A Crisis by the Numbers: Nursing Shortages in 2025 by State

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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. It appears the firm was correct. Between 2022 and 2025, the Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) noted a 1% increase in RN supply but a 3% increase in demand. The result was a deficit of about 295,800 nurses nationwide, falling within the predicted range. The persistent nursing shortage across U.S. healthcare systems is more than a temporary crisis. It’s a consistent, critical challenge that strains hospitals and other healthcare facilities nationwide.

As the demand for healthcare services escalates with an aging population and ongoing healthcare reforms, the gap between the supply and demand of RNs widens, but only in some areas. Vivian Health compared data across all 50 states and the District of Columbia to perform a comprehensive analysis of where nursing shortages may continue to impact healthcare systems. Our detailed examination explores the depth of the problem, pinpointing states facing the most significant shortages and those anticipated to have an oversupply for a quantitative view of the national distribution of nurses.

Nursing Shortages on a National Level

A study published in February 2024 by the JAMA Health Forum indicates the nursing workforce recovered in 2022 and 2023 following a substantial drop during the COVID-19 pandemic. It further emphasized that the workforce was on a trajectory to reach 4.56 million nurses in 2025, as previously forecast before the pandemic.

Other studies aren’t in total agreement. While the most recent projections do show nursing shortages easing, the gap between supply and demand decreases gradually over the 2027 to 2037 decade but doesn’t fully dissipate.

The U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) projected continued shortages of full-time equivalent (FTE) RNs on a national level. It anticipates a 10% RN shortage in 2027, dropping to 8% by 2032 and 6% by 2037.

While the shortage wanes over the projection decade, a shortage still remains. The 6% shortage equates to about 207,980 FTE RNs nationally. Furthermore, the shortage spread is far from equal, with some states projected to have a surplus of nurses while others continue to face significant shortages.

Projected RN Shortages by State Through 2037

The HRSA generated its projections using historical data up to and including some 2022 data. Because the pandemic impacted the nursing workforce, this effect may only be partially captured in the data available for current projections. These projections assume that previous patterns of graduation, employee departures and actively working nurses remain the same over the forecast period.

According to the HRSA’s projections, the adequate supply of RNs significantly varies by state. The following 10 states have the largest projected shortages by 2037:

• North Carolina 22%
• Washington 22%
• Maryland 20%
• South Carolina 19%
• Michigan 19%
• New Mexico 19%
• Oklahoma 18%
• California 18%
• Idaho 17%
• Georgia 17%

Keep in mind that, like national projections, the projections for an entire state may still mean that certain areas are better covered than others. For example, the HRSA report released in November 2024 projects a 13% shortage in nonmetropolitan areas compared to just 5% in metro areas.

Vivian Health reviewed the HRSA’s data to compare which states might see the gap in supply versus demand shrink between 2025 and 2037. From our research, we learned that 34 states would have a shortage in 2025 compared to 29 states in 2037. However, as some states’ shortages improve, others worsen.

For example, North Carolina has an anticipated shortage of 15% in 2025, rising to 22% by 2037. Conversely, Idaho has an expected shortage of 38% in 2025, falling to 17% by 2037. On the opposite end of the spectrum, Wyoming is expected to have nearly double the nurses the state needs in 2025, with an oversupply of 99%, but it drops to 77% by 2037. To see how your state fares, we’ve provided two tables below—one showing projected adequacy in 2025 and the other projected adequacy in 2037.

