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Industry Trends
By Moira K. McGhee
Feb 09, 2024
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Global consulting firm McKinsey & Company predicted in 2022 that the United States would see a shortfall of 200,000 to 450,000 registered nurses (RNs) for direct patient care by 2025. Quoting federal data, the American Hospital Association also announced in 2022 that an estimated half a million nurses would leave the profession by the end of that year, bringing the total shortage to 1.1 million. Those aren’t typos or simply statistics. Those are real numbers indicating that the demand for bedside nurses will outpace supply, with impacts felt within health systems across the nation.
Nurses are crucial members of the patient care team and the foundation of the healthcare field. However, nursing shortages have plagued the profession for decades. The severity of these shortages varies by study and by state, but no matter how you slice it, the issue represents a critical challenge to our nation’s healthcare infrastructure. Based on currently available data, some states may experience a distinct shortage while others may actually see a surplus. Vivian Health dove into various data points to attempt to unravel how dire the looming nursing deficit might be in each state.
What’s Causing Nursing Shortages?
The continuing nursing shortage is a multifaceted crisis with deeply rooted systemic challenges and current issues with equally significant impacts. At its core, the nation’s aging population demands more healthcare services while the nursing workforce ages in parallel, leading to a monumental retirement wave.
Concurrently, a persistent bottleneck in nursing education hindered by faculty shortages limits the number of new nurses entering the profession. Plus, increased stress and burnout exacerbated by the COVID-19 pandemic led to a substantial exodus of experienced nurses from the profession.
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10 Factors Contributing to Nurse Deficits
Each of the following factors contributes to the complexity of the nurse staffing struggle:
- Aging Population: The baby boomer generation, one of the largest generational cohorts, continues to age. By 2030, all baby boomers will be 65 or older, and as this substantial population segment ages, the demand for complex care and nurses to provide this care increases.
- Aging Workforce: Like those they serve, the nursing workforce is also aging, with an estimated one million RNs retiring from the workforce between 2017 and 2030. The impending retirement of a large chunk of nurses threatens to sharply reduce the experienced nursing workforce in less than a decade.
- Increased Burnout: Nurses are experiencing burnout at unprecedented levels due to high-stress environments, long hours and emotional demands of the job. The intense pressure has led to decreased job satisfaction, increased absenteeism and a significant number of nurses leaving or considering leaving the profession altogether.
- Nurses Leaving Bedside Jobs: An increasing number of nurses are leaving high-stress bedside positions for alternative roles in healthcare or different industries altogether. Commonly cited reasons for nurses leaving the bedside include burnout, unsafe staffing ratios, inadequate support staff, being underpaid and underappreciated, the inability to take breaks or adequate days off and inadequate mental health resources. In February 2023, the National Library of Medicine reported that the average nursing turnover rate nationwide was 8.8% to 37%, depending on the specialty and geographic location.
- Faculty Shortage: According to the American Association of Colleges of Nursing, nursing schools turned away nearly 92,000 qualified applicants for baccalaureate or graduate nursing programs in 2021. This number was the highest in decades and primarily due to capacity issues, including insufficient clinical sites, classroom space, faculty and clinical preceptors. Unfortunately, the salaries for faculty roles aren’t very competitive, making them less attractive to qualified instructors.
- Affordable Care Act (ACA) Impact: The ACA’s expansion of healthcare coverage increased the demand for healthcare services, putting additional pressure on the nursing workforce to meet the needs of a larger patient population.
- Growing Interest in Community-Based Care: The shift towards community-based care models demands more nurses outside traditional hospital settings, further stretching the available workforce.
- Economic Incentives in Other Fields: Competitive wages and less stressful working conditions in other sectors lure away trained nurses who might otherwise remain in nursing careers or attract potential nursing professionals away from the field, reducing the number of entrants into nursing programs.
- Violence in the Healthcare Setting: The presence of emotional or physical abuse in healthcare settings further adds to an already stressful environment. Violence in nursing has become an ever-present threat, from psychological trauma to varying degrees of physical injury, including death. Healthcare workers are five times more likely to sustain an injury due to workplace violence than other professions.
