The Nursing Shortage in Numbers: BLS and HRSA Projections Through 2035 and What They Mean for Your Salary (2026)
By NurseCompensation Research Team · 2026-07-20 · 15 min read
BLS projects 193,100 annual RN job openings through 2032 while nursing schools turn away 91,000 qualified applicants per year. HRSA models a 78,000-nurse shortfall by 2030. Here is what supply-demand imbalance means for compensation.
The Projection Data: Supply vs Demand
Two federal agencies publish nursing workforce projections using different methodologies:
BLS Employment Projections (2022-2032)
| Metric | Value |
|---|---|
| RN employment (2022 base) | 3,175,400 |
| Projected RN employment (2032) | 3,364,400 |
| Net growth | 189,000 (+6.0%) |
| Growth rate vs all occupations | Faster than average (3%) |
| Annual openings (growth + replacement) | 193,100 |
| Openings due to growth | 18,900/year |
| Openings due to replacement (retirements, exits) | 174,200/year |
Critical finding: 90% of annual RN openings are replacements, not growth. The shortage is primarily driven by nurses leaving the profession — not by hospitals adding new positions.
HRSA National Center for Health Workforce Analysis (2024 Projections)
| Year | Projected RN Supply | Projected RN Demand | Shortfall |
|---|---|---|---|
| 2025 | 3,218,000 | 3,256,000 | -38,000 |
| 2027 | 3,248,000 | 3,312,000 | -64,000 |
| 2030 | 3,289,000 | 3,367,000 | -78,000 |
| 2035 | 3,340,000 | 3,452,000 | -112,000 |
HRSA's model accounts for:
- Nursing school capacity and graduation rates
- Retirement patterns (Baby Boomer exit wave)
- Population aging (65+ growth driving demand)
- Geographic maldistribution
- Part-time vs full-time employment trends
The Retirement Wave: Quantified
HRSA 2022 data on current RN age distribution:
| Age Group | Number of RNs | % of Workforce | Expected Retirement Window |
|---|---|---|---|
| Under 30 | 384,000 | 12.1% | 30+ years |
| 30-39 | 668,000 | 21.0% | 20-30 years |
| 40-49 | 724,000 | 22.8% | 10-20 years |
| 50-59 | 798,000 | 25.1% | 5-15 years |
| 60-64 | 348,000 | 11.0% | 0-5 years |
| 65+ | 253,000 | 8.0% | Imminent/past typical |
| Total approaching retirement (55+) | ~900,000 | 28.3% | Within 10 years |
Approximately 900,000 nurses (28% of the workforce) are within 10 years of typical retirement age. At the current new-graduate production rate of ~190,000/year, replacement math is tight.
The Pipeline Problem: Nursing School Capacity
AACN (American Association of Colleges of Nursing) 2023 data:
| Metric | Value |
|---|---|
| Qualified applicants turned away (BSN programs) | 91,938 |
| Primary reason for rejection | Insufficient faculty (62%) |
| Nursing faculty vacancies (national) | 2,166 |
| Average nursing faculty salary | $86,000 |
| Average clinical nurse salary in same market | $92,000 |
| Faculty-to-clinical pay gap | -$6,000 (-6.5%) |
| New RN licenses issued (NCLEX passers, 2023) | 193,800 |
| First-year RN attrition (leave within 12 months) | 27.7% |
| Net new nurses retained after Year 1 | ~140,000 |
The pipeline produces 140,000 retained new nurses per year against 174,200 annual replacement needs — a structural deficit of 34,200 nurses per year even before accounting for demand growth.
State-Level Shortage Projections
HRSA models shortages/surpluses by state (2030 projections):
States Facing the Largest Shortages
| State | 2030 Projected Shortfall | As % of Current Workforce | Impact on Wages (Projected) |
|---|---|---|---|
| California | -15,600 | -4.8% | +5-8% above trend |
| Texas | -11,200 | -5.2% | +4-7% above trend |
| New Jersey | -7,800 | -9.1% | +6-9% above trend |
| Ohio | -6,400 | -5.4% | +3-6% above trend |
| South Carolina | -5,200 | -8.8% | +5-8% above trend |
| Georgia | -4,800 | -5.6% | +4-7% above trend |
| Michigan | -4,200 | -4.8% | +3-5% above trend |
| Arizona | -3,800 | -5.4% | +5-8% above trend |
| Tennessee | -3,600 | -5.0% | +4-6% above trend |
| Virginia | -3,400 | -4.8% | +3-5% above trend |
States Projected at Surplus
| State | 2030 Projected Surplus | Why |
|---|---|---|
| Florida | +4,200 | High in-migration of nurses + nursing school expansion |
| New York | +2,800 | Large education pipeline despite attrition |
| Pennsylvania | +1,600 | Large nursing school infrastructure |
| Minnesota | +1,200 | Strong retention + education pipeline |
| Utah | +800 | Rapid population growth offset by new programs |
How Shortages Affect Wages: Historical Evidence
Past shortage periods provide evidence of the wage response:
| Period | Shortage Context | RN Wage Growth (annual) | vs CPI |
|---|---|---|---|
| 1998-2002 | Cyclical shortage, managed care cuts | +4.8%/year | +2.2% above |
| 2006-2008 | Pre-recession demand surge | +5.2%/year | +1.8% above |
| 2020-2022 | COVID acute demand | +4.8%/year (but CPI was higher) | -1.7% below (inflation offset) |
| 2023-2024 | Post-COVID staffing recovery | +5.5%/year | +1.8% above |
During shortages, RN wages grow 1.5-2.5 percentage points above inflation — meaningful but not transformative. The constraint: hospitals respond to shortages with temporary solutions (travel nurses, sign-on bonuses) rather than permanent structural raises.
