2026 The U.S. Nursing Shortage: A State-by-State Breakdown

by Imed Bouchrika, PhD

Co-Founder and Chief Data Scientist

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The U.S. Nursing Shortage Table of Contents

1. Why the U.S. has a nursing shortage crisis
2. How entry-level pathways can bring new nurses into the workforce
3. What can increase the number of nurses in the U.S.?
4. What financial barriers keep people from becoming nurses?
5. How ADN-to-NP and bridge programs can expand advanced practice capacity
6. U.S. nursing shortage by state
7. How mentorship and professional development affect nurse retention
8. Why nurses are essential to society
9. How specialized certifications strengthen the nursing workforce
10. Can 12-month accelerated nursing programs help close the gap?
11. How RN-to-BSN programs with no clinicals can support working nurses
12. Career options with an MSN in Nurse Executive Leadership

Quick Answer: Why Is There a Nursing Shortage in the U.S.?

The U.S. nursing shortage is caused by a combination of retirement, burnout, limited nursing school capacity, faculty shortages, workplace stress, and rising demand for healthcare services. The country employed 3,172,500 registered nurses in 2023, while the population was projected to reach at least 336,997,624 citizens. Even with employment growth, healthcare systems continue to face uneven staffing conditions across states and settings.

The shortage is not only about recruiting more students. It also requires keeping experienced nurses at the bedside, expanding affordable education routes, improving working conditions, supporting career mobility, and using the broader healthcare workforce more effectively.

Why the US has a Nursing Shortage Crisis

Nursing has long been central to American healthcare. In earlier centuries, women provided care in homes, communities, wartime settings, and early hospitals. By the late 18th century, physicians began training women in maternity care, and by the 19th century, permanent hospital nursing roles became more common as institutions expanded care for vulnerable populations, including people experiencing homelessness and individuals with mental illnesses.

The profession also developed under major social barriers. African American nurses faced racial segregation and exclusion, yet gradually expanded their place in nursing education, hospitals, and professional organizations. Over time, nursing moved from informal caregiving into a licensed, specialized, and highly skilled profession.

Today, nursing includes bedside care, public health, informatics, administration, advanced practice, anesthesia, education, and community-based care. Advanced practice roles such as nurse practitioners and certified registered nurse anesthetists remain among high-paying career options for women. Nurses can also specialize in areas such as school health, where professionals must meet specific school nurse qualifications before practicing in many districts.

Despite this professional growth, the supply of nurses has not kept pace with healthcare demand in many locations. In 2024, the U.S. had 12.71 nurses and midwives per 1,000 individuals. The 2023 RN workforce of 3,172,500 served a national population projected to reach at least 336,997,624 citizens. The BLS projected RN employment growth of 177,400 by 2033, reflecting a 6% annual growth rate, but many healthcare systems still report shortages because demand, turnover, regional distribution, and working conditions vary widely.

Main Factors Behind the Shortage

One practical response is expanding affordable degree-completion options for licensed nurses. Programs such as low-cost online RN-to-BSN pathways can help working RNs build leadership, public health, evidence-based practice, and care coordination skills without leaving the workforce. Related programs in healthcare administration, including online healthcare management degrees, can also prepare professionals to address staffing, operations, and workforce planning challenges.

Bridging the Nursing Gap Through Entry-Level Opportunities

The nursing shortage cannot be solved only by asking current nurses to work more hours. The workforce needs more accessible entry points for people who are prepared to complete rigorous training, pass licensure requirements, and enter patient care roles safely.

Entry-level nursing pathways are especially important for career changers, adults with prior college credit, and students who want a direct route into healthcare. Some people begin with an associate degree in nursing, while others choose a bachelor’s degree or a direct-entry graduate pathway if they already hold a non-nursing bachelor’s degree.

Direct-entry MSN programs are designed for students who earned a bachelor’s degree in another field and want to move into nursing without first completing a separate traditional BSN. These programs can be demanding because they combine foundational nursing education, clinical training, and graduate-level coursework. For applicants comparing admissions flexibility and program design, Research.com’s guide to the easiest direct entry MSN programs can help clarify available options.

What Can Be Done to Increase the Number of Nurses in the US?

Increasing the nurse supply requires coordinated action from schools, employers, policymakers, and students. The most effective strategies address both entry into the profession and retention after graduation.

