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:

(Video) The Nursing Shortage Explained 2021

  • 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.

(Video) Nurse shortage could reach more than 1M by end of year

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.

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) The United States has critical nursing shortages across the country, doctor says

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 shortage of nurses in the US? ›

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.

Which are significant factors that have led 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.

When did the nursing shortage start in the US? ›

In the mid-1930s, reports of an emerging nurse shortage began surfacing throughout the United States. Mercy Hospital School of Nursing class of 1936Many in the health-care field greeted news of this shortage with surprise.

What state has the biggest shortage of nurses? ›

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.

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.

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.

What is the number one cause of nurse burnout? ›

One of the largest burnout risks for professionals in any industry is chronic lack of sleep. This is particularly common for nursing professionals who work long hours and consecutive shifts. In a survey conducted by Kronos Inc., 25% of nurses reported that they were unable to get enough sleep between shifts.

What are the biggest problems facing nursing today? ›

Biggest Challenges Nurses Faced In 2021 And How To Become More Resilient In The Future
  • Emotional Trauma. ...
  • Fear of Contracting COVID-19. ...
  • Exhaustion and Overworking. ...
  • Staffing Issues. ...
  • Underpayment. ...
  • Cultivating Resilience as a Nurse. ...
  • Summing Up.
4 Jan 2022

Will there always be a nursing shortage? ›

According to the U.S. Bureau of Labor Statistics, the country will need more than 203,000 new registered nurses every year through 2026 to fill the gap in care left by a retiring workforce. The average age of a nurse right now is 51.

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.

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.

What state has the lowest RN salary? ›

As of 2021, Hawaii tops the list at 119.3, while Mississippi comes in lowest, at 87.8. Adjusting each state's average RN salary by its cost of living index gives us a potentially more accurate means of comparing where nurses get paid the most.

Which 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 has the highest nurse salary? ›

California. California tops the list of 15 highest-paying states for nurses. According to the U.S. Bureau of Labor Statistics (BLS), the average annual salary for RNs in California is $124,000 per year, or $59.62 per hour, compared to the national average salary of $82,750.

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).

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 most stressful area of nursing? ›

The most stressful nursing jobs include ICU nurse, ER nurse, and NICU nurse. In these roles, nurses work in an intense environment with high stakes. They manage emergency situations and care for critically ill patients. Other stressful nursing jobs include OR nursing, oncology nursing, and psychiatric nursing.

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.

How much do nurses make? ›

How much do nurses make in each state?
StateHourly median wageAnnual median wage
New York$41.99$87,330
North Carolina$31.06$64,600
North Dakota$31.10$64,680
47 more rows

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.

Which field of nursing has the highest burnout rate? ›

Critical care nurses suffer the highest rates of burnout.

This is mainly due to the nature of the job, as critical care nurses work specialize in the emergency department (ED) and intensive care unit (ICU). As such, their work environment is constantly fast-paced, meticulous, and demanding.

Are nurses underpaid? ›

Nursing, a 90% female profession, has been historically underpaid. Caring professions like nursing are often regarded as 'women's work' and therefore are undervalued and underpaid or even unpaid.

Why is being a nurse so stressful? ›

In the United States, the number one cause of stress among nurses is teamwork — pressures associated with working together as a group, such as poor communication, conflict, and tension. This was followed by stressors linked to job circumstances, like employer demands and work satisfaction.

Where are the happiest nurses? ›

Let's take a look at some nursing specialties where nurses report being happiest.
  • School Nurse. ...
  • Labor and Delivery Nurse. ...
  • Case Management Nurse. ...
  • Nurse Educator. ...
  • Parish Nurse. ...
  • Travel Nurse.
26 Aug 2022

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.

Whats the most patients a nurse can have? ›

Generally, the nurse-to-patient ratio recommendation is one nurse to every four patients. According to a National Nurses United report, there are currently no federal mandates that regulate the number of patients registered nurses (RNs) can care for simultaneously.

What is the hardest part of 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.

Is the nursing industry growing or shrinking? ›

Employment of registered nurses is projected to grow 6 percent from 2021 to 2031, about as fast as the average for all occupations. About 203,200 openings for registered nurses are projected each year, on average, over the decade.

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.

What percentage of nurses drop out? ›

According to a National League for Nursing study, the national dropout rate for nursing programs was 20 percent. While the attrition rate is higher for some bachelor's degree nursing programs, most people in school to become registered nurses (RNs) stayed in school and pushed through.

Which country has a shortage of nurses? ›

Global shortage and international recruitment
CountryNumber of nursesDensity per 1,000 population
United Kingdom704,33212.12
United States of America2,669,6039.37
6 more rows

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 ...

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 has happened to the nursing profession? ›

Important Ways Nursing Has Changed

Whereas they used to be limited to battlefields and hospitals, nowadays you will find nurses in doctors' offices, schools, facilities, military bases, in patients' homes, and offering help via telehealth services—just to name a few.

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.

Is 2022 the year of the nurse? ›

In recognition of the essential role of nursing education during the pandemic, and in celebration of its historic and continuing inspiration to nurses everywhere, the National League for Nursing has announced 2022 as the Year of the Nurse Educator.

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.

How many nurses are considering 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.

What is the most an RN can make an hour? ›

While ZipRecruiter is seeing hourly wages as high as $59.38 and as low as $17.07, the majority of RN wages currently range between $28.85 (25th percentile) to $41.11 (75th percentile) across the United States.

What's the easiest state 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.

How much is a nurse paid per hour in USA? ›

This is the 2021 ranking. Click here to see the 2022 edition. The average hourly pay for nurses in the U.S. is $38.74 for registered nurses and $55.05 for nurse practitioners, according to the U.S. Bureau of Labor Statistics' occupational employment statistics survey released March 31.

What type of nurse is the least stressful? ›

The 10 Least Stressful Nursing Jobs This Year (2022)
  • Nurse Educators. ...
  • Institutional Nurses. ...
  • Research Nurses. ...
  • Public Health Nurses. ...
  • Occupational Health Nurses. ...
  • Case Management Nurses. ...
  • Home Health Nurses. ...
  • Clinic Nurses.
6 Jul 2022

What city has the highest pay for nurses? ›

Top 10 highest-paying cities for Registered Nurses
RankCity / Metro AreaAverage RN Salary
1San Jose-Sunnyvale-Santa Clara, CA$155,230
2San Francisco-Oakland, CA$151,640
3Vallejo-Fairfield, CA$146,360
4Santa Rosa, CA$141,440
6 more rows
10 Sept 2022

Which country respects nurses the most? ›

Norway, a Scandinavian country known as the land of Fjords, has one of the highest standards of living in the world as well as job satisfaction for nurses. While the average salary is $46,050, nurses have the ability to earn upwards of $100,000 depending on experience and specialty.

What states treat their nurses the best? ›

The Complete Ranking of the Best States to Work as a Nurse
RankState Name
3New York
32 more rows

Which state is easiest to get Nclex? ›

If you are looking for the best state for NCLEX or easiest state to pass NCLEX, here are the top 5:
  • #1 Connecticut. ...
  • #2 Montana. ...
  • #3 New York. ...
  • #4 Northern Mariana Islands. ...
  • #5 South Dakota.
20 Jan 2022

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.

What current issues are nurses facing? ›

3 Biggest Challenges Nurses Will Face in 2022
  • Covid-19 After Effects – Care Delays and Permanent Shift in Focus. ...
  • Even Greater Workload. ...
  • Expanding Social Care Responsibilities.


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