- Physician Shortage: The Association of American Medical Colleges (AAMC) foresees a shortage of between 37,800 and 124,000 physicians by 2034, including a projected shortfall of 17,000 to 48,000 doctors in general pediatrics, family medicine, geriatric medicine and similar primary care specialties. A shortage of physicians increases the need for nursing staff to shoulder the additional workloads and responsibilities and heightens the demand for advanced practice nurses impacted by strained educational resources.
RELATED: Can Virtual Nursing Address the Post-Pandemic Nursing Shortages?
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Projected RN Shortages by State Through 2030
Breaking down the national shortage by state, some states might have a shortage of nurses and lower growth potential, while others might have a surplus. Unfortunately, the most recent published reports providing a state-by-state breakdown use data from before the COVID-19 pandemic significantly impacted healthcare professionals. These reports also don’t account for the nurses who left the profession during or shortly after this severe nationwide crisis.
For this update, we utilized projections from the Health Resources and Services Administration’s (HRSA) Bureau of Health Workforce (BHW), which looked at each state’s projected 2030 RN supply minus demand to reveal state-level shortages and surpluses. The following table ranks states from largest shortage to largest surplus.
Keep in mind that these projections are technically outdated. While the table below indicates that only 7 states can expect shortages based on this report, preliminary data in the upcoming version includes several more. Also, state-by-state projections for registered nursing shortages aren’t uniform between sources, so you may see your state with an overage on one report and a shortage on another.
| State | 2030 Supply | 2030 Demand | Difference | % Deficit / Surplus |
| Alaska | 18,400 | 23,800 | -5,400 | -22.7% |
| South Carolina | 52,100 | 62,500 | -10,400 | -16.6% |
| South Dakota | 11,700 | 13,600 | -1,900 | -14.0% |
| California | 343,400 | 387,900 | -44,500 | -11.5% |
| New Jersey | 90,800 | 102,200 | -11,400 | -11.2% |
| Texas | 253,400 | 269,300 | -15,900 | -5.9% |
| Georgia | 98,800 | 101,000 | -2,200 | -2.2% |
| Arizona | 99,900 | 98,700 | 1,200 | 1.2% |
| Montana | 12,300 | 12,100 | 200 | 1.7% |
| Massachusetts | 91,300 | 89,300 | 2,000 | 2.2% |
| Illinois | 143,000 | 139,400 | 3,600 | 2.6% |
| Minnesota | 71,800 | 68,700 | 3,100 | 4.5% |
| Louisiana | 52,000 | 49,700 | 2,300 | 4.6% |
| Pennsylvania | 168,500 | 160,300 | 8,200 | 5.1% |
| New Hampshire | 21,300 | 20,200 | 1,100 | 5.4% |
| Michigan | 110,500 | 104,400 | 6,100 | 5.8% |
| Oregon | 41,100 | 38,600 | 2,500 | 6.5% |
| Alabama | 85,100 | 79,800 | 5,300 | 6.6% |
| North Dakota | 9,900 | 9,200 | 700 | 7.6% |
| Washington | 85,300 | 79,100 | 6,200 | 7.8% |
| Wisconsin | 78,200 | 72,000 | 6,200 | 8.6% |
| Connecticut | 43,500 | 40,000 | 3,500 | 8.8% |
| New York | 213,400 | 195,200 | 18,200 | 9.3% |
| Delaware | 14,000 | 12,800 | 1,200 | 9.4% |
| Tennessee | 90,600 | 82,200 | 8,400 | 10.2% |
| Oklahoma | 46,100 | 40,600 | 5,500 | 13.5% |
| North Carolina | 135,100 | 118,600 | 16,500 | 13.9% |
| Utah | 33,500 | 29,400 | 4,100 | 13.9% |
| Colorado | 72,500 | 63,200 | 9,300 | 14.7% |
| Maryland | 86,000 | 73,900 | 12,100 | 16.4% |
| Nebraska | 24,700 | 21,200 | 3,500 | 16.5% |
| Indiana | 89,300 | 75,300 | 14,000 | 18.6% |