• Expand nursing school capacity. More qualified applicants can enter the pipeline when programs have enough faculty, clinical placements, simulation resources, and student support services.
• Make nursing education more affordable. Tuition, fees, books, transportation, testing costs, and unpaid clinical time can prevent capable students from enrolling or finishing.
• Support flexible formats for adults and working students. Hybrid and online coursework can help students balance school, work, and family responsibilities, though clinical requirements still need careful planning.
• Improve bedside working conditions. Recruitment matters, but retention is equally important. Nurses are more likely to stay when staffing levels, safety policies, compensation, and leadership support are credible.
• Create clear advancement ladders. LPN-to-RN, RN-to-BSN, ADN-to-MSN, MSN, and certification pathways help nurses progress without starting over.

For people without prior nursing credentials, online ADN programs for non nurses may offer a practical starting point. Before enrolling, students should confirm that the program is properly accredited, approved for the state where they plan to seek licensure, and transparent about clinical placement expectations.

What Are the Economic Barriers for Aspiring Nurses?

The cost of becoming a nurse is one of the biggest obstacles for students who would otherwise enter the field. Tuition is only one part of the investment. Students may also need to budget for prerequisites, uniforms, background checks, immunizations, clinical travel, licensing exam fees, technology, books, and reduced work hours during clinical training.

Financial planning should begin before enrollment. Students can compare scholarships, grants, employer tuition assistance, military benefits, state workforce programs, and loan forgiveness opportunities. They should also review total program cost, not just advertised tuition. Research.com’s guide on how much nursing school costs can help applicants understand the types of expenses to expect.

How Can ADN to NP Bridge Programs Alleviate the Nursing Shortage?

Bridge programs can help experienced nurses move into higher-responsibility roles without repeating unnecessary coursework. ADN-to-MSN and ADN-to-NP pathways are designed for registered nurses who began with an associate degree and want to prepare for advanced practice, leadership, education, or specialized clinical responsibilities.

These pathways matter because the shortage is not limited to entry-level staffing. Healthcare systems also need nurse practitioners, nurse leaders, nurse educators, and specialized clinicians. A well-designed bridge program can help working RNs build advanced competencies while remaining employed, which supports both immediate patient care and long-term workforce development.

Students should compare admission requirements, clinical placement support, specialization options, state authorization, and certification outcomes. Research.com’s guide to ADN to NP bridge programs can help nurses evaluate accelerated advancement routes.

The US Nursing Shortage by State

The nursing shortage does not look the same everywhere. State-level conditions depend on population growth, retirements, hospital finances, licensure exam performance, nursing school capacity, workplace safety, and regional compensation. A national average can hide severe shortages in one area and less urgent conditions in another.

Research.com reviewed conditions in 10 states with major nursing workforce pressure based on current data from the U.S. BLS and other reputable sources. The examples below show how different the shortage can look from state to state.

1. California

California shows how retirement risk and workplace conditions can exist even when the overall nurse count appears large. Among RNs in the state, 20.3% of those aged 55 to 64 and 45.4% of those aged 65 and over planned to retire or leave nursing between 2024 and 2026. Reported challenges included workplace violence at 34.2%, staffing inadequacies at 47.1%, and persistent emotional exhaustion at 48.3%. Nursing school enrollment growth may help, but retention and safety remain central issues.

Number of Nurses in 2019: 302,770 RNs
Number of Nurses in 2024: 460,000–500,000 RNs

2. Texas

Texas has faced a worsening shortage pattern over several years. The unmet demand for nurses was 12.0% (34,163) in 2024, 12.3% (35,496) in 2025, and 12.6% (36,881) in 2026. The projected deficit is 14.3% (44,577) by 2030. Faculty shortages also limit nursing school enrollment, which can keep the state in a cycle where nursing positions remain unfilled.

Number of Nurses in 2019: 218,090 RNs
Number of Nurses in 2024: 243,702 RNs

3. Florida

Florida’s challenge includes licensure exam performance. The RN exam passing rate fell from 84.9% in 2024 to 69.1% in 2025, which may affect how many graduates can enter practice. By 2035, the state is expected to have demand for 59,100 nurses.

Number of Nurses in 2019:181,670 RNs
Number of Nurses in 2024: 326,000 RNs

4. New York

New York is expected to need almost 40,000 nurses by 2030. The state was also heavily affected during the pandemic in terms of job loss and COVID-19 deaths, which increased pressure on healthcare capacity. State leaders have taken steps to strengthen healthcare workforce education and training.

Number of Nurses in 2019:178,320 RNs
Number of Nurses in 2024: 198,500 RNs

5. Pennsylvania

Pennsylvania’s shortage reflects long-standing hospital turnover and bedside staffing concerns. In a 2024 survey of 1,000 Pennsylvania bedside nurses, 93% said their healthcare facility did not have enough nursing staff, and 88% said staffing levels were reducing service quality.

