The Nursing Shortage in 2026: What the Federal Data Actually Projects
By NurseComp Editorial · May 21, 2026 · 14 min read
Everyone says there is a nursing shortage. HRSA modeled it. BLS counted the openings. Here is what the federal workforce projections actually say — which states are worst, how big the gap is, and what it means for RN wages.
You have heard "nursing shortage" so many times it has become background noise. But the federal government has modeled it in detail, and the numbers are more specific — and more geographically uneven — than the headlines suggest.
The Sources
Two federal agencies provide the primary nursing workforce data:
- Bureau of Labor Statistics (BLS): Projects 193,000 RN openings per year through 2032 via the Occupational Outlook Handbook. These are openings from retirements, career exits, and net growth combined.
- Health Resources and Services Administration (HRSA): Published detailed nurse workforce supply-and-demand projections through 2038 (March 2024 modeling cycle). These model full-time-equivalent supply against projected demand by role and state.
Additionally, NSI Nursing Solutions publishes the annual National Health Care Retention & RN Staffing Report, which tracks hospital-level vacancy and turnover rates.
Sources: BLS OOH; HRSA Nurse Workforce Projections 2023–2038 fact sheet; NSI 2025 report.
The National Picture from HRSA
HRSA's 2023–2038 projections for selected nursing occupations (in full-time equivalents):
2026 Projections:
| Role | Projected Supply | Projected Demand | Adequacy |
|---|---|---|---|
| Registered Nurses | ~3,100,000 FTE | ~3,370,000 FTE | ~92% |
| Licensed Practical Nurses | ~560,000 FTE | ~730,000 FTE | ~77% |
| Nurse Practitioners | ~560,000 FTE | ~400,000 FTE | ~140% |
| Nurse Anesthetists | ~72,000 FTE | ~68,000 FTE | ~106% |
2033 Projections:
| Role | Projected Supply | Projected Demand | Adequacy |
|---|---|---|---|
| Registered Nurses | 3,269,070 FTE | 3,473,760 FTE | 94% |
| Licensed Practical Nurses | 578,050 FTE | 764,020 FTE | 76% |
| Nurse Practitioners | 638,990 FTE | 420,250 FTE | 152% |
| Nurse Anesthetists | 74,110 FTE | 68,930 FTE | 108% |
2038 Projections:
| Role | Projected Supply | Projected Demand | Adequacy |
|---|---|---|---|
| Registered Nurses | 3,509,970 FTE | 3,618,930 FTE | 97% |
| Licensed Practical Nurses | 565,690 FTE | 811,640 FTE | 70% |
| Nurse Practitioners | 766,260 FTE | 437,330 FTE | 175% |
Source: HRSA Nurse Workforce Projections, 2023–2038, bhw.hrsa.gov.
The Key Takeaway: 8% Unmet Demand in 2026
Prolink Healthcare, analyzing the HRSA projections, calculated that approximately 8.06% of U.S. nursing demand goes unmet in 2026. That is not a future hypothetical — it is the current reality. It shows up as:
- Harder-to-fill shifts (especially nights and weekends)
- Higher per-shift labor costs for travel and agency nurses
- Heavier patient loads for staff nurses
- Longer wait times in EDs and outpatient settings
- Increased pressure on patient throughput
Source: Prolink Healthcare 2026 Pulse of Travel Healthcare report; HRSA modeling.
Which States Face the Worst Shortages
HRSA projected the largest RN shortages (by 2038, but the trajectory starts now) in:
| State | Projected Shortage | FTE Deficit |
|---|---|---|
| California | 22% | 84,750 |
| North Carolina | 20% | 25,710 |
| Georgia | 20% | 25,110 |
| Michigan | 18% | 20,290 |
| Washington | 17% | 15,020 |
| Maryland | 16% | 10,890 |
| Oklahoma | 13% | 5,900 |
| South Carolina | 12% | 7,250 |
| Louisiana | 11% | 5,680 |
| Virginia | 8% | 8,020 |
These states face structural supply problems: aging populations driving demand up, insufficient nursing school capacity, faculty shortages limiting enrollment, and competition from neighboring states with higher pay.
Source: HRSA Nurse Workforce Projections 2023–2038 fact sheet.
Why the Shortage Exists: The Root Causes
The nursing shortage is not a single problem. Federal and academic analyses identify multiple converging factors:
1. Retirement wave. The average age of an RN in the U.S. is approximately 52 years old (NCSBN 2022 National Nursing Workforce Survey). Roughly 20% of the RN workforce is over 55. As Baby Boomer nurses retire, they are leaving faster than new graduates replace them.
Source: NCSBN 2022 National Nursing Workforce Survey.
2. Nursing school capacity constraints. AACN reported that U.S. nursing schools turned away approximately 78,190 qualified applicants from baccalaureate and graduate nursing programs in 2023 due to insufficient faculty, clinical sites, classroom space, and budget constraints.
The faculty shortage is the binding constraint: the average age of a nursing professor is 57, doctoral-prepared faculty earn far less than clinical NPs, and retirement is accelerating.
Source: AACN 2023–2024 enrollment and graduation survey; AACN Nursing Shortage Fact Sheet.
3. Turnover and exit from bedside. NSI Nursing Solutions reports hospital RN turnover rates of approximately 18–22% per year in recent data. The first-year turnover rate for new graduate nurses has been reported as high as 25–30% in some markets.
COVID-19 accelerated exits from bedside care, and many nurses who left have not returned. Surveys consistently show that workload, staffing ratios, and workplace violence are the top drivers.
Source: NSI 2025 National Health Care Retention Report; McKinsey 2022 healthcare workforce survey.
4. Demand growth from aging population. The U.S. population aged 65+ is projected to grow from approximately 58 million in 2022 to 82 million by 2050 (U.S. Census Bureau). Older adults consume disproportionately more healthcare services, directly increasing nursing demand.
Source: U.S. Census Bureau population projections.
What the Shortage Means for RN Wages
Supply-demand imbalance drives wages up. The connection is empirically clear:
- States with the worst projected shortages (California, Washington) already have the highest RN wages
- The 2020–2024 period saw the fastest RN wage growth in decades — directly driven by pandemic-era shortages
- Hospitals in shortage states are spending $12–$18 billion per year on travel nursing and agency staff at rates 2–3x higher than permanent staff
However, not all shortage translates equally to wage increases:
- Hospitals with unionized nursing staff see wage gains distributed more evenly
- Non-union hospitals may increase recruitment spending (sign-on bonuses, agency) without proportional base wage increases
- Rural critical access hospitals face shortages but lack the revenue to match urban pay, creating a self-reinforcing cycle
What This Means for Your Career Decisions
If you are a working RN or considering nursing:
- Geographic flexibility is the single largest compensation lever. Shortage states pay premiums. Within states, rural and underserved areas pay the highest relative premiums.
- Specialization in shortage areas compounds the effect. ICU, OR, L&D, and ED nurses in shortage states command the highest staff rates because those skills cannot be easily cross-trained.
- The shortage is structural and multi-decade. HRSA does not project RN supply adequacy reaching 97% nationally until 2038. This is not a temporary phenomenon.
- LPN shortage is worse than RN shortage. LPN supply adequacy is projected at only 70% by 2038. LPN roles in long-term care and skilled nursing may see disproportionate wage pressure.
- NP oversupply is real. Unlike RNs and LPNs, NP supply exceeds demand at 140–175% depending on projection year. This may moderate NP salary growth and tighten the job market for new NP graduates in saturated metro areas.
Sources: All data as cited above from HRSA, BLS, NCSBN, AACN, and NSI.