| Kentucky | 64,200 | 53,700 | 10,500 | 19.6% |
| Hawaii | 19,800 | 16,500 | 3,300 | 20.0% |
| Rhode Island | 15,000 | 12,500 | 2,500 | 20.0% |
| Vermont | 9,300 | 6,800 | 2,500 | 20.0% |
| Mississippi | 42,500 | 35,300 | 7,200 | 20.4% |
| West Virginia | 25,200 | 20,800 | 4,400 | 21.2% |
| Florida | 293,700 | 240,000 | 53,700 | 22.4% |
| Missouri | 89,900 | 73,200 | 16,700 | 22.8% |
| Idaho | 18,900 | 15,300 | 3,600 | 23.5% |
| Virginia | 109,200 | 86,500 | 22,700 | 26.2% |
| Maine | 21,200 | 16,500 | 4,700 | 28.5% |
| Iowa | 45,400 | 35,300 | 10,100 | 28.6% |
| Arkansas | 42,100 | 32,300 | 9,800 | 30.3% |
| Nevada | 33,900 | 25,800 | 8,100 | 31.4% |
| Kansas | 47,500 | 34,900 | 12,600 | 36.1% |
| Ohio | 181,900 | 132,800 | 49,100 | 37.0% |
| New Mexico | 31,300 | 21,600 | 9,700 | 44.9% |
| Wyoming | 8,300 | 5,500 | 2,800 | 50.9% |
Source: HRSA Supply and Demand Projections of the Nursing Workforce: 2014-2030
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Projected Demand for Registered Nurses
To understand how the COVID-19 pandemic might have impacted the shortage vs. surplus projections listed in HRSA’s report above, let’s look at how it impacted supply between 2020 and 2022. The National Council of State Boards of Nursing’s (NCSBN) research revealed that about 100,000 RNs left the workforce over a two-year period during the pandemic nationwide. To help determine the impact on a state level, we compared the number of employed RNs in 2020 and those employed in 2022 to see which states lost nurses over these two years instead of gaining nurses as they should have.
| State | Employed in 2020 | Employed in 2022 | Amount Change |
| Maryland | 71,390 | 49,790 | -21,600 |
| Pennsylvania | 147,280 | 137,970 | -9,310 |
| Oklahoma | 39,130 | 30,320 | -8,810 |
| Minnesota | 71,780 | 63,800 | -7,980 |
| Nebraska | 27,670 | 19,870 | -7,800 |
| Illinois | 136,640 | 129,390 | -7,250 |
| New York | 197,160 | 190,470 | -6,690 |
| New Jersey | 83,660 | 78,340 | -5,320 |
| Oregon | 41,000 | 37,400 | -3,600 |
| Wisconsin | 64,590 | 61,100 | -3,490 |
| Tennessee | 64,280 | 60,840 | -3,440 |
| South Carolina | 47,050 | 44,030 | -3,020 |
| Missouri | 73,330 | 70,440 | -2,890 |
| New Mexico | 18,740 | 15,910 | -2,830 |
| Arizona | 58,480 | 56,040 | -2,440 |
| Utah | 24,840 | 22,830 | -2,010 |
| Alabama | 51,280 | 49,370 | -1,910 |
| Idaho | 15,350 | 13,680 | -1,670 |
| Rhode Island | 12,680 | 11,190 | -1,490 |
| Michigan | 102,590 | 101,470 | -1,120 |
| Ohio | 131,400 | 130,370 | -1,030 |
| Colorado | 53,100 | 52,390 | -710 |
| Montana | 10,680 | 10,020 | -660 |
| New Hampshire | 14,010 | 13,510 | -500 |
| West Virginia | 21,550 | 21,110 | -440 |
| Kansas | 30,920 | 30,520 | -400 |
| Maine | 14,950 | 14,610 | -340 |
| Connecticut | 34,470 | 34,290 | -180 |
| Delaware | 11,660 | 11,490 | -170 |
| Nevada | 24,040 | 23,970 | -70 |
| Wyoming | 5,080 | 5,070 | -10 |
| Vermont | 6,920 | 6,930 | 10 |
| Hawaii | 11,770 | 11,800 | 30 |
| Mississippi | 29,270 | 29,370 | 100 |
| Indiana | 66,740 | 67,350 | 610 |
| South Dakota | 13,440 | 14,360 | 920 |
| Iowa | 33,110 | 34,050 | 940 |
| Alaska | 5,680 | 6,730 | 1,050 |
| District of Columbia | 10,580 | 11,820 | 1,240 |
| North Dakota | 10,060 | 11,300 | 1,240 |
| Kentucky | 43,320 | 44,970 | 1,650 |
| California | 323,900 | 325,620 | 1,720 |
| Louisiana | 41,940 | 43,790 | 1,850 |
| North Carolina | 102,150 | 104,300 | 2,150 |
| Virginia | 67,340 | 69,510 | 2,170 |
| Arkansas | 25,890 | 28,490 | 2,600 |