Number of Nurses in 2019: 148,040 RNs
Number of Nurses in 2024: 140,800 RNs

6. Ohio

Ohio’s shortage has been described not only as a lack of licensed nurses, but as a lack of nurses willing to remain at the bedside under current conditions. The Ohio Nurses Association has pointed to funding cuts, unsafe workplaces, and unmet nurse needs. In late 2024, Ohio hospitals reported an average RN vacancy rate of 15%, equal to about 14,500 open roles.

Number of Nurses in 2019: 125,470 RNs
Number of Nurses in 2024: 132,600 RNs

7. Illinois

Illinois is projected to have a nursing surplus of 8% in 2026, showing why state-level data must be interpreted carefully. A projected surplus does not mean every hospital or community has enough nurses. Illinois hospitals also face an estimated $600 million in annual operating losses, which has led the Illinois Hospital Association to seek increased state aid for fiscal year 2025-2026.

Number of Nurses in 2019: 129,530 RNs
Number of Nurses in 2024: 130,100 RNs

8. North Carolina

North Carolina is expected to face nearly 12,500 nursing vacancies by 2033. Nurses have reported leaving roles because of burnout and safety concerns, while those who remain may be asked to cover additional shifts. That pattern can worsen the same stressors that caused turnover in the first place.

Number of Nurses in 2019: 99,960 RNs
Number of Nurses in 2024: 107,500 RNs

9. Michigan

Michigan’s retention risk is significant. A late 2024 Michigan Health Council survey found that 32% of Michigan RNs planned to leave the profession or their current role within the next 12 months. Workload and inadequate compensation were primary concerns, and younger nurses appeared especially likely to consider leaving their positions.

Number of Nurses in 2019: 96,900 RNs
Number of Nurses in 2024: 101,470 RNs

10. Georgia

Georgia is projected to face a shortage of about 10,700 nurses by 2035. Updated workforce projections estimate RN supply at 101,600 compared with demand of 112,300. Hospitals have dealt with understaffing for years, while nursing schools work through their own constraints in training facilities and faculty capacity.

Number of Nurses in 2019: 75,430 RNs
Number of Nurses in 2024: 82,970 RNs

Specialized credentials can help nurses move into high-need areas more efficiently. For a broader look at credential options, review Research.com’s guide to nursing certifications.

How Online Clinical MSW Programs Can Support Healthcare Teams During the Nursing Shortage

The nursing shortage also highlights the importance of team-based care. Nurses should not be expected to absorb every clinical, emotional, social, and discharge-planning responsibility alone. Clinical social workers can support patients and families in areas such as mental health, grief, care coordination, community resources, and adjustment to illness.

Online clinical MSW programs can prepare social workers for clinical and healthcare-adjacent roles while allowing many students to balance graduate study with work or family obligations. These programs do not replace nurses. Instead, they can strengthen the broader care team so nurses can focus more consistently on nursing responsibilities.

How Clinical Social Workers Reduce Pressure on Nurses

Clinical social workers can assist with counseling, family support, crisis response, discharge barriers, and connections to mental health or community services. When these needs are handled by trained professionals, nurses may spend less time trying to manage complex psychosocial issues outside the core nursing role.

In hospital and community settings, social workers can also advocate for patient needs, help families understand care options, and support continuity after discharge. This type of collaboration can improve the patient experience and reduce avoidable strain on nursing teams.

Benefits of Online Clinical MSW Programs

Online clinical MSW programs may appeal to students who want to enter behavioral health, healthcare social work, trauma-informed care, aging services, or family support roles. Many programs include clinical training expectations, so applicants should confirm field placement requirements before enrolling.

For healthcare workforce planning, the key benefit is role clarity. Nurses, social workers, physicians, therapists, and care coordinators each bring different expertise. Expanding the pipeline of clinical social workers can help healthcare organizations distribute care responsibilities more appropriately.

Conclusion: Strengthening the Healthcare Workforce

Growing the nursing workforce is essential, but it is not the only solution. Healthcare systems also need interdisciplinary support. Professionals trained through online clinical MSW programs can help address mental health, family, and resource-navigation needs that often intensify nurse workload.

What Role Do Mentorship and Professional Development Programs Play in Nurse Retention?

Mentorship and professional development are retention tools, not optional extras. New nurses often enter practice with clinical knowledge but need help translating that knowledge into real patient care environments. Without guidance, early-career nurses can feel unsupported, overwhelmed, and more likely to leave.

