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Nurses are the foundation of the healthcare field, but nursing shortages have been the norm for decades. The COVID-19 pandemic pushed these shortages to crisis levels, with demand outweighing supply nearly everywhere. However, experts knew a significant shortage of registered nurses was looming even before the pandemic; it just exacerbated a situation already on the brink of being dire. Over the next few years, some states may feel the impact of nursing shortages more than others, but a surprising number may actually end up with a registered nurse surplus. It can benefit your nursing career to know which is which.
What’s Causing Nursing Shortages?
The perfect storm for a nursing shortage isn’t brewing – it’s already here, and the shortages in registered nursing staff will only worsen without course corrections. Five significant issues impacting ongoing shortages include:
- Turnover: In February 2023, the National Library of Medicine reported that the average turnover rate nationwide was 8.8% to 37%, depending on the nursing specialty and geographic location. While some turnover can be attributed to new graduate nurses deciding the profession isn’t what they thought it would be once they began working, a significant portion could be due to burnout.
- Burnout: Staffing shortages often lead to higher patient-to-nurse ratios that put more stress on the staff and result in poorer patient outcomes. Stress leads to burnout, worsened by the lengthy pandemic and compounded by insufficient staffing to create a vicious cycle that leads to further burnout and overall dissatisfaction with the job.
- Retirement: Another issue is the substantial number of nurses in the workforce nearing retirement age. Per a 2020 National Nursing Workforce Study conducted by the National Council of State Boards of Nursing, the average age for a registered nurse (RN) was 52 years old, potentially signaling a large wave of retirements over the next 15 years.
- Aging population: As the nation’s population of aging adults grows, the demand for complex care grows with it, as does the need for more nurses to provide this care. The U.S. Census Bureau predicts that by 2034, older adults will outnumber children, a first in U.S. history. It reports that 77 million people will be aged 65 or older compared to 76.5 million below age 18.
- Faculty shortage: According to the American Association of Colleges of Nursing, nursing schools turned away nearly 92,000 qualified applications of prospective students 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 applicants. The shortage in nursing faculty directly affects the number of nurses to fill future demands.
Projected Demand for Registered Nurses
To understand the supply issue, we must first look at demand. According to employment information compiled by O*NET Online, an agency within the U.S. Department of Labor, the projected demand for RNs continues to rise in every state, some more than others.
The following table indicates long-term projections of increased demand from 2020 through 2030 for all 50 states and the District of Columbia, sorted from largest to smallest change in demand. The base number reflects the number of RNs in 2020, with the projected number being the estimated amount needed by 2030.
| State | RNs Working 2020 | Projected RNs Working 2030 | % of Change | Avg Annual Job Openings |
| Arizona | 58,480 | 81,460 | 39.3 | 5,930 |
| Colorado | 53,100 | 68,270 | 28.6 | 4,430 |
| Nevada | 24,040 | 29,630 | 23.3 | 1,950 |
| Utah | 24,840 | 29,820 | 20 | 1,920 |
| Idaho | 15,350 | 18,400 | 19.9 | 1,110 |
| Georgia | 73,180 | 86,440 | 18.1 | 5,460 |
| Maryland | 71,390 | 83,710 | 17.3 | 5,250 |
| Texas | 220,980 | 258,720 | 17.1 | 16,210 |
| New York | 197,160 | 230,580 | 17 | 14,430 |
| Tennessee | 64,280 | 75,150 | 16.9 | 4,700 |
| Washington | 61,560 | 71,550 | 16.2 | 5,430 |
| Delaware | 11,660 | 13,350 | 14.5 | 820 |
| Florida | 189,120 | 216,510 | 14.5 | 13,250 |
| Alaska | 5,680 | 6,500 | 14.4 | 400 |
| New Mexico | 18,740 | 21,350 | 13.9 | 1,300 |
| North Dakota | 10,060 | 11,460 | 13.9 | 700 |