| Washington | 61,560 | 64,920 | 3,360 |
| Massachusetts | 87,860 | 94,100 | 6,240 |
| Florida | 189,120 | 197,630 | 8,510 |
| Georgia | 73,180 | 82,970 | 9,790 |
| Texas | 220,980 | 231,060 | 10,080 |
Source: CareerOneStop: Current Employment (2022) vs. 2020 Employment
The BLS estimates that nationwide employment of RNs was 3,172,500 in 2022, with projected employment of 3,349,900 by 2032, resulting in a 6% increase and 193,100 job openings annually. The new projections for RN employment from 2022 to 2032 will likely be higher than the 2020 – 2030 projections.
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Highest and Lowest RNs per Capita by State
To further determine where shortages might occur, we also looked at the number of RNs per capita by state to see which states had more employed RNs available for the current population in 2202. In this instance, per capita means the number of nurses for every 1,000 persons in the population.
Using the most recent (2022) data from the USDOL and U.S. Census Bureau, we calculated RN per capita for each state and ranked them from lowest to highest. Keep in mind the national average in 2022 was 9.22 RNs per resident. We consider any state with a number below the national average to have a shortage.
| State | Employed RNs (2022) | Population (2022) | RNs per 1,000 Residents |
| United States | 3,072,670 | 333,287,557 | 9.22 |
| Utah | 22,830 | 3,380,800 | 6.75 |
| Idaho | 13,680 | 1,939,033 | 7.06 |
| New Mexico | 15,910 | 2,113,344 | 7.53 |
| Oklahoma | 30,320 | 4,019,800 | 7.54 |
| Nevada | 23,970 | 3,177,772 | 7.54 |
| Georgia | 82,970 | 10,912,876 | 7.60 |
| Arizona | 56,040 | 7,359,197 | 7.61 |
| Texas | 231,060 | 30,029,572 | 7.69 |
| Virginia | 69,510 | 8,683,619 | 8.00 |
| Maryland | 49,790 | 6,164,660 | 8.08 |
| Hawaii | 11,800 | 1,440,196 | 8.19 |
| South Carolina | 44,030 | 5,282,634 | 8.33 |
| Washington | 64,920 | 7,785,786 | 8.34 |
| California | 325,620 | 39,029,342 | 8.34 |
| New Jersey | 78,340 | 9,261,699 | 8.46 |
| Tennessee | 60,840 | 7,051,339 | 8.63 |
| Wyoming | 5,070 | 581,381 | 8.72 |
| Oregon | 37,400 | 4,240,137 | 8.82 |
| Florida | 197,630 | 22,244,823 | 8.88 |
| Montana | 10,020 | 1,122,867 | 8.92 |
| Colorado | 52,390 | 5,839,926 | 8.97 |
| Alaska | 6,730 | 733,583 | 9.17 |
| Arkansas | 28,490 | 3,045,637 | 9.35 |
| Connecticut | 34,290 | 3,626,205 | 9.46 |
| Louisiana | 43,790 | 4,590,241 | 9.54 |
| New York | 190,470 | 19,677,151 | 9.68 |
| New Hampshire | 13,510 | 1,395,231 | 9.68 |
| Alabama | 49,370 | 5,074,296 | 9.73 |
| North Carolina | 104,300 | 10,698,973 | 9.75 |
| Indiana | 67,350 | 6,833,037 | 9.86 |
| Kentucky | 44,970 | 4,512,310 | 9.97 |
| Mississippi | 29,370 | 2,940,057 | 9.99 |
| Nebraska | 19,870 | 1,967,923 | 10.10 |
| Michigan | 101,470 | 10,034,113 | 10.11 |
| Rhode Island | 11,190 | 1,093,734 | 10.23 |
| Illinois | 129,390 | 12,582,032 | 10.28 |
| Wisconsin | 61,100 | 5,892,539 | 10.37 |
| Kansas | 30,520 | 2,937,150 | 10.39 |
| Maine | 14,610 | 1,385,340 | 10.55 |
| Pennsylvania | 137,970 | 12,972,008 | 10.64 |
| Iowa | 34,050 | 3,200,517 | 10.64 |
| Vermont | 6,930 | 647,064 | 10.71 |
| Ohio | 130,370 | 11,756,058 | 11.09 |
| Minnesota | 63,800 | 5,717,184 | 11.16 |
| Delaware | 11,490 | 1,018,396 | 11.28 |
| Missouri | 70,440 | 6,177,957 | 11.40 |
| West Virginia | 21,110 | 1,775,156 | 11.89 |
| Massachusetts | 94,100 | 6,981,974 | 13.48 |
| North Dakota | 11,300 | 779,261 | 14.50 |
| South Dakota | 14,360 | 909,824 | 15.78 |