Formal mentorship gives newer nurses access to experienced colleagues who can explain unit culture, clinical judgment, time management, communication, and coping strategies. Professional development adds another layer by helping nurses build skills in leadership, specialty practice, evidence-based care, informatics, or advanced clinical practice.

Nurses who want to move into advanced practice should also understand the timeline and education requirements involved. Research.com’s guide, What is the shortest path to a nurse practitioner?, explains how different routes compare.

The Impact of Accelerated Nursing Education Programs on the Nursing Shortage

Accelerated nursing education can help, but only when quality, clinical readiness, licensure alignment, and student support are protected. Fast routes are useful for motivated students and working nurses, yet a shorter timeline does not remove the need for rigorous training.

For licensed RNs, fast track RN to BSN online programs can support degree completion while allowing nurses to stay employed. These programs often focus on leadership, evidence-based practice, community health, health assessment, and systems thinking rather than repeating entry-level clinical preparation.

Accelerated Programs Can Help with Staffing Needs

Accelerated RN-to-BSN options can help nurses qualify for roles that prefer or require bachelor’s-level preparation. They may also support movement into specialties, charge nurse responsibilities, case management, public health, or graduate study. However, they do not instantly solve bedside vacancies unless employers also address retention.

Specialized Knowledge Matters as Care Becomes More Complex

As patients present with more complex health needs, nurses benefit from deeper preparation in areas such as gerontology, community health, mental health, leadership, and care coordination. Accelerated programs can help working nurses add these competencies without pausing their careers.

Flexibility Can Improve Access

Online and hybrid formats can reduce scheduling barriers for nurses who cannot attend traditional daytime classes. Flexibility is especially valuable for working RNs, parents, rural students, and nurses whose schedules change frequently.

Education Alone Does Not Guarantee Retention

Career advancement can improve confidence and professional satisfaction, but education cannot compensate for unsafe staffing, chronic overtime, poor leadership, or workplace violence. Employers that want to keep nurses need both advancement pathways and healthier practice environments.

The Importance of Nurses to Society

Nurses are often the healthcare professionals patients see most consistently. They assess changes in condition, administer medications, coordinate with physicians and other clinicians, educate patients, comfort families, and identify problems before they become emergencies.

For students asking what you can do with a BSN, the shortage shows that nursing can lead to many practice settings and career directions. Hospitals, clinics, schools, public health agencies, long-term care facilities, telehealth providers, and community organizations all depend on nurses.

• Nurses help patients recover. They assess symptoms, monitor progress, deliver treatments, administer medications, and communicate changes to the healthcare team.
• Nurses support patients and families emotionally. Illness can be frightening and confusing. Nurses often explain next steps, answer questions, and help families feel less alone during treatment.
• Nurses keep healthcare systems functioning. RNs spend extensive time on communication, coordination, handoffs, patient interviews, and care planning. During day shifts, RNs spend at least 3.2 hours of a 12.5-hour shift on communication and coordination of patient care, including 52 minutes in doctors’ medical visits and one hour in team conferences and nursing handovers.

Advanced practice roles can also increase access to care. Nurses who complete online nurse practitioner programs may prepare for expanded clinical responsibilities, depending on state law and certification requirements. Different levels of nursing degrees lead to different scopes of practice and career options.

Compensation varies by role, location, employer, and experience. In May 2024, the annual median wage for RNs was $86,070, while the annual median wage for NPs was $126,200. Students asking what degree is needed for nurse practitioner certification should know that MSN preparation is a common route to NP eligibility. Flexible online MSN programs can help working nurses compare advanced practice, leadership, education, and specialty pathways.

How Can Specialized Certifications Enhance Nursing Workforce Capabilities?

Specialized certifications help nurses document expertise in areas such as critical care, oncology, informatics, emergency care, case management, and other high-need fields. They do not replace degree or licensure requirements, but they can strengthen clinical confidence, improve mobility, and help employers match nurses to specialized roles.

Certifications are especially useful when healthcare organizations need targeted skills quickly. For example, an experienced RN may not need another full degree to demonstrate competence in a specialty area, while an LPN may use LPN to RN online programs as part of a broader plan to move into registered nursing responsibilities.

Can 12-Month Accelerated Nursing Programs Bridge the Nursing Gap?

12-month accelerated nursing programs online can help bring prepared students into the nursing pipeline faster, especially when designed for people who already have college-level coursework or a prior degree. Their value is speed with structure: students complete a compressed curriculum while still meeting clinical and academic standards.

