AACN Fact Sheet - Nursing Shortage (2023)

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(Video) There is No Nursing Shortage: Here's the Real Issue | Nurse Practitioner Reacts
(Video) Addressing the Nurse Staffing Crisis: Priorities and Recommendations

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The U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows. Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care. The American Association of Colleges of Nursing (AACN) is working with schools, policy makers, nursing organizations, and the media to bring attention to this healthcare concern. AACN is leveraging its resources to shape legislation, identify strategies, and form collaborations to address the shortage.

Current and Projected Shortage Indicators

  • According to the Bureau of Labor Statistics’ Employment Projections 2021-2031, the Registered Nursing (RN) workforce is expected to grow by 6% over the next decade. The RN workforce is expected to grow from 3.1 million in 2021 to 3.3 million in 2031, an increase of 195,400 nurses. The Bureau also projects 203,200 openings for RNs each year through 2031 when nurse retirements and workforce exits are factored into the number of nurses needed in the U.S.
  • The Advanced Practice Registered Nurse (APRN) workforce, including Nurse Practitioners, Nurse Anesthetists, and Nurse Midwives, is expected to grow much faster than average for all occupation, by 40% from 2021 through 2031, according to the BLS’ Occupational Outlook Handbook. Approximately 30,200 new APRNs, which are prepared in master’s and doctoral programs, will be needed each year through 2031 to meet the rising demand for care.
  • According to the United States Registered Nurse Workforce Report Card and Shortage Forecast published in the September/October 2019 issue of the American Journal of Medical Quality, a shortage of registered nurses is projected to spread across the country through 2030. In this state-by-state analysis, the authors forecast a significant RN shortage in 30 states with the most intense shortage in the Western region of the U.S.
  • In April 2022, Dr. David Auerbach and colleagues published a nursing workforce analysis in Health Affairs, which found that total supply of RNs decreased by more than 100,000 from 2020 to 2021 – the largest drop than ever observed over the past four decades. A significant number of nurses leaving the workforce were under the age of 35, and most were employed in hospitals.
  • The Institute of Medicine in its landmark report on The Future of Nursing called for increasing the number of baccalaureate-prepared nurses in the workforce to at least 80% to enhance patient safety. The current nursing workforce falls short of this recommendations with only 65.2% of registered nurses prepared at the baccalaureate or graduate degree level according to the latest workforce survey conducted by the National Council of State Boards of Nursing.

Contributing Factors Impacting the Nursing Shortage

Nursing school enrollment is not growing fast enough to meet the projected demand for RN and APRN services.

(Video) New research shows how to help nurses during shortage

Though enrollment in entry-level baccalaureate programs in nursing increased by 3.3% in 2021, AACN did report drops in both PhD and master’s nursing programs by 0.7% and 3.8%, respectively. These trends are raising concerns about the capacity of nursing schools to meet the projected demand for nursing services, including the need for more nurse faculty, researchers, and primary care providers.

A shortage of nursing school faculty is restricting nursing program enrollments.

  • According to AACN’s report on 2021-2022 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, U.S. nursing schools turned away 91,938 qualified applications (not applicants) from baccalaureate and graduate nursing programs in 2021 due to insufficient number of faculty, clinical sites, classroom space, and clinical preceptors, as well as budget constraints. Most schools pointed to a shortage of clinical learning sites, faculty, and classroom space as reasons for not accepting all qualified applicants.

A significant segment of the nursing workforce is nearing retirement age.

  • According to a 2020 National Nursing Workforce Survey conducted by the National Council of State Boards of Nursing found that the average age for an RN is 52 years old, which may signal a large wave over the next 15 years.
  • In a Health Affairs blog posted in May 2017, Dr. Peter Buerhaus and colleagues project than more than 1 million registered nurses will retire from the workforce by 2030.

Changing demographics signal a need for more nurses to care for our aging population.

  • The U.S. Census Bureau reported that by 2034, there will be 77.0 million people age 65 years and older compared to 76.5 million under the age of 18. With larger numbers of older adults, there will be an increased need for geriatric care, including care for individuals with chronic diseases and comorbidities.

Amplified by the pandemic, insufficient staffing is raising the stress level of nurses, impacting job satisfaction, and driving many nurses to leave the profession.