| District of Columbia | 11,820 | 671,803 | 17.59 |
Sources: U.S. Department of Labor and U.S. Census Bureau
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Some States May See Balancing of Supply and Demand
Despite the current unknowns as to potential shortages and surpluses of RNs nationwide, some states have indicated that they’re starting to see a balancing of supply and demand.
For example, California had a projected shortfall of 11.5% by 2030, per the HRSA report above. However, its 2022 Forecasts of the Registered Nurse Workforce in California report created by the University of California, San Francisco, and supported by the California Board of Registered Nursing, noted an expected gap of 6.2% by the end of that year. However, the report predicted that RN shortages would persist only until 2029 when supply and demand became balanced. By 2037, the state projects a nursing surplus of 8.1%.
Conversely, data within Alaska indicates the state will continue grappling with shortcomings in its nursing staff. It had the highest deficit of RNs in the HRSA’s 2014-2030 report at 22.7% but didn’t rank in the top 10 states in its upcoming 2020-2035 projections.
Despite this change, the Alaska Healthcare Workforce Analysis published in December 2022 stated that RNs are the top category needing new healthcare workers annually to keep up with resulting needs. Based on its average quarterly count in 2021, the state had 6,995 RNs, with an average churn of 21%. The state needs 1,463 new workers for replacements, plus 81 more for growth, creating a total of 1,544 new RNs needed each year.
Historically, Alaska has found it challenging to attract and retain skilled nurses and other medical professionals, with the pandemic exacerbating the situation. For nurses seeking job security, the Last Frontier can definitely help them fulfill that goal. Besides RNs, LPNs will also feel a projected shortage of 36%.
According to the 2022 Alaska Hospital and Healthcare Association Salary and Benefits Report, hospital RN vacancy rates averaged 24% in 2022, with an average of 161 days to fill a vacant position. Travel nursing jobs in Alaska are typically abundant to help fill the staffing gaps in hospitals, nursing homes and assisted living facilities, with above-average travel RN salaries.
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Is There Really a Nursing Shortage?
Some organizations and nursing unions insist that the nation has plenty of registered nurses licensed, just not enough of them actively practicing. While recurrent shortages of RNs have been reported for decades, there isn’t any objective measure of whether a labor shortage truly exists (though many RNs attest to routine staffing shortages in their workplaces).
Although rising RN vacancy rates suggest a shortage, higher than usual vacancies may arise temporarily, such as when there’s a particularly bad flu season, transient demand due to seasonality or when an area builds a new hospital. Health systems may also post vacancies without actively seeking to fill these positions.
Per the Oregon Hospital Association’s 2020 Nursing Workforce Data File, the state had 59,778 licensed RNs that year. However, only about 75% were actively practicing. The lower number of practicing nurses versus licensed nurses also occurred in other nursing positions, with about 86% of CNAs, 83% of LPNs and 78% of APRNs actively practicing in their fields during this period compared to the number licensed.