| Mississippi | 29,270 | 33,220 | 13.5 | 2,010 |
| Massachusetts | 87,860 | 98,560 | 12.2 | 5,900 |
| Oregon | 41,000 | 45,980 | 12.1 | 2,580 |
| Iowa | 33,110 | 37,070 | 12 | 2,220 |
| South Dakota | 13,440 | 15,050 | 12 | 900 |
| Oklahoma | 39,130 | 43,800 | 11.9 | 2,620 |
| West Virginia | 21,550 | 24,110 | 11.9 | 1,440 |
| North Carolina | 102,150 | 113,920 | 11.5 | 6,780 |
| California | 323,900 | 358,900 | 10.8 | 21,200 |
| Wyoming | 5,080 | 5,630 | 10.8 | 330 |
| Montana | 10,680 | 11,810 | 10.6 | 700 |
| South Carolina | 47,050 | 52,040 | 10.6 | 3,070 |
| Vermont | 6,920 | 7,610 | 10 | 450 |
| Arkansas | 25,890 | 28,240 | 9.1 | 1,640 |
| Pennsylvania | 147,280 | 160,380 | 8.9 | 9,280 |
| Hawaii | 11,770 | 12,800 | 8.8 | 740 |
| Kentucky | 43,320 | 47,140 | 8.8 | 2,730 |
| New Hampshire | 14,010 | 15,240 | 8.8 | 880 |
| New Jersey | 83,660 | 90,850 | 8.6 | 5,240 |
| Virginia | 67,340 | 72,900 | 8.3 | 4,190 |
| Alabama | 51,280 | 55,450 | 8.1 | 3,180 |
| Michigan | 102,590 | 110,750 | 8 | 6,350 |
| Indiana | 66,740 | 71,950 | 7.8 | 4,120 |
| Nebraska | 27,670 | 29,810 | 7.7 | 1,700 |
| Kansas | 30,920 | 33,190 | 7.3 | 1,890 |
| Ohio | 131,400 | 140,780 | 7.1 | 7,990 |
| Minnesota | 71,780 | 76,540 | 6.6 | 4,320 |
| Missouri | 73,330 | 78,130 | 6.5 | 4,410 |
| District of Columbia | 10,580 | 11,150 | 5.4 | 620 |
| Rhode Island | 12,680 | 13,340 | 5.2 | 740 |
| Illinois | 136,640 | 142,890 | 4.6 | 7,870 |
| Connecticut | 34,470 | 35,830 | 3.9 | 1,960 |
| Wisconsin | 64,590 | 67,120 | 3.9 | 3,670 |
| Maine | 14,950 | 15,440 | 3.3 | 840 |
| Louisiana | 41,940 | 42,690 | 1.8 | 2,270 |
Source: O*NET Online
Projected Registered Nursing Shortages
The American Association of Colleges of Nursing states that nursing is the largest healthcare profession in the nation, with nearly 4.2 million registered nurses nationwide. Furthermore, the U.S. Bureau of Labor Statistics (BLS) projects that employment of RNs will grow another 6% from 2021 to 2031, with an average of 203,200 RN job openings every year during the decade.
The Health Resources & Services Administration’s (HRSA) Bureau of Health Workforce (BHW) projects a national shortage of 78,610 full-time equivalent RNs in 2025 and a shortage of 63,720 in 2030. However, it projects a national surplus of 16,180 RNs in 2035, but the data used to create these estimates is from 2020. These numbers could be skewed without knowing the full impact of the COVID-19 pandemic on the nursing profession.
While the exact shortage won’t be available until the BHW can collect more data over several years, a national shortage of some degree is almost guaranteed. However, not every state may come up short.
An in-depth U.S. Healthcare Labor Market Report created by Mercer in 2021 as a follow-up to its 2017 study explores which states will experience a shortage of RNs and which will actually have a surplus. If current trends hold, the report projects severe healthcare staff shortages in some states as soon as 2026, but other states will not only keep up with demand but also surpass it.
The Mercer report provides details for the 48 contiguous states. Of those, 21 will fall short of filling the demand for qualified RNs by at least 1,000 nurses by 2026. They’re already falling behind. The table below shows the five states with the most significant nursing shortages, followed by the remaining 16 states with estimated shortages rounded to the nearest 1,000.
| State | Current RN Shortage |
| Pennsylvania | -20,345 |
| North Carolina | -13,112 |
| Colorado | -10,431 |
| Illinois | -8,654 |
| Massachusetts | -7,576 |
| Estimated RN Shortage | |
| Arizona | -5,000 |
| Indiana | -5,000 |
| Maryland | -5,000 |
| Maine | -2,000 |
| Nebraska | -2,000 |
| North Dakota | -2,000 |
| West Virginia | -2,000 |
| Delaware | -1,000 |
| Iowa | -1,000 |
| Louisiana | -1,000 |
| Mississippi | -1,000 |
| Montana | -1,000 |
| New Jersey | -1,000 |
| Oregon | -1,000 |
| South Dakota | -1,000 |
| Wyoming | -1,000 |
The Mercer report projects that the District of Columbia will have a shortage of about 2,000 nurses during this same period.
