What's Causing the American Nursing Shortage? (2023)

What's Causing the American Nursing Shortage? (1)Share on Pinterest

America’s healthcare workforce has been spotlighted during the COVID-19 pandemic. This spotlight has also brought increased focus to the nursing shortage that began in 2012 and is expected to last until 2030.

The shortage is driven by many factors, including an increased need for healthcare around the country. As American’s largest generation — the baby-boom generation — gets older, there will be an unprecedented strain on the healthcare system, with over a million new nurses needed by 2030.

Nurses are a vital part of the healthcare system. Studies have shown that when hospitals and other healthcare facilities have the appropriate amount of nurses, it improves patient safety, mortality rates, and overall patient outcomes.

Unfortunately, having enough nurses to care for patients isn’t always easy. For nearly a decade, the United States has been facing a critical nursing shortage. The shortage is expected to continue for several more years. In fact, over 1 million new registered nurses (RNs) will be needed by 2030 to meet healthcare demands.

In addition to newly created roles, the roles of nurses expected to retire or leave the profession will also need to be filled. The United States Bureau of Labor Statistics (BLS) projects this will create a total of 175,900 openings for RNs every year until 2029.

RNs aren’t the only role that will need new graduates over the next decade. The BLS also projects growth across multiple nursing roles, including:

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  • Licensed practical nurses (LPNs). An additional 65,700 new LPN roles will be created by 2029, for a growth of 9 percent.
  • Nurse anesthetists. An additional 6,200 new nurse anesthetist roles will be created by 2029, for a growth of 14 percent.
  • Nurse practitioners. An additional 110,700 nurse practitioner roles will be created by 2029, for a growth of 52 percent.
  • Nurse midwives. An additional 800 nurse midwife roles will be created by 2029, for a growth of 12 percent.

The need for nurses with master’s degrees, such as nurse anesthetists and nurse practitioners, will also drive some need for new RNs. This is because current RNs advance their education and take on these higher-level nursing roles.

More education for nurses is another large piece of the overall puzzle. RNs can choose to earn licensure through a bachelor’s degree, associate degree, or diploma. Recent recommendations have advocated for 80 percent of RNs to hold bachelor’s degrees, but currently, only 64.2 percent of RNs do.

There is a need for nurses across the country, but certain areas face a much greater shortage than others. The southern and western portions of the nation are expected to face some of the largest needs for nurses. California alone is projected to need about 44,500 new RNs by 2030.

The United States Department of Health and Human Services predicts that these states will have the greatest need for nurses by 2030 (in order of greatest need):

  1. California
  2. Texas
  3. New Jersey
  4. South Carolina
  5. Alaska
  6. Georgia
  7. South Dakota

Why is there a nursing shortage?

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The nursing shortage is a complex problem with several causes. There are many factors at play, from a larger-than-ever population of older adults to nursing burnout.

The combination of these factors is driving the nursing shortage and causing it to grow over time.

The growing population of older adults

The generation born between 1946 and 1964, known as baby boomers, is one of the largest in American history. About 21 percent of current American adults are baby boomers. There will be a projected 71 million Americans age 65 or older by 2029.

Age-related conditions lead to a significant rise in the need for healthcare services. In fact, the Centers for Disease Control and Prevention (CDC) reports that over half of Americans over age 65 have two or more chronic health conditions.

Plus, with advances in healthcare and movements to improve healthcare access, the baby boomer generation will likely have a longer lifespan than previous generations.

Healthcare reforms

Recent changes to the healthcare system have increased the number of Americans who can access care. This has shifted the healthcare focus into many nursing-driven roles.

For example, the Affordable Care Act made it possible for more Americans to get health insurance. In many states, the Affordable Care Act meant that more people qualified for Medicaid. Newly insured people are now able to seek the care they couldn’t in previous years, creating a demand for more nurses.

There have also been initiatives to minimize hospital stays over the last several years. This has led to the increasing importance of primary care, urgent care, and home healthcare.

Nurses have an important role to play and will see increased demand as healthcare continues to change in America.

Retirement and burnout

The millions of Americans who will be reaching their mid-60s over the next decade doesn’t just mean there will be an increased need for healthcare services. Those Americans will also be retiring and leaving job openings in fields like nursing.