  • According to data published in Nurse.com’s 2022 Nurse Salary Research Report, 29% of nurses across all license types considering leaving in 2021, compared with 11% in 2020.Among nurses who are considering leaving the profession, higher pay was the most influential motivation to stay, followed by better support for work-life balance and more reasonable workload.
  • In March 2022, the American Nurses Foundation and the American Nurses Association released the results of itsCOVID-19 Impact Assessment Survey, which found that 52% of nurses are considering leaving their current position due primarily to insufficient staffing, work negatively affecting health and well-being, and inability to deliver quality care. In addition, 60% of acute care nurses report feeling burntout, and 75% report feeling stressed, frustrated, and exhausted.
  • In September 2021, the American Association of Critical-Care Nurses reported survey findings which show 66% of acute care nurses have considered leaving nursing after their experiences during the pandemic.

Impact of Nurse Staffing on Patient Care

Many scientific studies point to the connection between adequate levels of registered nurse staffing and safe patient care.

  • In November 2021,new research in Nursing OutlookexaminedVariations in Nursing Baccalaureate Education and 30-day Inpatient Surgical Mortality. Researchers found that having a higher proportion of baccalaureate-prepared nurses (BSN) in hospital settings, regardless of educational pathway, is associated with lower rates of 30-day inpatient surgical mortality. The findings support promoting multiple BSN educational pathways.
  • In the July 2017 issue of BMJ Quality & Safety, the international journal of healthcare improvement, Dr. Linda Aiken and her colleagues released findings from a study of acute care hospitals in Belgium, England, Finland, Ireland, Spain, and Switzerland, which found that a greater proportion of professional nurses at the bedside is associated with better outcomes for patients and nurses. Reducing nursing skill mix by adding assistive personnel without professional nurse qualifications may contribute to preventable deaths, erode care quality, and contribute to nurse shortages.
  • In a study published in the journal BMJ Quality & Safety in May 2013, researcher Heather L. Tubbs-Cooley and colleagues observed that higher patient loads were associated with higher hospital readmission rates. The study found that when more than four patients were assigned to an RN in pediatric hospitals, the likelihood of hospital readmissions increased significantly.
  • In the August 2012 issue of the American Journal of Infection Control, Dr. Jeannie Cimiotti and colleagues identified a significant association between high patient-to-nurse ratios and nurse burnout with increased urinary tract and surgical site infections. In this study of Pennsylvania hospitals, the researchers found that increasing a nurse’s patient load by just one patient was associated with higher rates of infection. The authors conclude that reducing nurse burnout can improve both the well-being of nurses and the quality of patient care.
  • In a study publishing in the April 2011 issue of Medical Care, Dr. Mary Blegen and her colleagues from the University of California, San Francisco found that higher nurse staffing levels were associated with fewer deaths, lower failure-to-rescue incidents, lower rates of infection, and shorter hospital stays.
  • In March 2011, Dr. Jack Needleman and colleagues published findings in the New England Journal of Medicine, which indicate that insufficient nurse staffing was related to higher patient mortality rates. These researchers analyzed the records of nearly 198,000 admitted patients and 177,000 eight-hour nursing shifts across 43 patient-care units at large academic health centers. The data show that the mortality risk for patients was about 6% higher on units that were understaffed as compared with fully staffed units. In the study titled “Nurse Staffing and Inpatient Hospital Mortality,” the researchers also found that when a nurse’s workload increases because of high patient turnover, mortality risk also increases.
  • A growing body of research clearly links baccalaureate-prepared nurses to lower mortality and failure-to-rescue rates. The latest studies published in the journals Health Services Research in August 2008 and the Journal of Nursing Administration in May 2008 confirm the findings of several previous studies which link education level and patient outcomes. Efforts to address the nursing shortage must focus on preparing more baccalaureate-prepared nurses in order to ensure access to safe patient care.
  • In March 2007, a comprehensive report initiated by the Agency for Healthcare Research and Quality was released on Nursing Staffing and Quality of Patient Care. Through this meta-analysis, the authors found that the shortage of registered nurses, in combination with an increased workload, poses a potential threat to quality. Increases in registered nurse staffing was associated with reductions in hospital-related mortality and failure to rescue as well as reduced length of stays.
  • A shortage of nurses prepared at the baccalaureate level is affecting health care quality and patient outcomes. In a study published September 24, 2003, in the Journal of the American Medical Association (JAMA), Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a “substantial survival advantage” if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level. In hospitals, a 10% increase in the proportion of nurses holding BSN degrees decreased the risk of patient death and failure to rescue by 5%.

