Nursing Shortage Fact Sheet

The U.S. is experiencing a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for healthcare 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, policymakers, 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.

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  • According to the Bureau of Labor Statistics’ Occupational Outlook Handbook, the Registered Nursing (RN) workforce is expected to expand by 5% over the next decade. The RN workforce is anticipated to grow from 3.39 million in 2024 to 3.56 million in 2034, an increase of 166,100 nurses. The Bureau also projects 189,100 openings for RNs each year through 2034 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 occupations, by 35% from 2024 through 2034, according to the Bureau of Labor Statistics. Approximately 32,700 new APRNs, which are prepared in master’s and doctoral programs, will be needed each year through 2034 to meet the rising demand for primary and specialty care.

  • According to Nursing Workforce Projections, 2023-2038 published by the Health Resources and Services Administration (HRSA) in December 2025, federal authorities project a shortage of 267,330 full-time RNs by 2028. The ten states with the largest projected nursing shortage in 2038 are California (22%), North Carolina (20%), Georgia (20%), Michigan (18%), Washington (17%), Maryland (16%), Oklahoma (13%), South Carolina (12%), Louisiana (11%) and Virginia (8%).Data for each state may be accessed through HRSA’s Workforce Projections Dashboard.

  • According to the 2026 NSI National Health Care Retention & RN Staffing Report, the RN vacancy rate in acute care settings in the U.S. is 8.6%, down from 9.6% in 2024. The report also found that the RN turnover rate in hospitals is 17.6% with the average time needed to recruit an experienced RN ranging from 56 to 102 days.

  • In May 2026, the International Council of Nurses (ICN) issued a report titled Our Nurses. Our Future. Empowered Nurses Save Lives, calling for urgent investment in nursing. To address the shortage of 5.8 million nurses worldwide, ICN called on governments to fund national workforce plans, improve working conditions, invest in education, expand scope of practice, and elevate nurse leadership.

  • 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 recommendation, though more than two-thirds of RNs are educated at the baccalaureate or graduate level. The exact percentage has been reported as 69% by HRSA and 72.9% by the National Council of State Boards of Nursing.

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

Though enrollment in entry-level baccalaureate programs in nursing increased by 7.6% in 2025, AACN reported a drop in PhD programs for the eleventh consecutive year (down 3%) . This trend is raising concerns about the capacity of nursing schools to meet the projected demand for nurses, 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 2025-2026 Enrollment and Graduations in  Baccalaureate and Graduate Programs in Nursing, U.S. nursing schools turned away 92,672 qualified applications (not applicants) from baccalaureate and graduate nursing programs in 2025 due to insufficient number of faculty, clinical sites, classroom space, and clinical preceptors, as well as budget constraints. Within this total, nearly 17,000 applications were turned away from graduate programs, which limits the pool of potential nurse educators, given that most full-time teaching roles require a master’s or doctoral degree.

  • According to a Special Survey on Vacant Faculty Positions released by AACN in October 2025, a total of 1,588 full-time faculty vacancies were identified in a survey of 1,075 nursing schools with baccalaureate and/or graduate programs across the country (80.3% response rate). Besides the vacancies, schools cited the need to create an additional 150 faculty positions to accommodate student demand. The data show a national nurse faculty vacancy rate of 7.2%. Most of the vacancies (80.8%) were faculty positions requiring or preferring a doctoral degree. 

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

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

  • The U.S. Census Bureau reported that number of Americans aged 65 and older is projected to increase from 58 million in 2022 to 82 million by 2050 (23% of the population). With larger numbers of older adults, there will be an increased need for geriatric care, including care for individuals with chronic diseases and comorbidities.

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 2026 Nurse Salary Research Report, 24% of nurses across all license types considered leaving in 2025, compared with 23% in 2024. 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. The report also found that 60% of nurses report feeling overwhelmed and 53% are experiencing burnout.

  • Published on April 9, 2024, in JAMA Open Network, Dr. K. Jane Muir from the University of Pennsylvania and colleagues examine Top Factors in Nurses Ending Health Care Employment Between 2018 and 2021. In a cross-sectional study of 7887 nurses, the authors identified that the top contributing factors for leaving healthcare employment were planned retirement (39%), burnout (26%), insufficient staffing (21%), and family obligations (18%). To improve retention, the authors call on employers to focus on reducing burnout, improving nurse staffing levels, and supporting work-life balance.