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In fact, the average age of RNs in this country is 50 years old. Additionally, the COVID-19 pandemic sped up the retirement of many nurses across the country, leading to an even greater nursing shortage.

The retirement of experienced nurses also leaves a lack of nurses qualified to train and educate new nurses. As current nurse educators retire, nursing programs around the country need capable teachers to take their place. Without enough faculty, nursing programs won’t be able to train enough nurses to address the shortage.

However, nurses reaching retirement age aren’t the only ones leaving the profession. As the COVID-19 pandemic demonstrated, nursing is an incredibly stressful and demanding job. Nursing burnout and lack of support are common and lead to skilled RNs leaving the field or transitioning to other healthcare roles.

Unlike many other fields that face employer shortages, there is no way to minimize the demand for healthcare. Hospitals and other healthcare facilities will always need qualified nurses. Unfortunately, that also means a shortage creates several challenges, such as:

  • Nurse burnout. Burnout is both a cause and symptom of the nursing shortage. Understaffed nursing units increase the pressure and stress on nurses. The mental and physical toll of this pressure can quickly lead to burnout.
  • Longer wait times for care. Patients have to wait longer when healthcare facilities don’t have the nursing staff they need. When seeing more patients, nurses are often rushed and stressed. That can lower patient satisfaction and negatively affect patient outcomes.
  • Medication errors and fatalities. Patient care and safety are improved when there’s an appropriate number of nurses on staff. Errors in medication and other care delivery are more likely when facilities are understaffed. These errors can have serious consequences.

How can we solve the shortage?

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The nursing shortage has many causes that all need to be addressed. We will need multiple solutions to address this complicated issue. Some possible steps to take include:

  • More educational opportunities. Nursing programs can increase their enrollment by offering options that make it easier for aspiring nurses to get the education they need. Encouraging and supporting students to earn a bachelor’s degree and to move on to higher education is an important step toward preparing qualified nurses. Additionally, online course options and flexible schedules can make school possible for more people.
  • Increased nurse leadership. Taking on leadership roles in healthcare systems can create opportunities for nurses. Experienced nurses in these roles can provide mentoring and education to younger nurses and demonstrate a possible career path to new graduates. They can create the benefits packages and job tools that help attract and retain new nurses.
  • Advocacy. Healthcare policies that are driven by nurses advocacy organizations can help create changes that will address the nursing shortage and the needs of nurses. For example, legislation that regulates how many nurses are needed in healthcare facilities could boost nurse education and recruitment. Improved staffing practices can also provide a supportive workplace for current nurses and help to recruit new nurses.

Preventing burnout: Support and advocacy resources

Nurses can benefit from many levels of support to help prevent burnout. A few ways to help them continue doing what they love can come in the forms of self-care, support systems, and changes in policy.

If you’re a nurse or have a loved one who’s a nurse, here are a few resources to learn more about these ways to prevent burnout:

Self-care and support


The takeaway

(Video) How To Ease the U.S. Nursing Shortage

The United States nursing shortage is driven by many factors, including an increased need for care, large numbers of the workforce reaching retirement age, and recent healthcare legislation.

The situation is further complicated by nursing burnout. Since burnout is often caused by short staffing and job stress, which in turn leads to nurses leaving the field, the burnout cycle will continue until the nursing shortage and the needs of nurses can be addressed.

Increased access to nursing education, improved staffing practices, and more leadership roles for nurses are a few possible solutions to this complex problem.


Why is there a nursing shortage in the United States? ›

The U.S. faces a nursing shortage due to an aging population and retiring nurses, creating abundant opportunities for nurses nationwide. The need for nurses aligns with all-time highs in increased demand for healthcare.

What factors are contributing to the nursing shortage? ›

The United States nursing shortage is driven by many factors, including an increased need for care, large numbers of the workforce reaching retirement age, and recent healthcare legislation.

Is there a nursing shortage in the US right now? ›

Nursing has been an in-demand profession for years, with nearly every major hospital hiring for one of healthcare's most important roles. According to the U.S. Bureau of Labor Statistics (BLS), on average, around 195,400 openings for registered nurses are projected from 2021-2031.