2025 Projected Adequacy by State 

State	2025 Supply	2025 Demand	2025 Adequacy
Idaho	10,940	17,570	62%
New Mexico	12,290	19,350	64%
Oklahoma	28,100	41,020	69%
Virginia	57,720	82,540	70%
South Carolina	39,940	55,120	72%
Maryland	44,680	59,270	75%
Arizona	51,870	68,220	76%
Iowa	25,350	32,020	79%
Colorado	39,320	49,240	80%
Kentucky	39,890	49,470	81%
West Virginia	16,280	20,160	81%
Georgia	82,370	99,260	83%
Missouri	54,230	65,310	83%
Pennsylvania	112,370	135,100	83%
Arkansas	26,870	32,020	84%
Michigan	86,090	102,000	84%
Tennessee	60,580	72,070	84%
Louisiana	42,400	49,750	85%
New Hampshire	11,840	13,980	85%
North Carolina	90,810	107,200	85%
Kansas	24,640	28,720	86%
Maine	13,080	15,230	86%
Nebraska	15,990	18,630	86%
Washington	60,940	69,980	87%
California	286,880	327,670	88%
Texas	222,250	253,610	88%
Mississippi	28,080	31,240	90%
Florida	206,640	225,290	92%
Nevada	25,640	27,830	92%
New Jersey	76,540	83,150	92%
Indiana	65,570	67,310	97%
Ohio	120,690	122,640	98%
Oregon	40,400	41,080	98%
Utah	25,950	26,290	99%
New York	185,050	184,710	100%
Montana	11,440	11,190	102%
Illinois	121,700	116,130	105%
Delaware	11,390	10,630	107%
Connecticut	39,940	37,060	108%
Wisconsin	60,010	55,760	108%
Minnesota	57,850	52,590	110%
Rhode Island	12,260	10,950	112%
South Dakota	10,240	9,130	112%
Alabama	59,250	51,910	114%
Massachusetts	81,040	65,470	124%
North Dakota	9,460	7,540	125%
Hawaii	15,940	11,870	134%
Vermont	8,520	6,350	134%
Alaska	9,570	6,590	145%
District of Columbia	11,200	5,800	193%
Wyoming	10,290	5,160	199%

Source: Department of Health and Human Services, Health Resources and Services Administration, Health Workforce Projections

Of the 34 states with a shortage in 2025, all but nine see their supply increase in 2037. However, only seven of the 26 states with an increased supply end up with an oversupply, between 1% and 23%. Utah notably goes from 99% adequacy in 2025 to 123% in 2037, a jump of 24%. While this increase is less than West Virginia’s jump of 27%, this state’s overage is much lower at 108%.

On the flip side, six states see their adequacy drop even more—from 1% to 14%—between 2025 and 2037. Oregon has the largest projected decrease, dropping from 98% adequacy to 84% (still higher than North Carolina’s 78%). Georgia and Maine are the only two states where adequacy doesn’t change, remaining at 83% and 86%, respectively.

Fifteen states and the District of Columbia have overages in 2025, and the HRSA projects eight to see adequacy continue to rise, between 3% and 19%. North Dakota has the most significant climb, rising from 125% to 144%, the third-highest overage. Of the remaining eight that drop, six will still have an oversupply.

New York was the only state at an even 100% in 2025. It and Delaware are in the exception column, with New York dropping from 100% to 99% and Delaware from 107% to 97% in 2037, moving both states to the shortage category. No state was at an even 100% in 2037.