Efforts to Address the Nursing Shortage

  • AACN is committed to working with the education and healthcare community to create a highly educated nurses in sufficient numbers to meet the needs of the nation’s diverse patient population. To address the nursing shortage, AACN is advocating for federal legislation and increased funding for nursing education (Title VIII, FAAN Act); promoting a post-baccalaureate nurse residency program to aid in nurse retention; encouraging innovation in nursing programs, including the development of fast-track programs (second-degree BSN and MSN programs; baccalaureate to doctoral); and working with partner organizations to highlight careers in nursing, including those requiring graduate level preparation.
  • Since 2010, AACN has operated NursingCAS, the nation’s centralized application service for nursing education programs that prepare nurses for entry-level and advanced roles. One of the primary reasons for launching NursingCAS was to ensure that all vacant seats in schools of nursing are filled to better meet the nation’s need for RNs, APRNs, and nurse faculty.
  • In June 2022, the National Council of State Legislatures issued a brief profiling different legislative approaches states are using to address the nursing shortage, including adapting scope of practice laws and offering financial incentives for preceptors,
  • In a report on How To Ease the Nursing Shortage in America released in May 2022, the Center for American Progress calls for bold policies toward solving the nursing shortage to ensure that more patients with access to safe, high-quality nursing services. The report highlights how federal and state policymakers can address the shortage through coordinated planning, action, and investment.
  • Many statewide initiatives are underway to address both the shortage of RNs and nurse educators. For example, in October 2022, the University of Minnesota and Minnesota State joined forces to create Coalition for Nursing Equity and Excellence, which will work with every school of nursing in the state, healthcare providers, and others stakeholders to increase enrollment in nurse education programs, expand equity in the nursing workforce, and increase student success. Additional initiatives are also underway in Florida and Louisiana among other states.
  • Nursing schools are forming strategic partnerships and seeking private support to help expand student capacity.

Recent Articles on the Nursing Shortage

Last Update: October 2022


Robert Rosseter
(202) 463-6930, ext. 231

(Video) Beyond Nurse Staffing Ratios, Creating a New Reality


What is a good thesis statement for nursing shortage? ›

Thesis Statement Research suggests that the nursing profession faces shortages because of insufficient potential educators and high turnover in the sector.

What are the common factors contributing to the nursing shortage? ›

There are four main contributors to the nursing shortage: Retiring nurses or those choosing to leave the profession. The aging population necessitates increasing the level of care patients require. A nursing faculty shortage capping pre-licensure admission capacity.

Is there a nursing shortage in the US? ›

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

How many nurses are needed in the US? ›

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

What is the most important issue facing nursing today? ›

Exhaustion and Overworking

According to a 2021 PubMed report, 34.1% of nurses experienced emotional exhaustion, 12.6% fought depersonalization, and 15.2% felt a lack of personal accomplishment. These are all signs of burnout. All healthcare personnel are at a greater risk of burnout.

How can we stop the nursing shortage? ›

6 Innovative Ways Top Nursing Executives Are Surviving the Nursing Shortage
  1. Listening to nurses' concerns.
  2. Prioritizing workplace culture.
  3. Adjusting protocol to meet nurses' needs.
  4. Increasing diversity and representation in nursing.
  5. Addressing the need for more nurse educators.
  6. Supporting nurses leading healthcare innovation.

What is the most common nursing error? ›

Here are a few of the most common nursing mistakes: Forgetting to turn on the bed alarm for a patient at high risk for falls. Incorrectly programming an IV pump resulting in underdosing or overdosing. Failing to report a change in a patient's condition.

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.

How can the nursing shortage be increased in 2022? ›

  1. Impact of Nurse Staffing Shortage on the Healthcare Industry. ...
  2. Steps to Manage Nurse Staffing Issues in 2022. ...
  3. Adopt Flexibility in Nurse Staffing. ...
  4. Create Career Development Programs for Nurses. ...
  5. Continued Education. ...
  6. Focus on Mental Health. ...
  7. Conduct Interviews. ...
  8. Improve Your Overall Retention Strategies.

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.

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.

Which country needs nurses the most? ›

15 Highest Paying Countries in need of Nurses
  • Canada. Average Annual Nursing Salary: $71,590. ...
  • Switzerland. Average Annual Nursing Salary: $85,927. ...
  • Australia. Average Annual Nursing Salary: $75,000. ...
  • Ireland. Average Annual Nursing Salary: $42,000. ...
  • United States. Average Annual Nursing Salary: $75,300. ...
  • Chile. ...
  • New Zealand. ...
  • Germany.
22 Jan 2022

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.

