How Will the Nurse Shortage Affect Your State?

February 8, 2017 

As health care evolves in the United States, nurses play a critical role in meeting a growing demand. The aging baby boomer population and the implementation of the Affordable Care Act contribute to the predicted need for health care professionals — especially in primary care. With their training and skills, nurse practitioners (NPs) can help alleviate the projected shortage of primary care providers.

The supply of NPs is projected to increase by 30 percent to 72,100 by 2020, according to a 2013 report by the U.S. Health Resources and Services Administration (HRSA). Advanced practice nursing begins with registered nurse (RN) education and licensure, so it is useful to know the RN demand and projected shortages.

Nursing@Georgetown created the graphic below — based on data from a 2014 HRSA report, “The Future of the Nursing Workforce: National- and State-Level Projections, 2012-2025” — to help illustrate which states will need more nurses over the next decade.

  • Where Will the U.S. Need Nurses?

    Exploring state supply and demand in the nursing landscape of tomorrow

    Will your state need more nurses over the next decade? According to a 2013 report by the U.S. Health Resources and Services Administration, the supply of nurse practitioners (NPs) is projected to increase by 30 percent to 72,100 in 2020. Advanced practice begins with registered nurse (RN) education and licensure, so it is useful to know where RN demand and shortages are projected. Read on to learn how each state stacks up.

    Map DataProjected Nursing Demand in 2025Projected Nursing Supply in 2025Projected Difference in 2025 (Pos = Surplus/Neg = Shortage)
    Alabama
    55,700
    70,100
    14,400
    Alaska
    7,300
    4,600
    -2,700
    Arizona
    87,200
    59,100
    -28,100
    Arkansas
    31,800
    47,700
    15,900
    California
    393,600
    389,900
    -3,700
    Colorado
    59,000
    46,100
    -12,900
    Connecticut
    41,500
    45,200
    3,700
    Delaware
    12,500
    16,200
    3,700
    Florida
    225,500
    229,700
    4,200
    Georgia
    101,400
    94,700
    -6,700
    Hawaii
    13,400
    13,200
    -200
    Idaho
    15,400
    16,100
    700
    Illinois
    140,100
    149,800
    9,700
    Indiana
    71,400
    91,600
    20,200
    Iowa
    35,300
    56,600
    21,300
    Kansas
    32,800
    47,600
    14,800
    Kentucky
    51,000
    67,500
    16,500
    Louisiana
    46,500
    64,700
    18,200
    Maine
    17,500
    15,800
    -1,700
    Maryland
    72,000
    59,900
    -12,100
    Massachusetts
    85,500
    85,900
    400
    Michigan
    104,600
    116,000
    11,400
    Minnesota
    66,500
    84,900
    18,400
    Mississippi
    35,800
    47,000
    11,200
    Missouri
    67,700
    85,000
    17,300
    Montana
    12,100
    11,300
    -800
    Nebraska
    21,900
    22,100
    200
    Nevada
    32,400
    24,600
    -7,800
    New Hampshire
    18,000
    18,500
    500
    New Jersey
    98,500
    119,400
    20,900
    New Mexico
    22,100
    18,700
    -3,400
    New York
    212,400
    235,800
    23,400
    North Carolina
    120,000
    107,100
    -12,900
    North Dakota
    7,600
    10,400
    2,800
    Ohio
    137,400
    212,800
    75,400
    Oklahoma
    37,300
    55,000
    17,700
    Oregon
    40,100
    34,100
    -6,000
    Pennsylvania
    152,600
    178,400
    25,800
    Rhode Island
    14,000
    11,900
    -2,100
    South Carolina
    54,600
    54,000
    -600
    South Dakota
    10,600
    14,500
    3,900
    Tennessee
    76,100
    92,200
    16,100
    Texas
    278,300
    284,400
    6,100
    Utah
    25,400
    31,200
    5,800
    Vermont
    8,100
    8,800
    700
    Virginia
    87,300
    106,700
    19,400
    Washington
    75,100
    68,100
    -7,000
    West Virginia
    21,100
    29,000
    7,900
    Wisconsin
    68,800
    78,100
    9,300
    Wyoming
    4,900
    6,800
    1,900

    Data for Washington, D.C., are not presented because the small sample size in the American Community Survey — used to create “The Future of the Nursing Workforce: National- and State-Level Projections, 2012-2015” — generated unstable supply estimates.

    SOURCE

    “The Future of the Nursing Workforce: National- and State-Level Projections, 2012-2015,” U.S. Health Resources and Services Administration, 2014, 8-9. Accessed October 10, 2016.
    bhw.hrsa.gov/sites/default/files/bhw/nchwa/projections/nursingprojections.pdf

Understanding the Nurse Workforce

The American Association of Colleges of Nursing notes that an aging population, coupled with “nursing schools across the country … struggling to expand capacity to meet the rising demand for care given the national move toward health care reform,” will result in a shortage of nurses.

A 2015 report produced by the Georgetown University Center on Education and the Workforce — “Nursing: Supply and Demand Through 2020” — factors in the age and makeup of the current nurse workforce, the size of graduating nursing classes, and nurses’ career decisions to predict a dearth of approximately 193,000 professional nurses in the United States by 2020. A 2012 report, “United States Registered Nurse Workforce Report Card and Shortage Forecast,” concurs. It predicts a nursing shortage by 2030 throughout the country, especially in the West and South, because of projected changes in population. 

The Pursuit of Nursing

Predictions vary regarding the degree of the nurse scarcity ahead, but some regions, like Southern states, have a higher predicted need for health care professionals. Aging population growth and policy changes enable more individuals to access health care, but an inadequate nurse supply can have a significant impact on the availability of quality care, thereby increasing negative patient outcomes.

State-specific scope of practice regulations for NPs will also affect health care. In states that support full practice for NPs, advanced practice nurses can function as primary care providers, which can help to alleviate the anticipated dearth of primary care physicians. However, states with restricted practice regulations, such as California and Texas, cannot take full advantage of care NPs provide. In states with both a predicted nurse shortage and restricted NP practice, shortfalls in RNs and NPs will likely have greater impact on patient care. This will affect many Southern states, including Georgia and South Carolina. 

The projected nursing shortfall has a patchwork of causes. Some experts find that the main element is the fluctuating number of students pursuing nursing studies. Other factors include a demanding job environment; inconsistent wages; and challenges to recruitment, training, and retention. Rural areas are more vulnerable to such factors, especially in the Western and Southwestern regions of the United States.

As the authors of “Nursing: Supply and Demand through 2020” explain, “Stressful working environments, along with long hours and erratic schedules in some nursing positions, contribute to many nurses moving in and out of the field based on economic conditions and personal circumstances.” According to the report, of the 5.2 million licensed nursing professionals in 2013, only 3.6 million worked as a nurse during that time.

The report also found that many of today’s nursing schools are not equipped to meet the needs of students interested in pursuing the nursing profession. In the 2011-2012 school year, Bachelor of Science in Nursing programs rejected 37 percent of qualified applicants; associate degree programs rejected 51 percent of qualified applicants. These programs are limited by lack of adequate faculty and facilities to meet educational needs.

Conclusion

Registered nurses can advance their careers to help meet growing demand in the years ahead. Programs like Nursing@Georgetown’s Master of Science degree in Nursing online offer an opportunity for nurses to continue to practice their profession, simultaneously advancing their careers and fulfilling future needs in their communities.

Please note that this blog post is for informational purposes only. Individuals should consult their health care professionals before following any of the information provided. Nursing@Georgetown does not endorse any organizations or websites contained in this post.