Long-Term State-Wide Adequacy Projections Through 2037

State	2037 Supply	2037 Demand	2037 Adequacy
North Carolina	101,080	129,930	78%
Washington	68,790	87,730	78%
Maryland	54,960	68,550	80%
Michigan	90,120	111,410	81%
New Mexico	17,000	20,920	81%
South Carolina	49,930	61,790	81%
California	302,720	367,720	82%
Oklahoma	36,390	44,510	82%
Georgia	93,010	112,000	83%
Idaho	17,060	20,650	83%
Oregon	41,370	49,200	84%
Maine	15,570	18,090	86%
Texas	271,570	310,700	87%
New Jersey	79,540	90,680	88%
Louisiana	46,380	52,320	89%
Colorado	54,770	60,470	91%
Virginia	84,310	92,900	91%
Arizona	77,220	83,690	92%
Kansas	31,850	34,590	92%
Missouri	64,520	69,870	92%
Pennsylvania	136,880	148,140	92%
New Hampshire	15,890	16,870	94%
Mississippi	31,430	33,000	95%
Tennessee	77,950	81,740	95%
Delaware	11,850	12,170	97%
Iowa	32,890	34,040	97%
Florida	267,260	270,660	99%
Indiana	71,280	72,190	99%
New York	189,880	191,570	99%
Arkansas	34,070	33,840	101%
Kentucky	53,770	53,010	101%
Nevada	32,940	31,500	105%
Connecticut	40,110	37,820	106%
Nebraska	21,760	20,260	107%
Illinois	126,650	117,490	108%
Montana	13,420	12,480	108%
West Virginia	21,000	19,530	108%
Massachusetts	80,190	72,270	111%
Alaska	8,450	7,450	113%
Rhode Island	13,680	11,770	116%
Wisconsin	68,250	58,850	116%
Alabama	64,610	55,030	117%
Minnesota	68,980	58,890	117%
Ohio	145,620	123,300	118%
Utah	42,720	34,600	123%
South Dakota	12,830	10,300	125%
Vermont	8,100	6,500	125%
Hawaii	16,270	12,430	131%
North Dakota	11,670	8,090	144%
District of Columbia	9,130	6,210	147%
Wyoming	9,310	5,260	177%

Source: Department of Health and Human Services, Health Resources and Services Administration, Health Workforce Projections

In 2037, HRSA projects that 29 states will still have a nursing shortage. However, three states—Florida, Indiana and New York—will only be short by 1%. Of the 22 states with overages, Arkansas and Kentucky are only over by 1%.

Notably, the District of Columbia had the most significant decline in supply versus demand over the projection period but remained well above adequacy, decreasing from 193% to 147%. It continues to have the second-highest overage, with Wyoming’s decrease of 22% keeping it firmly in the lead. Its continued surplus falls from 199% to 177%.

Nurses Per Capita by State

To better understand how organizations determine whether a state will be understaffed or overstaffed, we looked at nurses per capita. In this instance, per capita means the number of nurses for every 1,000 persons in a state’s population. We used 2023 data from the U.S. Department of Labor (USDOL) and the U.S. Census Bureau (the most recent available from the USDOL) to calculate RN per capita for each state and ranked them from lowest to highest.

The national per capita was 9.43 RNs for every 1,000 residents. Using this figure, you could assume that any state with less than 9.43 RNs per capita would be considered as having a nurse shortage. Using this premise, 23 states were below the national rate. However, since there’s a national RN deficit, the per capita nationwide is technically also too low.

The following table provides the RN per capita in each state and the District of Columbia.

Location	# Nurses	Population	Per Capita
Idaho	14,060	1,971,122	7.13
Utah	24,730	3,443,222	7.18
Maryland	49,770	6,217,062	8.01
Oklahoma	32,610	4,063,882	8.02
Louisiana	36,840	4,588,071	8.03
Nevada	25,890	3,214,363	8.05
Virginia	70,650	8,734,685	8.09
Texas	251,840	30,727,890	8.20
Hawaii	11,920	1,441,387	8.27
Washington	65,030	7,857,320	8.28
Arizona	63,150	7,473,027	8.45
Georgia	93,730	11,064,432	8.47
California	332,560	39,198,693	8.48
New Mexico	18,030	2,121,164	8.50
Montana	9,740	1,131,302	8.61
New Jersey	82,950	9,379,642	8.84
Tennessee	63,460	7,148,304	8.88
Alaska	6,590	736,510	8.95
South Carolina	48,790	5,387,830	9.06
Colorado	53,480	5,901,339	9.06
Florida	207,910	22,904,868	9.08
Oregon	38,770	4,253,653	9.11
Wyoming	5,350	585,067	9.14
United States	3,175,390	336,806,231	9.43
New York	188,060	19,737,367	9.53
North Carolina	104,380	10,881,189	9.59
Arkansas	29,690	3,069,463	9.67
Mississippi	28,910	2,943,172	9.82
Alabama	50,450	5,117,673	9.86
Connecticut	36,430	3,643,023	10.00
Indiana	68,850	6,880,131	10.01
Michigan	102,240	10,083,356	10.14
New Hampshire	14,380	1,402,199	10.26
Rhode Island	11,350	1,103,429	10.29
Iowa	33,300	3,218,414	10.35
Wisconsin	61,870	5,930,405	10.43
Kansas	31,120	2,951,500	10.54
Maine	14,770	1,399,646	10.55
Kentucky	48,710	4,550,595	10.70
Illinois	139,910	12,642,259	11.07
Pennsylvania	144,100	13,017,721	11.07
Vermont	7,260	648,708	11.19
Ohio	133,300	11,824,034	11.27
Delaware	11,810	1,036,423	11.39
Nebraska	22,870	1,987,864	11.50
Minnesota	66,700	5,753,048	11.59
West Virginia	20,860	1,770,495	11.78
Missouri	73,190	6,208,038	11.79
Massachusetts	87,320	7,066,568	12.36
North Dakota	10,350	789,047	13.12
District of Columbia	10,810	687,324	15.73
South Dakota	14,600	918,305	15.90

