The U.S. Nursing Shortage: What Healthcare Leaders Should Prepare For

The nursing shortage is not one national number. It is a mix of regional, specialty, scheduling, retention, and experience gaps that affect organizations differently. Recent federal projections point to continued pressure, especially outside major metropolitan areas, while hospitals and ambulatory settings continue to compete for experienced clinicians.

What the latest data says

The U.S. Bureau of Labor Statistics projects registered nurse employment to grow faster than the average for all occupations and anticipates a large number of annual openings, many created when nurses retire or leave the workforce. HRSA’s 2023–2038 workforce projections also anticipate a national RN shortfall, with nonmetropolitan communities facing a substantially larger gap than metro areas.

Why the shortage feels different on the ground

A national supply estimate can hide local realities. A hospital may have enough licensed nurses in its region but still struggle to cover cardiac catheterization, perioperative, critical-care, night-shift, or EHR implementation needs. Orientation time, burnout, inconsistent schedules, and the loss of experienced preceptors can compound the challenge.

A practical workforce response

Healthcare leaders can combine permanent recruiting with a flexible staffing layer. Start by identifying the units, shifts, credentials, and implementation periods where vacancies create the greatest operational risk. Build a verified pool of specialty clinicians, standardize onboarding, and monitor retention and time-to-fill by unit rather than only at the organization level.

Flexible staffing is most effective when it supports a long-term workforce plan. It can protect capacity during vacancies, seasonal surges, leaves, and Epic go-lives while leaders improve scheduling, career development, and the work environment for permanent teams.

Sources

U.S. Bureau of Labor Statistics, Registered Nurses: https://www.bls.gov/ooh/healthcare/registered-nurses.htm

HRSA, Nurse Workforce Projections 2023–2038: https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/nursing-projections-factsheet.pdf

Educational information only. Workforce conditions vary by location and may change.