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

  • In the March-April 2025 Nursing Outlook, Dr. Yin Li from Emory University and colleagues explore The Effect of Registered Nurse Staffing and Skill Mix on Length of Stay and Hospital Costs. The authors found that a one-unit increase in RN hours per patient day and a 1% increase in RN skill mix reduced hospital stays by 2% and 1%, respectively. Enhancing staffing to nine RN hours per patient day and an 80% RN skill mix could save 63,580 inpatient days annually, reducing costs by $152.9 million. 

  • In the July 2024 issue of Medical Care, Dr. Karen Lasater and colleagues from the University of Pennsylvania propose that Alternative Models of Nurse  Staffing May Be Dangerous in High-Stakes Hospital Care. In a review of more than 6.5 million Medicare patient records, the research team found a 10 percentage-point reduction in RNs was associated with 7% higher odds of in-hospital death, 1% higher odds of readmission, 2% increase in expected days, and lower patient satisfaction. This translates to 10,947 avoidable deaths and 5,207 avoidable readmissions annually, generating roughly $68.5 million in additional Medicare costs.

  • Using data from more than 213,000 hospital admissions, researchers with the University of Southampton (UK ) published results from a study in September 2024 which found that insufficient staffing by RNs and nursing assistants is associated with an increase in the risk of mortality, longer hospital stays, and a higher incidence of deep vein thrombosis, pneumonia, and pressure ulcers.
  • In November 2021, new research in Nursing Outlook examined Variations 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 published 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. 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 care quality. Increases in registered nurse staffing were associated with reductions in hospital-related mortality and failure to rescue rates as well as reduced length of stays.

  • A shortage of nurses prepared at the baccalaureate level is affecting healthcare 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%.

  • AACN is committed to working with the higher education and healthcare community to prepare more 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 (e.g., Title VIII, Future Advancement of Academic Nursing 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.

  • Updated in April 2026, 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 July 2026, the University of Maryland announced receiving more than $6 million in funding from the Maryland Health Services Cost Review Commission to expand nursing education capacity and meet nursing workforce needs. Additional initiatives are also underway in Alabama, Connecticut, Florida, Missouri, Pennsylvania, and Texas, and other states.

  • Nursing schools are forming strategic partnerships and seeking private support to help expand student capacity. For example, Chamberlain University and SSM Health announced a new partnership in July 2025 to launch the Aspiring Nurse program with the goal of graduating more than 400 nurses annually across four states. See also efforts launched by Texas State University and CHRISTUS Health, McDaniel College and LifeBridge Health, Idaho State University and Kootenai Health; Illinois College and Memorial Health; Emory University and the Georgia Nursing Leadership Coalition; Washington State University and Providence Health & Services; and the University of Oklahoma and area schools.

Auerbach, D., Buerhaus, P.I., Donelan, K., & Staiger, D.O. (2022, April 27). A Worrisome Drop in the Number of Young Nurses. Health Affairs.

Auerbach, D., Buerhaus, P.I., Donelan, K., & Staiger, D.O. (2024, February 16). Projecting the Future Registered Nurse Workforce After the COVID-19 Pandemic. JAMA Health Forum, 5(2), e235389.

Buerhaus, P.I., Staiger, D.O., Auerbach, D.I., Yates, C., & Donelan, K. (2022, January). Nurse employment during the first fifteen months of the COVID-19 pandemic. Health Affairs, 41(1).

Firth, S. (2022, May 16). More Support Needed to Shore Up Nurse Pipeline, Experts Say. MedPage Today.

Lasater, K.B., McHugh, M.D., & Muir, K.J. (2026, February 9). Organizational Factors to Reattract Nurses to Hospital Employment. JAMA Network Open, 9(2), e2556570.

Meredith, P., Turner, L., Saville, C., & Griffiths, P. (2024, September). Nurse understaffing associated with adverse outcomes for surgical admissions. British Journal of Surgery, 111(9), doi.org/10.1093/bjs/znae215.

Suran, M. (2023, October 23). Overworked and Understaffed, More Than 1 in 4 US Nurses Say They Plan to Leave the Profession. JAMA Medical News, 330(16), 1512-1514. doi:10.1001/jama.2023.10055.

Taylor, M. (2026, April 27). The current state of nursing: 2026. Becker’s Clinical Leadership.

 

Updated: July 2026

Contact

Robert Rosseter
rrosseter@aacnnursing.org