These programs are not ideal for everyone. The workload can be intense, and students may have limited ability to work while enrolled. Applicants should evaluate prerequisite expectations, clinical schedules, faculty support, licensure outcomes, accreditation, and total cost before choosing an accelerated option.

What Are the Benefits of RN to BSN Programs with No Clinicals in Addressing the Nursing Shortage?

RN-to-BSN programs with no added clinicals can be useful for licensed RNs who already completed clinical preparation during their initial nursing education. These programs may focus on leadership, research, public health, informatics, ethics, and systems-based care rather than requiring new in-person rotations.

The main advantage is reduced disruption. Working nurses can continue serving patients while completing bachelor’s-level coursework. That flexibility can improve degree completion and help nurses qualify for advancement, leadership, or graduate school without leaving the workforce.

Still, students should confirm what “no clinicals” means. Some programs may include projects, community-based assignments, practicums, or capstone experiences even if they do not require traditional clinical rotations. Research.com’s guide to the best RN to BSN programs with no clinicals can help nurses compare flexible completion options.

What Career Opportunities Does an MSN in Nurse Executive Leadership Open Up?

An MSN in Nurse Executive Leadership prepares nurses for administrative and strategic roles that affect staffing, quality improvement, budgets, patient safety, compliance, and organizational performance. These roles are important during a shortage because poor workforce planning can worsen turnover, while strong leadership can improve retention and care delivery.

Common leadership paths include Chief Nursing Officer, Nurse Manager, Director of Nursing, clinical operations leader, quality improvement manager, and workforce development leader. Nurses considering this direction can review Research.com’s guide to jobs with an MSN degree in executive leadership.

How to Choose a Nursing Path During the Shortage

The shortage can create opportunity, but it should not push students into rushed decisions. Nursing is demanding, regulated, and clinically rigorous. Choosing the right program requires careful comparison.

1. Start with your current education level. A high school graduate, LPN, ADN-prepared RN, BSN-prepared RN, and non-nursing bachelor’s graduate will need different pathways.
2. Confirm accreditation and state approval. Program quality and licensure eligibility matter more than convenience or marketing claims.
3. Ask how clinical placements work. Do not assume an online program eliminates in-person requirements.
4. Compare total cost, not only tuition. Include fees, supplies, exam costs, travel, lost work time, and financing.
5. Evaluate schedule realism. Accelerated programs can be efficient, but they may not fit students who need full-time employment.
6. Look at student support. Advising, tutoring, NCLEX preparation, career services, and mentorship can affect completion.
7. Match the program to your goal. Bedside nursing, public health, nurse practitioner practice, leadership, education, informatics, and anesthesia require different preparation.

Common Mistakes to Avoid

Help Save Lives as a Nurse

The nursing shortage is a serious public health and workforce challenge, but it also creates meaningful opportunities for people who are prepared for the responsibility of patient care. Aspiring RNs, NPs, nurse leaders, and specialty nurses can contribute to stronger healthcare systems if they choose programs carefully and enter the field with realistic expectations.

For nurses planning graduate study, an online MSN program may support advanced practice, education, leadership, or specialty goals. A master’s degree can also help nurses prepare for NP certification exams and other advanced credentials, depending on program design and state requirements.

Before committing, compare undergraduate and graduate nursing options, speak with admissions and financial aid advisors, and review healthcare career requirements for your intended role and state.

Key Insights

• The shortage has multiple causes. Retirement, burnout, limited faculty capacity, clinical placement constraints, and rising care demand all contribute to the nursing gap.
• State conditions vary widely. California, Texas, Florida, New York, Pennsylvania, Ohio, Illinois, North Carolina, Michigan, and Georgia show different patterns in retirement risk, vacancies, exam outcomes, finances, and projected demand.
• Recruitment alone is not enough. Healthcare systems must also improve nurse retention through safer staffing, mentorship, professional development, and credible leadership.
• Education pathways can help when matched to the student. ADN, direct-entry MSN, accelerated BSN, LPN-to-RN, RN-to-BSN, ADN-to-MSN, and MSN programs serve different goals and timelines.
• Affordability matters. Tuition, clinical travel, reduced work hours, supplies, and licensure costs can keep qualified students out of nursing unless financial support is available.
• Specialization strengthens the workforce. Certifications, BSN completion, and graduate study can help nurses move into high-need roles without requiring every professional to follow the same route.
• Program quality should come before speed. Students should verify accreditation, state approval, clinical requirements, total cost, licensure alignment, and support services before enrolling.

References

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