What has happened to the demand for new nurses in the United States? ›

The RN workforce is expected to grow from 3.1 million in 2021 to 3.3 million in 2031, an increase of 195,400 nurses. The Bureau also projects 203,200 openings for RNs each year through 2031 when nurse retirements and workforce exits are factored into the number of nurses needed in the U.S.

How do we fix the nursing shortage? ›

The nursing shortage cannot be solved unless higher education institutions train more nurses. Research and interviews with experts present ample evidence that capacity within higher education is significantly lower than what is needed.

Where is the largest nursing shortage? ›

California has the worst nursing shortage in the United States. It's predicted that by 2030, California will be in need of over 44,000 nurses. Other states with major hospital staff shortages include New Mexico, Vermont, Rhode Island, West Virginia, and Arizona.

What are the biggest challenges facing nurses today? ›

Read on to learn about some of the challenges nurses may face today.
Improving workplace conditions for nurses improves healthcare for all.
  • Inadequate Staffing. ...
  • Stress. ...
  • Safety on the Job. ...
  • Workplace Violence. ...
  • Improving Self-Care.

Why are nurses in such high demand? ›

With an advancing baby boomer population, the Affordable Care Act expanding access to medical services, clinical and faculty employment numbers low, and proficient nurses leaving their posts to retire, the call for more healthcare professionals to enter the medical field is a ringing reality.

Where is the future of nursing headed? ›

More nurses will choose to specialize.

Nurses who choose to specialize find that they are in higher demand and can often command higher salaries. The U.S. Bureau of Labor Statistics (BLS) reports that Registered Nurses have a median salary of $77,600 and a projected job growth of 6% between 2021 and 2031.

Is the shortage of nurses expected to resolve soon? ›

Nursing shortages have been a problem for decades and will persist well after Covid-19 subsides. Not only is the US population aging, but nurses themselves are getting older. Some researchers estimate that 1 million registered nurses will retire by 2030.

Is the nursing shortage getting worse? ›

Nursing shortage looms large and projected to intensify in next 18 months: report. A national nursing workforce report is advocating for dramatic action to better support the nation's nurses amid the current staffing crisis during the global COVID-19 pandemic.

Why are new nurses leaving? ›

Often there is not enough staff for the number of patients, and the demand placed on nurses has only increased in recent years. The patient volume and acuity have increased and there is not enough staff to meet that demand.

Will there still be a nursing shortage in 2025? ›

Researchers estimated that the US will have a 10 to 20 percent nursing gap by 2025 as the number of patients needing care exceeds the number of nurses. The RN supply could potentially see a low of 2.4 million, while the RN demand could be a low of 2.8 million nurses.

How is the US nursing shortage being addressed? ›

In response to this national shortage, states have examined a variety of options to recruit and retain nurses. Specific policy levers include loosening licensing requirements, changing scope of practice laws, bolstering educational programs, and offering monetary incentives.

What are new nurses lacking? ›

Concerns of new nurses lacking confidence have been reported for many years. Ortiz (2016), who interviewed 12 new nurses working in hospitals in New York state, reported that all participants lacked professional confidence during their first year of practice.

How long will there be a shortage of nurses? ›

Before Covid struck, HHS expected seven states — Alaska, California, Georgia, New Jersey, South Carolina, South Dakota and Texas — to have staffing shortages by 2030.

What state has highest RN salary? ›

Highest-paying states for registered nurses

California tops our list of the highest-paying states, where registered nurses make $124,000 per year on average. Following it is Hawaii, at $106,530, and Oregon at $98,6300.

What type of nurse is most in demand? ›

Registered nurse (RN)

BSN-prepared nurses are the most sought-after RNs in the job market and can advance to leadership and management roles more quickly than the ASN nurse.

Where are nurses the happiest? ›

There are countless nursing specialties that one can choose from, especially given the ongoing nursing shortage. But Nurse.org found that nurse educators, home health nurses, nurse managers, OR-perioperative nurses, and pediatric nurses reported the highest levels of job satisfaction.

