Yes, the United States is experiencing a significant nursing shortage, and it’s projected to get worse. The median age of registered nurses hit 50 in 2024, and 40% of the RN workforce reported plans to leave the profession within five years, according to the National Council of State Boards of Nursing. At the same time, nursing schools are turning away tens of thousands of qualified applicants each year because they don’t have enough faculty to train them. The result is a gap between how many nurses the country needs and how many it can produce.
How Big the Shortage Is Right Now
The shortage isn’t a single national number. It plays out unevenly across states, hospital systems, and specialties. Some regions are already critically understaffed, while others are managing for now but facing steep projected deficits. The ten states expected to have the largest nursing shortages by 2035 are Washington (26%), Georgia (21%), California (18%), Oregon (16%), Michigan (15%), Idaho (15%), Louisiana (13%), North Carolina (13%), New Jersey (12%), and South Carolina (11%). Those percentages represent the gap between projected demand and projected supply.
Rural areas tend to feel the pinch most acutely. Smaller hospitals and clinics in less populated regions struggle to compete with urban medical centers on salary and working conditions, making recruitment harder and turnover faster.
Why Nursing Schools Can’t Keep Up
One of the most frustrating parts of the shortage is that plenty of people want to become nurses. In 2024, U.S. nursing schools turned away 80,162 qualified applications from baccalaureate and graduate programs. These weren’t students who failed to meet admission standards. They were qualified and ready to enroll, but schools didn’t have the capacity to accept them.
The biggest bottleneck is faculty. There simply aren’t enough nursing professors to teach the next generation. A 2025 survey of 863 nursing schools found 1,588 full-time faculty vacancies, putting the national nurse faculty vacancy rate at 7.2%. Beyond those open positions, schools said they needed to create an additional 150 faculty roles just to meet current student demand. The problem is self-reinforcing: nurses with advanced degrees can typically earn more in clinical practice than in academia, so the teaching pipeline stays thin.
Clinical training sites and preceptors (the experienced nurses who supervise students during hands-on rotations) are also in short supply. Even when a school has classroom space, it may not have enough hospital partnerships to give every student the clinical hours they need to graduate.
An Aging Workforce Heading for the Exit
The supply problem isn’t just about new nurses coming in. It’s also about experienced nurses leaving. With a median age of 50, a large portion of the workforce is approaching retirement age within the next decade. The 2024 National Nursing Workforce Survey found that 40% of RNs plan to leave the profession in the next five years, a figure that reflects not only retirements but also burnout-driven departures among younger nurses.
The pandemic accelerated this trend dramatically. Nurses who might have worked another five or ten years left early, exhausted by crisis-level staffing, mandatory overtime, and emotional toll. Many who stayed shifted to less demanding roles, moved into travel nursing, or reduced their hours. The workforce that emerged from 2020 to 2023 was smaller, older, and more stretched than before.
What This Means for Patient Care
Nurse staffing levels directly affect whether patients live or die. Research published in the International Journal of Nursing Studies found that shifts with high registered nurse staffing had 8.7% lower odds of patient mortality compared to average staffing. Shifts with low staffing saw 10% higher odds of mortality. These aren’t abstract statistics. They represent real differences in how quickly a deteriorating patient gets noticed, how carefully medications are administered, and how thoroughly complications are caught.
Interestingly, the study also found that simply filling gaps with unlicensed or administrative personnel didn’t help. Both high and low levels of non-nursing staff were associated with slightly higher mortality, suggesting that the skill set of registered nurses specifically, not just the number of bodies on a unit, is what protects patients.
The Financial Pressure on Hospitals
Replacing a single nurse costs a hospital up to $72,000 when you factor in recruiting, onboarding, training, and the lost productivity during the transition period. For a hospital losing dozens of nurses per year, those costs add up to millions. High turnover also creates a vicious cycle: remaining staff pick up heavier workloads, burn out faster, and leave sooner, triggering yet another round of expensive recruitment.
Travel nurses, who fill temporary gaps at premium rates, became a financial lifeline during the pandemic but also a budget strain. Hospitals that relied heavily on travelers found themselves paying two or three times the cost of permanent staff, with less continuity of care.
International Recruitment Is Getting Harder
For years, hospitals have looked overseas to fill nursing vacancies. Applications through VisaScreen, the credentialing program for foreign-trained healthcare workers seeking U.S. work visas, increased 212% between 2018 and 2023. In 2024, the program received 24,733 applications, a slight 4.6% dip from the prior year but still well above pre-pandemic levels.
That pipeline is now uncertain. U.S. Citizenship and Immigration Services stopped approving H-1B applications for some nurses who had been working in specialized roles at Magnet hospitals, reverting the visa program to its previous, more restrictive state. Policy shifts around immigration make international recruitment a less reliable long-term strategy, even as demand for it grows.
What’s Being Done to Close the Gap
The most significant structural change is the Nurse Licensure Compact, which now includes 43 U.S. jurisdictions. Nurses who live in a compact state can hold a single multistate license that allows them to practice across state lines without applying for a new license in each state. This makes it far easier for nurses to move to areas with the greatest need, take telehealth positions, or respond to emergencies in neighboring states.
Other efforts are focused on expanding nursing school capacity. Some states have invested in loan forgiveness and salary supplements to attract more nurses into teaching roles. A handful of programs are experimenting with simulation-based clinical training to reduce dependence on hospital placement sites. Community colleges are expanding accelerated BSN programs to create faster pathways into the profession.
None of these solutions work overnight. Training a new nurse takes two to four years depending on the degree, and building faculty pipelines takes even longer. The shortage is likely to remain a defining feature of American healthcare for at least the next decade, with the sharpest effects concentrated in states that are already behind.