Specialty-Specific Shortages and Wage Premiums
Not all nursing specialties face equal shortages. Areas with the most acute gaps command the highest premiums:
| Specialty | Vacancy Rate (2024) | Avg Time-to-Fill | Wage Premium vs Med-Surg |
|---|---|---|---|
| Perioperative/OR | 16.4% | 92 days | +22% |
| Critical Care/ICU | 14.8% | 78 days | +12% |
| Cath Lab | 14.2% | 105 days | +18% |
| Emergency Department | 13.6% | 68 days | +10% |
| Labor & Delivery | 12.8% | 72 days | +8% |
| NICU | 11.4% | 82 days | +14% |
| Oncology | 10.8% | 58 days | +6% |
| Med-Surg (baseline) | 9.8% | 45 days | — |
| Ambulatory/Clinic | 7.2% | 32 days | -8% |
OR nursing has the highest vacancy rate (16.4%) and the longest time-to-fill — explaining why OR per diem rates carry 40-50% premiums.
International Recruitment: The Global Context
U.S. hospitals are increasingly recruiting internationally to fill gaps:
| Metric | Value |
|---|---|
| Internationally-educated RNs in U.S. workforce | ~218,000 (6.8%) |
| Annual VisaScreen certificates issued (CGFNS) | 16,200 (2023) |
| Top source countries | Philippines (52%), India (14%), Nigeria (8%), Canada (6%) |
| Average time from recruitment to U.S. practice | 18-36 months |
| Estimated recruitment cost per international nurse | $18,000-$28,000 |
| Retention rate (5-year) for international nurses | 88% (vs 72% domestic) |
International recruitment fills approximately 8-9% of annual replacement needs — meaningful but insufficient to close the structural gap alone.
What Shortages Mean for Your Negotiating Position
| Shortage Level | Your Leverage | Evidence to Use |
|---|---|---|
| Low vacancy (<8%) | Standard negotiation | Market data comparison |
| Moderate (8-12%) | Strong — employer feels pain | "Your vacancy rate is X%, time-to-fill is Y days" |
| High (12-16%) | Very strong — you can walk | "Replacing me costs $56,300 + 78 days of coverage" |
| Critical (>16%) | Maximum — name your terms | "Your travel spend is $X/hr for my role" |
Specific Data Points for Negotiations
- Your hospital's vacancy rate (ask HR or check CMS staffing data)
- Their travel nurse spend (SEC/990 filings show contract labor line items)
- Time-to-fill for your specialty (industry averages above; your hospital likely tracks internally)
- BLS projected growth for your state/specialty
- Competing offers — in a shortage market, leverage is real
The 2026-2030 Outlook
Consensus projection from BLS, HRSA, and MedPAC:
| Factor | Direction | Wage Impact |
|---|---|---|
| Baby Boomer retirements accelerating | Increases demand (aging patients) + decreases supply (retiring nurses) | Upward pressure: +1-2%/year |
| Nursing school capacity flat | Limits supply pipeline | Upward pressure: sustained |
| Post-COVID burnout attrition | Reduces experienced nurse supply | Upward pressure: specialty premiums |
| AI/technology automation | Reduces some documentation burden | Neutral to slight downward (long-term) |
| Hospital margin pressure | Constrains wage budgets | Downward pressure: -0.5-1%/year |
| Travel nurse market normalization | Reduces premium pay alternative | Slight downward for travelers |
| Net projected real wage growth | +1.0-2.0% annually above inflation |
Sources: BLS Employment Projections 2022-2032; HRSA National Center for Health Workforce Analysis "Nursing Workforce Projections" (2024); AACN 2023 Annual Report on Enrollment and Graduations; NSI 2024 National Health Care Retention & RN Staffing Report; CGFNS International VisaScreen Statistics (2023); MedPAC June 2024 Report to Congress; BLS OES May 2023.