Which state is the hardest to become a nurse? ›

Whether you're a first-time travel nurse or a seasoned veteran, the matter of obtaining licensure in a new state you'd like to work in is always a hurdle.
5 States that Take Longest to Get an RN License In
  1. Ohio (4-6 months) ...
  2. 2. California (3-6 months) ...
  3. Maryland (10 weeks) ...
  4. Maine (8-10 weeks) ...
  5. Alaska (8 weeks)
4 Oct 2018

What states have the happiest nurses? ›

Best States for Nurses Satisfaction and Happiness
  • Minnesota (Quality of life ranking #2, Hospital rating by nurses 86%)
  • Wisconsin (Quality of life ranking #3, Hospital rating by nurses 88%)
  • Oregon (Quality of life ranking #18, Hospital rating by nurses inconclusive)
15 Feb 2022

What state is the easiest to become a nurse? ›

Easiest states to become a nurse – Length of licensing process
  • Maine: 1-2 weeks.
  • Maryland: 2-3 days.
  • Missouri: 2 weeks.
  • Nevada: 1-2 weeks.
  • North Carolina: 1-2 weeks.
  • North Dakota: 1-2 weeks.
  • Texas: 2 weeks.
  • Vermont: 3-5 business days.

What is the hardest thing about being a nurse? ›

Seeing the death of their patients.

Most nurses said seeing the death of patients was the hardest part of their job, including Heather, a nurse from North Carolina, and Chelsey Rodgers, a former nurse who now runs an education company called Tribe RN.

What are the five nursing problems? ›

The five stages of the nursing process are assessment, diagnosing, planning, implementation, and evaluation. All steps in the nursing process require critical thinking by the nurse.

Is RN school Hard? ›

Nursing requires more dedication than many other careers. However, it's one of the most rewarding jobs you can have. Nursing school is notoriously difficult—and it's not for everyone. Graduate school is challenging as well.

Why type of nurse makes the most money? ›

The Certified Registered Nurse Anesthetist consistently ranks as the highest-paid nursing career. That is because Nurse Anesthetists are highly skilled Registered Nurses who work closely with medical staff during medical procedures that require anesthesia.

When did the nursing shortage begin? ›

The Beginning of the Shortage

This is exactly what happened in the mid-1930s, when several technological, economic, and health care-related events combined to increase the demand for registered nurses and to lay the groundwork for a shortage.

Who makes the most in the nursing field? ›

Certified Registered Nurse Anesthetists (CRNAs) earn a nationwide average of $202,470 per year according to the BLS; this makes CRNAs the highest-paying type nursing job by a significant margin.

Will nurses be replaced by machines? ›

It seems unlikely that robots will take over all the duties of a nurse within our lifetime. However, it is important to upgrade your skills in order to remain attractive for employers as machines begin to fulfill more tasks, and nurses are assigned new responsibilities in their place.

What country produces the most nurses? ›

The Philippines is the largest exporter of nurses worldwide. For many decades, the country has consistently supplied nurses to the United States and Saudi Arabia.
Table 1.
Work SettingNumberPercentage
II. International163,75684.75
5 more rows

Which country has high demand for nurses? ›

USA. In the US, a registered nurse's salary is well above the average income. An RN will earn around $67,490 per year. The lowest nurse's income is around $45,000, while the top 10% of nurses pull in over $94,000 per year.

What will happen if the nursing shortage is not addressed? ›

If this shortage is not addressed, patients may experience more negative health outcomes. Studies, such as Spetz's 2011 article in Medical Care, show that higher nurse staffing protected patients from poor outcomes.

Will nurses be replaced in the future? ›

Robots and automated tech will essentially just be another tool for nurses to bring increased efficiency to their jobs, and while there are many exciting developments coming out of the healthcare tech industry, including those that make nurses jobs easier, it's probably safe to say that you won't be out of a job ...

How can we fix staffing shortages in healthcare? ›

These include: Adjusting staff schedules, hiring additional HCP, and rotating HCP to positions that support patient care activities. Cancel all non-essential procedures and visits. Shift HCP who work in these areas to support other patient care activities in the facility.

Why do hospitals pay travel nurses more? ›

So, why do travel nurses get paid more? It's because they fill short-term needs, accept assignments in areas with severe nursing shortages, receive extra compensation for their flexibility and work in hard-to fill specialties.