At the end of 2022, the NCSBN recorded more than 5.3 million active RN licenses nationwide. However, holding a license doesn’t necessarily mean all these professionals are actively working as bedside nurses. They may be retired, hold multiple single-state licenses to work as travel nurses or have found ways to use their nursing credentials in ways that don’t require them to provide direct patient care, such as teaching, consulting or writing.
The shortage of RNs may be even more severe if you subtract the number of nurses with an active license who aren’t actually practicing. We compared the number of actively licensed nurses by state based on 2022 NCSBN records versus employed RNs based on 2022 USDOL records below.
| State | Actively Licensed RNs in 2022 per NCSBN | Employed RNs in 2022 per USDOL | Difference |
| Alabama | 98,929 | 49,370 | 49,559 |
| Alaska | 16,885 | 6,730 | 10,155 |
| Arizona | 107,827 | 56,040 | 51,787 |
| Arkansas | 46,069 | 28,490 | 17,579 |
| California | 497,668 | 325,620 | 172,048 |
| Colorado | 85,041 | 52,390 | 32,651 |
| Connecticut | 89,876 | 34,290 | 55,586 |
| Delaware | 21,199 | 11,490 | 9,709 |
| District of Columbia | 36,368 | 11,820 | 24,548 |
| Florida | 361,134 | 197,630 | 163,504 |
| Georgia | 140,535 | 82,970 | 57,565 |
| Hawaii | 33,322 | 11,800 | 21,522 |
| Idaho | 28,778 | 13,680 | 15,098 |
| Illinois | 213,163 | 129,390 | 83,773 |
| Indiana | 128,358 | 67,350 | 61,008 |
| Iowa | 57,757 | 34,050 | 23,707 |
| Kansas | 53,240 | 30,520 | 22,720 |
| Kentucky | 73,649 | 44,970 | 28,679 |
| Louisiana | 65,627 | 43,790 | 21,837 |
| Maine | 28,803 | 14,610 | 14,193 |
| Maryland | 87,672 | 49,790 | 37,882 |
| Massachusetts | 168,951 | 94,100 | 74,851 |
| Michigan* | 169,808 | 101,470 | 68,338 |
| Minnesota | 129,302 | 63,800 | 65,502 |
| Mississippi | 52,437 | 29,370 | 23,067 |
| Missouri | 122,150 | 70,440 | 51,710 |
| Montana | 21,792 | 10,020 | 11,772 |
| Nebraska | 31,180 | 19,870 | 11,310 |
| Nevada | 56,601 | 23,970 | 32,631 |
| New Hampshire | 26,654 | 13,510 | 13,144 |
| New Jersey | 142,471 | 78,340 | 64,131 |
| New Mexico | 31,667 | 15,910 | 15,757 |
| New York | 386,331 | 190,470 | 195,861 |
| North Carolina | 154,397 | 104,300 | 50,097 |
| North Dakota | 17,440 | 11,300 | 6,140 |
| Ohio | 239,491 | 130,370 | 109,121 |
| Oklahoma | 50,453 | 30,320 | 20,133 |
| Oregon | 80,932 | 37,400 | 43,532 |
| Pennsylvania | 245,377 | 137,970 | 107,407 |
| Rhode Island | 29,294 | 11,190 | 18,104 |
| South Carolina | 79,061 | 44,030 | 35,031 |
| South Dakota | 19,672 | 14,360 | 5,312 |
| Tennessee | 113,294 | 60,840 | 52,454 |
| Texas | 380,867 | 231,060 | 149,807 |
| Utah | 44,154 | 22,830 | 21,324 |
| Vermont | 22,020 | 6,930 | 15,090 |
| Virginia | 116,181 | 69,510 | 46,671 |
| Washington | 126,460 | 64,920 | 61,540 |
| West Virginia | 34,492 | 21,110 | 13,382 |
| Wisconsin | 118,015 | 61,100 | 56,915 |
| Wyoming | 9,594 | 5,070 | 4,524 |
Sources: NCSBN, USDOL and Michigan Nurse Mapping Project
(*Michigan wasn’t participating in the Nursys Licensure Verification system in 2022, so we used data from the Michigan Nurse Mapping Project from the Michigan Public Health Institute)
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New Nursing Shortages Data Due Soon
A new HRSA report covering nurse workforce projections for 2020-2035 is expected soon but remains unavailable at this publication. However, preliminary data released via a brief in November 2022 already indicates a significant shift from the previous calculations listed above, including many more states having nurse staff deficits and at much higher rates. While it still predicts a surplus nationally in 2035, these estimates still utilize data from 2020, so the full impact of the pandemic still isn’t reflected. More accurate estimates won’t be possible until several more years of data become available.
