The U.S. Nursing Shortage: A State-by-State Breakdown
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Key Takeaways
- The nursing shortage is deepening, but it varies from state to state and city to city.
- Wide state gaps in nurse-to-population ratios expose regional healthcare strains.
- The federal government projects about 190,000 RN openings annually through 2034.
The U.S. nursing shortage is expected to worsen over the next several years as many nurses exit the field for reasons including burnout and an aging workforce. To worsen matters, nursing schools are unable to keep up with industry demand for more graduates. The Bureau of Labor Statistics (BLS) projects 189,100 openings for RNs each year until 2034.
Explore this guide detailing the nursing shortage, including employment data for your state.
U.S. Nurse-to-State Population Ratio
Sources: Census.gov, BLS
Local Nurse Employment vs. National Nurse Employment
The BLS defines location quotient as “the ratio of the area concentration of occupational employment to the national average concentration.” In other words, this unique data point demonstrates how states and metropolitan areas stack up with the national average in terms of nurse employment. A quotient greater than one indicates the occupation has a higher-than-average employment level, while a location quotient of lower than one indicates the occupation is less prevalent in that area.
Major cities with higher populations tend to always need more nurses, with most city hospitals offering many open positions. According to data from the BLS, 14 states and the District of Columbia have local concentrations of less than one.
- District of Columbia (0.6 location quotient)
- Utah (0.7)
- Idaho (0.8)
- Maryland (0.8)
- California (0.9)
- Nevada (0.9)
- Washington (0.9)
- Wyoming (0.9)
- Colorado (0.9)
- Texas (0.9)
- Virginia (0.9)
- Oklahoma (0.9)
- Georgia (0.9)
- Arizona (0.9)
- Oregon (0.9)
Metropolitan areas tend to maintain the highest location quotients of local nurse employment to national nurse employment:
- Bloomsburg Berwick, Pennsylvania (3.2 location quotient)
- Morgantown, West Virginia (2.4)
- Greenville, North Carolina (2.3)
- Ann Arbor, Michigan (2.1)
- Sioux Falls, South Dakota (2.0)
Larger cities tend to suffer more from nursing shortages due to higher population densities. Simply put, there needs to be more new nurses entering the field to properly manage the volume of people who need healthcare within most large cities.
Factors Contributing to the National Nursing Shortage
According to the American Association of Colleges of Nursing (AACN), many factors contribute to the national nursing shortage, including:
- Lack of school enrollment: In 2023, nursing schools turned down over 65,000 qualified applications due to several reasons, including lack of faculty. That same year, there were nearly 2,000 full-time nursing faculty vacancies.
- High turnover: For years, nurse turnover has climbed at a steady rate. Per the American Nurses Association (ANA), reasons for the exits include burnout, bullying and incivility, high nurse-to-patient ratios, and first-year “blues.”
- Nurse retirements: Over 1 million RNs are projected to retire by 2030. As of 2022, 23% of RNs working in outpatient settings have either retired already or are set to retire within the next five years.
- An aging population: By 2050, the older adult population is projected to rise 23%. This increases the demand for geriatric nurses who provide care to older adults with chronic conditions.
State legislators are addressing the nursing shortage. Hospitals and schools are also taking action. Still, the issue does not seem likely to go away anytime soon. Keep up with your state’s nursing workforce picture and keep track of where demand may make candidates more sought-after.
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