What will be the nursing shortage by 2030? ›

According to the report, as many as 13 million more nurses may be needed by 2030; the world's current nursing workforce totals approximately 28 million. The report explains that taking action to sustain and retain workers could minimize the shortage.

Which nurse is more prone to burn out? ›

Critical care nurses tend to suffer the highest rates of burnout. Critical care specialties include the emergency department (ED) and intensive care unit (ICU). Emergency department nurses tend to experience the highest rates of burnout.

At what age do most nurses retire? ›

For nurses with time to plan, the prospect of an early or timely retirement with a properly sized financial portfolio and social security benefits appeals to them when they reach the current full retirement age of about 67 years or even before at 62 years (without full social security benefits).

Is being a nurse worth it 2022? ›

High demand and good job outlook

You do not have to worry about not finding a job as a nurse. According to the Bureau of Labor Statistics (BLS), the position of a registered nurse has a promising job outlook with a projected growth of 9% from 2020 to 2030.

Why is nursing turnover so high? ›

Among the most common reasons for nurse turnover include nurses feeling underappreciated, dealing with short staffing, and the strains of hard mental/physical labor.

Is there a real nursing shortage? ›

California tops the list with an estimated 44,500 deficit in registered nurses, nearly three times the deficit in the next shortest state.

Are more nurses leaving the profession? ›

Ninety percent of respondents are considering leaving the nursing profession in the next year, with 71% of nurses that have more than 15 years of nursing experience thinking about leaving as soon as possible or within the next few months.

How big is the U.S. nursing shortage? ›

According to the U.S. Bureau of Labor Statistics (BLS), on average, around 195,400 openings for registered nurses are projected from 2021-2031. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.

What state has the biggest nursing shortage? ›

California has the worst nursing shortage in the United States. It's predicted that by 2030, California will be in need of over 44,000 nurses. Other states with major hospital staff shortages include New Mexico, Vermont, Rhode Island, West Virginia, and Arizona.

How can we improve the nursing shortage? ›

6 strategies to address nursing shortages in the next 18 months
  1. Healthy work environment. ...
  2. Diversity, equity and inclusion. ...
  3. Work schedule flexibility. ...
  4. Stress injury continuum. ...
  5. Innovative care delivery models. ...
  6. Total compensation.
5 May 2022

Is there really a nursing shortage in America a closer look at nursing demand? ›

Despite being one of the fastest-growing occupations in the country, demand for nurses is outpacing the supply, she wrote. According to Bureau of Labor Statistics projections, by 2022 there will be more than 1 million jobs for RNs.

Why are nurses leaving the profession? ›

Early Retirement and Burnout

Unprecedented stress brought on by the COVID-19 pandemic has prompted many nurses to leave the profession early and retire from their current positions. This is on top of those who are already close to retirement age.

What state is in most need of nurses? ›

Which states have the highest need for nurses?
  • California (274,650)
  • Texas (207,810)
  • New York (180,730)
  • Florida (174,710)
  • Pennsylvania (139,480)

What type of RN is most in demand? ›

BSN-prepared nurses are the most sought-after RNs in the job market and can advance to leadership and management roles more quickly than the ASN nurse.

How old is the average nurse? ›

The median age of a registered nurse is 52 years old. 9.4% of the RN and 8.1% of the LPN/LVN workforce are men. The number of male nurses has tripled over the past 50 years. In the Pacific region of the U.S., 30.5% of nurses are people of color, the largest percentage in the country.

What is the problem with nursing shortage? ›

Nursing shortages lead to errors, higher morbidity, and mortality rates. In hospitals with high patient-to-nurse ratios, nurses experience burnout, dissatisfaction, and the patients experienced higher mortality and failure-to-rescue rates than facilities with lower patient-to-nurse ratios.

What is the biggest problem in nursing today? ›

Personal Health

Along with being mentally exhausting, working as a nurse is physically strenuous. Many nurses suffer from back problems and sore feet. Working 12-hour shifts is physically demanding but wearing specially-designed shoes can ease problems and keep nurses on their feet at all times.


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