The U.S. is projected to experience a shortage of RNs that is expected to intensify as Baby Boomers age and the need for health care grows. Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care.
The American Association of Colleges of Nursing (AACN) is working with schools, policy makers, nursing organizations, and the media to bring attention to this healthcare worry. AACN is leveraging its resources to shape legislation, identify strategies, and form collaborations to address the shortage. To keep stakeholders abreast of the issues, this fact sheet has been developed along with a companion web resource.
Current & projected shortage indicators
According to the Bureau of Labor Statistics Employment Projections 2014-2024, the RN workforce is expected to grow from 2.7 million in 2014 to 3.2 million in 2024, an increase of 439,300 or 16%. The Bureau also projects the need for 649,100 replacement nurses in the workforce bringing the total number of job openings for nurses due to growth and replacements to 1.09 million by 2024.
Back in October 2010, the Institute of Medicine (IOM) released its landmark report on The Future of Nursing, initiated by the Robert Wood Johnson Foundation, which called for increasing the number of baccalaureate-prepared nurses in the workforce to 80% and doubling the population of nurses with doctoral degrees. The current nursing workforce falls far short of these recommendations, with only 55% of registered nurses prepared at the baccalaureate or graduate degree level.
Nursing school enrollment is not growing fast enough to meet the projected demand for RNs. Though AACN reported a 3.6% enrollment increase in entry-level baccalaureate programs in nursing in 2016, the increase is not sufficient to meet the projected demand for nursing services, including the need for more nurse faculty, researchers, and primary care providers.
A shortage of nursing school faculty is also restricting nursing program enrollments. According to AACN's report on 2016-2017 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, U.S. nursing schools turned away 64,067 qualified applicants from baccalaureate and graduate nursing programs in 2016 due to budget constraints, and an insufficient number of faculty, clinical sites, classroom space, and clinical preceptors.
Almost two-thirds of the nursing schools responding to the survey pointed to a shortage of faculty and/or clinical preceptors as a reason for not accepting all qualified applicants into their programs.
Additionally, a significant segment of the nursing workforce is nearing retirement age. According to a 2013 survey conducted by the National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers, 55% of the RN workforce is age 50 or older. They project that more than 1 million RNs will retire within the next 10 to 15 years.
Insufficient staffing raises the stress level of nurses, impacting job satisfaction, and driving many nurses to leave the profession. Many nurses themselves believe the nursing shortage presents a major problem for the quality of their work life, the quality of patient care, and the amount of time nurses can spend with patients.
Strategies to address the nursing shortage
Several initiatives are underway to address both the shortage of RNs and nurse educators. For example, in January 2014, the University of Wisconsin announced the $3.2 million “Nurses for Wisconsin” initiative to provide fellowships and loan forgiveness for future nurse faculty who agree to teach in the state after graduation. This program was launched in response to projections that Wisconsin could see a shortage of 20,000 nurses by 2035.
Nursing schools are forming strategic partnerships and seeking private support to help expand student capacity. For example, the University of Minnesota announced a partnership with the Minnesota VA Health Care System to expand enrollment in the school's BSN program. With a focus on enhancing care to veterans, the VA committed $5.3 million to the university to expand clinical placement sites, fund additional faculty, and support interprofessional engagement.
AACN has expanded NursingCAS, the nation's centralized application service for RN programs, to include graduate nursing programs. One of the primary reasons for launching NursingCAS was to ensure that all vacant seats in schools of nursing are filled to better meet the need for RNs, APRNs, and nurse faculty. In 2016, more than 38,800 vacant seats were identified in baccalaureate and graduate nursing programs. NursingCAS provides a way to fill these seats and maximize the educational capacity of schools of nursing.