Source: USDOL and U.S. Census Bureau

Licensed Versus Actively Working

Another aspect to consider is that there are likely many more licensed RNs than there are actively employed and those employed may not be employed at the bedside, potentially impacting shortage data. Furthermore, RNs may hold multiple single-state licenses but can only work in one place at a time. These nurses may be counted as part of the workforce in several states, potentially skewing the numbers further to some degree. Travel nursing jobs can also muddy the waters, especially if an RN has a multistate license through the Enhanced Nurse Licensure Compact from her home state but frequently works in other states instead.

Vivian explored the differences between active RN licenses posted by the National Council of State Boards of Nursing versus employed RNs from the USDOL in 2023. You can compare those differences in the following table.

State	Active RN Licenses in 2023 per NCSBN	Employed RNs in 2023 per USDOL	Difference
Alabama	104,695	50,450	54,245
Alaska	20,800	6,590	14,210
Arizona	111,992	63,150	48,842
Arkansas	46,960	29,690	17,270
California	523,864	332,560	191,304
Colorado	87,295	53,480	33,815
Connecticut	80,219	36,430	43,789
Delaware	19,658	11,810	7,848
District of Columbia	43,947	10,810	33,137
Florida	375,078	207,910	167,168
Georgia	143,998	93,730	50,268
Hawaii	31,615	11,920	19,695
Idaho	27,297	14,060	13,237
Illinois	235,502	139,910	95,592
Indiana	123,464	68,850	54,614
Iowa	58,116	33,300	24,816
Kansas	53,256	31,120	22,136
Kentucky	74,145	48,710	25,435
Louisiana	66,616	36,840	29,776
Maine	28,785	14,770	14,015
Maryland	89,483	49,770	39,713
Massachusetts	161,279	87,320	73,959
Michigan	173,905	102,240	71,665
Minnesota	134,563	66,700	67,863
Mississippi	52,355	28,910	23,445
Missouri	118,954	73,190	45,764
Montana	23,451	9,740	13,711
Nebraska	33,044	22,870	10,174
Nevada	58,554	25,890	32,664
New Hampshire	26,837	14,380	12,457
New Jersey	146,031	82,950	63,081
New Mexico	33,260	18,030	15,230
New York	439,616	188,060	251,556
North Carolina	158,174	104,380	53,794
North Dakota	17,894	10,350	7,544
Ohio	221,760	133,300	88,460
Oklahoma	53,376	32,610	20,766
Oregon	84,255	38,770	45,485
Pennsylvania	241,328	144,100	97,228
Rhode Island	29,974	11,350	18,624
South Carolina	84,701	48,790	35,911
South Dakota	19,800	14,600	5,200
Tennessee	115,507	63,460	52,047
Texas	401,653	251,840	149,813
Utah	44,324	24,730	19,594
Vermont	11,958	7,260	4,698
Virginia	118,430	70,650	47,780
Washington	120,813	65,030	55,783
West Virginia	36,539	20,860	15,679
Wisconsin	118,033	61,870	56,163
Wyoming	8,942	5,350	3,592
United States	5,643,150	3,175,390	2,467,760