However, even with a nationwide surplus, shortages and surpluses among states in 2035 still fluctuate, ranging from the largest shortage of 26% in Washington to the most significant oversupply of 48% in North Dakota. From the details available, the 10 states with the most significant shortfalls in nursing staff in 2035 include:
- Washington (26%)
- Georgia (21%)
- California (18%)
- Oregon (16%)
- Michigan (15%)
- Idaho (15%)
- Louisiana (13%)
- North Carolina (13%)
- New Jersey (12%)
- South Carolina (11%)
Details for the remaining states haven’t been released as of February 6, 2024.
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What About Other Nurses?
According to the BLS, 59% of RNs worked in hospitals in 2022, compared to just 15% of LPN/LVNs. Nearly half of licensed practical/vocational nurses worked in nursing and residential care facilities or home healthcare services during this period.
While most research focuses on registered nurse shortages, the 2022 report on Nurse Workforce Projections from the HRSA projects that the demand for LPN/LVNs will also grow faster than the supply. It estimates a national shortage of 141,580 LPN/LVNs by 2035 as demand between 2020 and 2035 outpaces the projected supply, resulting in a shortage of 17% overall compared to a 5% shortage in 2025.
Like RNs, the actual shortage or surplus of LPN/LVNs varies by state. According to the HRSA report, Alaska will be hardest hit with an 88% shortage of LPNs, while Arkansas will see a surplus of 51% by 2035. Also notable is that NCSBN research indicates that LPN/LVNs have seen their ranks decline by 33,811 since the pandemic began, and this downward trend continues.
How Nurse Demand and Shortages Impact You
Bear in mind that many factors can impact supply and demand, so a projected surplus can quickly become a shortage and vice versa. Also, different studies may result in differing outcomes based on the parameters used for each, and projections assume that historical patterns of graduation, labor force participation and departure from the labor force remain unchanged over the entire forecast period.
Many issues can impact whether parameters stay the same over a decade, which is why annual updates are necessary. As new data becomes available, Vivian will update this post to reflect current trends.
There will always be a constant need for healthcare services and registered nurses and other nursing professionals to provide these services. Whether you’re a travel nurse or a staff nurse looking for a change of scenery, knowing which states expect to have a surplus of nurses versus those facing shortages can help narrow your options.
States with nursing shortages will likely pursue recruitment strategies beneficial to nurses, such as offering higher salaries, better benefits, flexible scheduling and other incentives to attract nurses to the area. On the flip side, states with a surplus of nurses may not offer the most competitive wages.
Some healthcare employment locations have historically paid more than others with or without a shortage. However, higher costs of living often offset these inflated salaries. When comparing your relocation or travel assignment options, make sure the salary is a livable wage.
Vivian Health had nearly 93,000 staff, travel, local contract, per diem and locum tenens jobs posted for registered nurses in February 2024. Browse healthcare jobs to plan your next career move faster and easier than ever on Vivian.
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Editor’s Note: This blog post was originally published in October 2021, and has been updated annually to reflect the most recent data.
Moira K. McGhee
Moira K. McGhee is Vivian’s Senior Editor & All-Around Wordsmith. As part of the Vivian Health team, she strives to help support the empowerment of nurses and other healthcare professionals in their pursuits to find top-notch travel, staff, local contract and per diem positions faster and easier than ever.