States Projected to Have a Nursing Surplus
Surprisingly, current trends indicate that 16 states will incur a surplus of nurses by 2026, particularly those in the South. As supply outpaces demand, it’s projected that the first five states in the following table will have the most significant pool of surplus nurses, followed by 11 states with a surplus estimated to be at least 1,000 nurses over demand, rounded to the nearest 1,000.
| State | Current RN Surplus |
| Georgia | 64,002 |
| Texas | 22,313 |
| South Carolina | 14,689 |
| Florida | 5,430 |
| Ohio | 5,232 |
| Estimated RN Surplus | |
| Kentucky | 4,000 |
| Oklahoma | 4,000 |
| Connecticut | 3,000 |
| Missouri | 3,000 |
| Tennessee | 3,000 |
| Washington | 3,000 |
| Arkansas | 1,000 |
| California | 1,000 |
| Kansas | 1,000 |
| Michigan | 1,000 |
| Wisconsin | 1,000 |
The report expects the remaining 11 contiguous states to have a shortage or a surplus of less than 1,000 by 2026, so they appear on the list as unchanged. These states include Alabama, Idaho, Nevada, Minnesota, New Hampshire, New Mexico, New York, Rhode Island, Utah, Vermont and Virginia.
What About Other Nurses?
According to the BLS, 60% of RNs worked in hospitals in 2021, compared to just 15% of licensed practical/vocational nurses (LPN/LVNs). Nearly half of LPN/LVNs worked in nursing and residential care facilities or home healthcare services during this period. While most research focuses on registered nurse shortages, a 2022 report on Nurse Workforce Projections from the HRSA indicates that the demand for LPN/LVNs is also projected to grow faster than the supply. One primary reason for the rising demand for LPNs is the country’s aging population driving the need for nurses to care for older patients in residential care and home health environments.
This report projects 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. 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.
During this same projection period, the report indicates that the supply of nurse practitioners will hit 205%, more than double the projected demand in 2035. However, this overage varies between metro and nonmetro areas. Similarly, the report indicates a surplus of 31% among nurse midwives and 58% among nurse anesthetists nationwide.
Projections Not Set in Stone
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.
For example, an August 2022 survey in California conducted by the University of California, San Francisco, indicated supply and demand projections estimate a shortage of RNs, at least for the short term. The data suggested that this shortage will likely diminish as RN education enrollments return to and surpass pre-pandemic levels.
The Nurse Workforce Projection Report conducted in 2021 by the Florida Hospital Association and the Safety Net Hospital Alliance of Florida also contradicts reports indicating that the state will have a surplus of nurses. Instead, this report projects a major shortfall of 37,400 RNs and 21,700 licensed practical nurses by 2035 due to an uneven distribution of nurses across the state.
What’s Being Done About Registered Nursing Shortages?
Some national, state and local entities are attempting to do something about the nursing shortage to prevent it from getting worse and eventually reverse the course.
On a national level, the National Council of State Legislatures (NCSL) issued a brief in June 2022 profiling various legislative approaches states could use to address the nursing shortage. These approaches included adapting nursing scope of practice laws and offering preceptors financial incentives.
State-level initiatives already underway address the shortage of RNs and the educators needed to train new nurses by examining various options to recruit and retain nurses. Besides changing scope of practice laws and offering monetary incentives, as outlined by the NCSL, they’ve also explored loosening licensure requirements, such as adopting the Nurse Licensure Compact (NLC). The NLC also includes LPNs, potentially helping with nursing shortages on multiple levels.
Most states also bolster education programs through student loan forgiveness or loan repayment. These programs help attract nurses to the state, and specific programs for nurse educators attract much-needed teaching faculty. For example, the Illinois Nurse Educator Loan Repayment Program repays up to $5,000 annually for up to four years to address the lack of qualified instructors to staff nursing education courses in the state.
Finally, on a local level, individual nursing schools seeking private support and forming strategic partnerships hope to help expand their student capacity. For example, the Minneapolis VA Health Care System committed $53 million to the University of Minnesota School of Nursing in a collaborative agreement to expand clinical placement sites and fund additional faculty.
How Nurse Demand and Shortages Impact You
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. You can easily research salary by role and location using Vivian’s salary tool for full pay transparency.
Vivian Health posted more than 29,000 staff nursing jobs and over 72,500 travel nursing jobs at prime locations around the country at the beginning of April 2023.
Register today and see how we can empower you to find your perfect job faster and easier than ever before.
Are RN’s the only Nurses?
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.
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.
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.
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
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.
Not sure how that Georgia “surplus” is going. Lots of needs in Georgia get posted.
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!
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!