom space, and budget.

The Bureau of Labor Statistics (BLS) projects RN employment to grow faster than the average for all occupations, with roughly 190,000 openings per year over the decade as nurses retire or leave the field. The pandemic made the shortage worse. At its height, nurse-to-patient ratios stretched as high as 1-to-4 because of staff shortages, driving stress, burnout, and turnover that left positions open nationwide.

The effects outlasted the pandemic. Higher staffing levels are tied to better patient outcomes, shorter hospital stays, and lower mortality, and they reduce nurse stress and burnout. Nurses are the frontline of the system, and the shortage needs to be addressed before it becomes a full crisis.

What Is Driving the Shortage

Four forces are doing most of the work: rising demand from an aging population, an aging nursing workforce, too few nurse educators, and high turnover.

An Aging Population

As Americans age, demand for care climbs. The Census Bureau projects that by 2030 the entire baby-boom generation, 73 million people, will be 65 or older. Older adults need more care, and the CDC reports that 19% of people over 55 have three or more chronic conditions. Demand is uneven: states with older-than-average populations, like Florida and Maine, feel the strain first.

An Aging Workforce

The nursing workforce is aging alongside the patients. The median RN is 50 years old, and a sizable share are 65 or older. Many will retire within the decade, opening vacancies faster than schools can fill them.

Faculty Shortages

Training new nurses takes educators, and there are not enough. Even with applications at record levels, nursing schools turned away nearly 66,000 qualified applicants in 2023 for lack of faculty, clinical and classroom space, and preceptors. The educator gap is driven by faculty retirements and by clinical and private-sector employers that offer better pay than academia. Master's and doctoral programs are not producing educators fast enough to replace those leaving, so the gap is expected to widen.

Turnover

Stress and burnout push nurses out. A 2022 survey reported that COVID-19 worsened an already serious problem, with 47% of healthcare workers having left or considering leaving the profession. Research from McKinsey points to staffing levels, demanding workloads, and the emotional toll as the main reasons nurses go. Higher patient ratios make the remaining nurses feel they cannot keep up, which fuels more departures, which raises ratios again.

Which States Are Hit Hardest

The shortage is not spread evenly. The Health Resources and Services Administration (HRSA) projects some states, including Florida, Ohio, and Virginia, to have a surplus by 2030. Many others will fall short. States with the largest projected gaps in 2035 include Washington, California, Georgia, Oregon, Michigan, Idaho, Louisiana, Texas, New Jersey, South Carolina, and North Carolina. Measured by nurses per 1,000 people, Nevada joins the list. The southern and western regions broadly need more healthcare workers.

How the Shortage Is Being Addressed

Reversing the shortage takes recruiting new nurses and improving conditions so the current ones stay. Federal and state governments and advocacy groups have built programs toward both goals:

• The CARES Act funds training and aid for underserved areas, and nurses working in HRSA-designated shortage areas qualify for educational support.
• The Nursing Education Loan Repayment Program repays up to 85% of educational loans for nurses in qualifying facilities in critical-shortage areas.
• Many states offer loan repayment, scholarships, and tax credits.
• Nursing schools are partnering with public and private agencies to expand capacity.
• Facilities are adopting better staffing policies and higher wages, and some pursue the American Nurses Credentialing Center's magnet recognition to support nursing excellence and patient safety.

Is Now a Good Time to Become a Nurse?

Yes. The BLS projects strong demand for RNs and much faster than average growth for advanced practice RNs. Opportunities are widest in the states and regions where demand runs highest. Nurses with bachelor's degrees or higher will have the most options, especially as facilities pursue magnet status and the need for APRNs grows.