What are three challenges nurses face today? ›

Nursing is one of the most rewarding and challenging professions in health care. During a 12-hour shift, nurses may take on a demanding workload due to staffing shortages; endure workplace bullying; risk exposure to infection; and, despite all their professional experience, still lose patients.

What are the four current trends in nursing? ›

A growth in telehealth, an increase in online nursing education, expanding nurse practitioner ranks, the movement of nurses into nonclinical careers, growing practice authority, and technological advances are all changing the face of 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 can we fix the shortage of healthcare workers? ›

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

How do nurses deal with understaffing? ›

Top 10 tips for coping with short staffing
  1. Prioritize your assignments. ...
  2. Organize your workload. ...
  3. Be a team player. ...
  4. Use UAPs wisely. ...
  5. Recruit additional talent. ...
  6. Communicate effectively—and nicely. ...
  7. Inform and involve nursing administration. ...
  8. Encourage family participation.

How do you avoid the top 7 nursing errors? ›

Let's examine what you can do to prevent these types of errors.
The big seven
  1. collaborate with other healthcare team members.
  2. clarify interdisciplinary orders.
  3. ask for and offer assistance.
  4. utilize evidence-based performance guidelines or bundles.
  5. communicate information to patients and families.
  6. limit overtime.

How did Radonda make the mistake? ›

However, Vaught overrode the medical cabinet and withdrew the wrong medication. She mistakenly administered the powerful paralytic vecuronium instead, which led to total muscle paralysis and stopped Murphey's ability to breathe and caused her death.

What state are nurses the happiest? ›

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

Where do the happiest nurses work? ›

But Nurse.org found that nurse educators, home health nurses, nurse managers, OR-perioperative nurses, and pediatric nurses reported the highest levels of job satisfaction.

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.

Why are there so many shortages right now 2022? ›

As the world slowly recovers from the effects of the COVID-19 pandemic, industries and manufacturers are finding it harder to meet ever-increasing global demands. Businesses have dealt with supply chain issues that resulted in product shortages since the start of the year.

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.

Why are there so many shortages in 2022? ›

The supply chain just hasn't been the same since the 2020 Covid-19 pandemic began. From labor issues to inflation to closures, lots of factors have come into play that have led to food shortages and empty shelves of other essentials. And prices are going up, too.

What is a Category 5 nursing shortage? ›

DG: By 2001, the American Hospital Association reported 126,000 nursing vacancies nationwide. That was 12% of the country's nursing positions unfilled. Peter called this a Category 5 shortage.

Will nurses still be needed in the future? ›

According to the BLS (Bureau of Labor Statistics), there is likely to be a 7% increase in demand for Registered Nurses between 2019 and 2029. That's an additional 221,900 nurses. There are a few reasons for this: The population is aging.

What will be the nursing shortage by 2030? ›

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

Which nursing specialty is the hardest? ›

Here are just a few of the specialties our readers mentioned — along with a little insight into what makes these nursing jobs so difficult.
  • Oncology. There's no surprise that this specialty is near the top of the list. ...
  • Hospice. ...
  • Medical-Surgical. ...
  • Geriatric Care. ...
  • Emergency Room. ...
  • Psychiatry. ...
  • Correctional Nursing.

What is the most respected nursing specialty? ›

20 Best Nursing Career Specialties
  • Nurse Researcher. ...
  • Psychiatric Mental Health Nurse. ...
  • Trauma Nurse. ...
  • Travel Nurse. ...
  • Pediatric Nurse. ...
  • Geriatric Nurse. ...
  • Acute Care Nurse. ...
  • Oncology Nurse. Oncology nurses care for patients receiving treatment for various stages of cancer.
18 Feb 2021

Who is the highest paid nurse in the US? ›

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

What city pays nurses the most? ›

The San Jose — Sunnyvale — Santa Clara, California, metro area pays RNs the highest-average salary in the United States. According to BLS data, RNs in San Jose — Sunnyvale — Santa Clara metro area make $155,230 annually, which is $72,480 higher than the national average.

Which state Nclex is the easiest? ›

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

Which country pays nurses very well? ›

Norway: Norway, the nation of the fjords, is an oil-rich country with one of the world's best living standards. Nurses have a comfortable life since the average yearly pay for a Registered Nurse is $50,000, but it may rise to $100,000 for those with more educational qualifications or those with a lot of experience.

Who Is World's Best nurse? ›

1: Florence Nightingale

It is because of her research and her knowledge that we have many of our sanitation procedures. She gained much of her information from nurses she personally trained, and she operated during the Crimean War in the 1890s.

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.


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