Sources: NCSBN Active RN Licenses in 2023 and Department of Labor 2023 Employment

What About Other Types of Nurses

While the bulk of our investigation covered RNs, we also looked at the projections for licensed practical/vocational nurses (LPN/LVNs) and nurse practitioners (NPs) to understand the outlook for these nursing professionals. The HRSA projects the demand for LPN/LVNs to grow faster than supply, but the opposite for NPs.

RELATED: The Impact of Federal Staffing Mandates on LPNs in Long-Term Care

In its nurse workforce report, nationwide projections for LPN/LVNs would result in a shortage of 302,440 FTE LPNs by 2037. The HRSA indicated the projected supply of LPN/LVNs would only meet 80% of demand in 2027, and this adequacy would fall to 72% by 2032 and 64% by 2037. Like RNs, LPN adequacy varies greatly by state, ranging from an astounding 80% shortage in Maine to a 17% overage in West Virginia by 2037.

Supply was anticipated to exceed demand for NPs, resulting in a 26% overage by 2027, rising to 53% by 2032 and 76% by 2037. However, distribution among states remains a factor. For example, California opened a pathway for NPs to practice without physician supervision to help alleviate the state’s ongoing primary care clinician shortage. California projects a shortage of 8,000 primary care clinicians by 2030, which includes doctors, physician assistants and NPs.

What’s Causing Nursing Shortages?

In the wake of the COVID-19 pandemic, the number of nurses with the intent to leave their jobs was high but expected to wane. However, it stayed higher than many expected. Many health systems have seen the anticipated turnover occur, with an overall decrease in the active nursing workforce.

While several of these systems have had some success in rebuilding their nursing workforces, others haven’t. Estimates in early 2023 still suggested a shortage of nurses nationwide, especially within acute-care settings.

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. Based on data from McKinsey & Company, experts don’t expect the educational pipeline to be able to keep up with demand. This shortcoming is expected to result in a gap between nurse graduates and job openings of more than 800,000 in 2031.

RELATED: Can Virtual Nursing Address the Post-Pandemic Nursing Shortages?

Specific factors contributing to the complexity of the nurse staffing deficits include:

• 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 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 continued staffing shortages. The intense pressure has led to decreased job satisfaction, increased absenteeism and many 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 insufficient 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.

• 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 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 bodily injury, including death. Healthcare workers are five times more likely to sustain an injury due to workplace violence than other professions.

How Nurse Demand and Shortages Impact You

Nursing shortages confronting health systems are well documented, but the data isn’t always in agreement on the severity of the issue. Discrepancies between findings can be attributed to variations in data collection methods, changes over time not consistently reflected among studies or reports and differences in local or regional impacts. Furthermore, projections assume that historical patterns of graduation, labor force participation and departure from the labor force remain unchanged over the entire forecast period.

Bear in mind that many factors can impact supply and demand, so a projected surplus can quickly become a shortage and vice versa. Many issues can influence whether parameters stay the same for a decade, which is why annual updates are necessary and why Vivian Health updates this post each year as new data becomes available.

No matter what the data indicates, there will always be a constant need for healthcare services and RNs 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.

RELATED: Is Travel Nursing Still Worth It? Insights, Trends & Predictions

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 or the perks you want.

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 options or travel assignment locations, make sure the salary is a livable wage.

Vivian Health had nearly 194,000 staff, travel, local contract, per diem and locum tenens jobs on its jobs marketplace in February 202e. Browse healthcare jobs on Vivian to plan your next career move faster and easier than ever.

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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.