Comments (11)
By john reiners
May 5, 2024 at 10:17 am
I find that at the hospital where I work, we have been on mandatory overtime for the last 10 years. They have increased our patient ratio to try and get us off OT, but we have still remained on OT with a larger workload. Many I work with have retired or quit nursing because of this, which in turn makes us shorter of RNs and we get even more OT. We are NEVER short-staffed of Supervisors and above. It’s the bedside nurse who is constantly taking the hit.
Reply
By JoannieO
May 1, 2024 at 7:14 pm
I worked as an RN in multiple health care settings for 45 years. At age 72, I didn’t renew my licensure. We were always short staffed, during the 70s and 80s! But at least you always had a job with good pay + benefits.
Reply
By Sharon Crosson
May 7, 2023 at 3:41 pm
Are RN’s the only Nurses?
Reply
By Moira K. McGhee
May 9, 2023 at 1:13 am
Hello Sharon and thanks for reaching out. Most of the data used for this post only included details on RNs. However, we try to cover the entire nursing profession when possible, so a section covering other levels of nursing has been added. Thank you for your feedback.
Reply
By Michele Maxey, BSN, RN, CCRN
May 2, 2023 at 7:27 pm
I appreciate your article and the work you put in. However, this indicates a 5k surplus in my home state of Ohio, yet many hospitals work short staffed every night. Also there are travel contracts in both urban and rural settings. Are there just early retirees with active licenses? Or newly licensed that already quit the career field added in? Stats compared to daily grind reality doesn’t seem to match.
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By Moira K. McGhee
May 2, 2023 at 7:53 pm
Hello Michele and thanks for reaching out! The information provided indicates long-term projections from 2020 through 2030, which likely won’t mesh with the current reality. Also, keep in mind that these are projections from a single study using specific parameters. Other studies using different paraments may see different results, especially those completed on the state level. Many factors can impact supply and demand. A projected surplus can quickly become a shortage and vice versa. We’ll routinely revisit this post to provide updates based on the most current data available, so check back to compare any changes in your state after each update.
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By Helen Gardner
May 2, 2023 at 7:09 pm
Hi Moira! Thanks for sharing this enlightening information!
I am RN/BSN nurse in Texas, currently unemployed due to medical issues. I am 67 years young and have embraced my nursing career since 1974. Is there demand, and will there be demand, for veteran nurses? If so, what field would you recommend? TYIA
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By Moira K. McGhee
May 2, 2023 at 8:34 pm
Hello Hellen! I’m so glad you found the information helpful. RNs are always in high demand, so veteran nurses should also find plenty of opportunities. For recommended fields, consider reaching out to your local hospitals to learn their greatest needs within the areas matching your expertise. If you’d like to have more control over your schedule and work fewer hours, you might consider a per diem role. Vivian has some per diem positions in Texas posted here https://www.vivian.com/nursing/per-diem/texas/. If you like to travel, have you considered travel nursing? Many travel nurses are professionals who choose to travel for the last part of their careers, either before or during their retirement. Travel nursing also gives you more freedom and flexibility in deciding when and where you want to work. Vivian always has numerous travel nursing jobs posted from locations nationwide, which you can find here https://www.vivian.com/nursing/travel/. I hope this helps you find the job you’re seeking. If you have any questions, please don’t hesitate to go to the “Contact Vivian” option under the Resources tab to speak with our 24/7 help desk.
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By Rita Williams
April 7, 2023 at 6:57 pm
Not sure how that Georgia “surplus” is going. Lots of needs in Georgia get posted.
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By Jacqueline Garrett
October 31, 2021 at 8:59 pm
Moira,
Your articles are amazing and your information is very accurate with SO MANY helpful resources to help both travel and staff RNs! As one who personally has seen and experienced the life and struggles of human life in ICU both before and during COVID, I want to THANK YOU for helping my fellow RNs!!! We went from Heroes to zeroes in no time flat, so your detailed research and information on shortages, mandates, and bans, positions, projected shortages, etc are very valuable resources for all of us! I wanted to say you are amazing, (and a blessing), and I plan to share your articles with all the nurses I know! Thank you again for all that you do and God Bless!
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By Moira K. McGhee
August 8, 2022 at 2:49 pm
Thank you Jacqueline for your kind words! I’m so glad my articles have been a helpful resource for you and your fellow nurses. Take care of yourself out there!
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