The United States is in the midst of a nursing shortage that is expected to intensify as baby boomers age and the need for health care grows. Compounding the problem is the fact that nursing colleges and universities across the country are struggling to expand enrollment levels to meet the rising demand for nursing care.

The American Association of Colleges of Nursing (AACN) is concerned about the shortage of Registered Nurses (RNs) and is working with schools, policy makers, kindred organizations, and the media to bring attention to this health care crisis. AACN is working to enact legislation, identify strategies, and form collaborations to address the nursing shortage. To keep stakeholders abreast of current statistics related to the shortage, this fact sheet has been developed along with a companion Web resource.

Current and Projected Shortage Indicators

In the January/February 2007 issue of Health Affairs, Dr. David I. Auerbach and colleagues estimated that the U.S. shortage of registered nurses (RNs) will increase to 340,000 by the year 2020. Though this is significantly less than earlier projections for a shortfall of 800,000 RNs which was made back in 2000, the study authors note that the nursing shortage is still expected to increase by three times the current rate over the next 13 years. The study is titled Better Late Than Never: Workforce Supply Implications of Late Entry into Nursing. http://content.healthaffairs.org/cgi/content/abstract/26/1/178
Based on finding from the Nursing Management Aging Workforce Survey released in July 2006 by the Bernard Hodes Group, 55% of surveyed nurses reported their intention to retire between 2011 and 2020. The majority of those surveyed were nurse managers.
In April 2006, officials with the Health Resources and Services Administration (HRSA) released projections that the nation's nursing shortage would grow to more than one million nurses by the year 2020. In the report titled What is Behind HRSA's Projected Supply, Demand, and Shortage of Registered Nurses?, analysts show that all 50 states will experience a shortage of nurses to varying degrees by the year 2015.
According to a report released by the American Hospital Association in April 2006, U.S. hospitals need approximately 118,000 RNs to fill vacant positions nationwide. This translates into a national RN vacancy rate of 8.5%. The report, titled The State of America's Hospitals - Taking the Pulse, also found that 49% of hospital CEOs had more difficulty recruiting RNs in 2005 than in 2004.
According to the latest projections from the U.S. Bureau of Labor Statistics published in the November 2005 Monthly Labor Review, more than 1.2 million new and replacement nurses will be needed by 2014. Government analysts project that more than 703,000 new RN positions will be created through 2014, which will account for two-fifths of all new jobs in the health care sector.
According to a report published in November 2004 as a Web exclusive of Health Affairs, Dr. Peter Buerhaus and colleagues found that "despite the increase in employment of nearly 185,000 hospital RNs since 2001, there is no empirical evidence that the nursing shortage has ended. To the contrary, national surveys of RNs and physicians conducted in 2004 found that a clear majority of RNs (82%) and doctors (81%) perceived shortages where they worked."
Contributing Factors Impacting the Nursing Shortage

Enrollment in schools of nursing is not growing fast enough to meet the projected demand for nurses over the next ten years.

Though AACN reported a 7.6% enrollment increase in entry-level baccalaureate programs in nursing in 2006 over the previous year, this increase is not sufficient to meet the projected demand for nurses. HRSA officials stated in an April 2006 report that "to meet the projected growth in demand for RN services, the U.S. must graduate approximately 90 percent more nurses from US nursing programs."

A shortage of nursing school faculty is restricting nursing program enrollments.

According to AACN's report on 2006-2007 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, U.S. nursing schools turned away 42,866 qualified applicants from baccalaureate and graduate nursing programs in 2006 due to insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints. Almost three quarters (71.0%) of the nursing schools responding to the 2006 survey pointed to faculty shortages as a reason for not accepting all qualified applicants into entry-level nursing programs.
According to a study released by the Southern Regional Board of Education (SREB) in February 2002, a serious shortage of nursing faculty was documented in 16 SREB states and the District of Columbia. Survey findings show that the combination of faculty vacancies (432) and newly budgeted positions (350) points to a 12% shortfall in the number of nurse educators needed. Unfilled faculty positions, resignations, projected retirements, and the shortage of students being prepared for the faculty role pose a threat to the nursing education workforce over the next five years.