A State-by-State Breakdown of The U.S. Nursing Shortage
Are you aware of the U.S. nursing shortage? Nursing shortages persist nationwide, particularly in the southwestern U.S. Contributing factors include a lack of educators, an increasing number of nurses exiting the workforce, and the escalating demand for healthcare. These elements form a vicious cycle, where overwork leads to burnout, further intensifying the shortage.
The U.S. continues to face a critical nursing shortage. Insufficient nurse educators restrict nursing schools’ ability to admit enough students to alleviate the shortfall. This shortage results in increased burnout, prompting more nurses to leave the profession and exacerbating the issue.
Moreover, the retirement of Baby Boomers coincides with an aging population’s heightened need for healthcare providers. The COVID-19 pandemic has further strained the nursing workforce. Explore the nursing shortage by state and discover the measures legislators are taking to address it.
To comprehensively understand the shortage on a national level, we compiled the most recent data on registered nurses employed in each state from the U.S. Bureau of Labor Statistics (BLS). We compared these numbers to state population estimates to highlight the nursing shortage by state. The table below ranks states from those with the lowest to highest nurse-to-state population ratios.
U.S. Nurse-to-State Population Ratio
| LOCATION | EMPLOYED REGISTERED NURSES (2022) | STATE POPULATION (2022) | NURSES PER 1,000 POPULATION |
|---|---|---|---|
| United States | 3,072,670 | 333,287,557 | 9.22 |
| Alabama | 49,370 | 5,074,296 | 9.73 |
| Alaska | 6,730 | 733,583 | 9.17 |
| Arizona | 56,040 | 7,359,197 | 7.61 |
| Arkansas | 28,490 | 3,045,637 | 9.35 |
| California | 325,620 | 39,029,342 | 8.34 |
| Colorado | 52,390 | 5,839,926 | 8.97 |
| Connecticut | 34,290 | 3,626,205 | 9.46 |
| Delaware | 11,490 | 1,018,396 | 11.28 |
| District of Columbia | 11,820 | 671,803 | 17.59 |
| Florida | 197,630 | 22,244,823 | 8.88 |
| Georgia | 82,970 | 10,912,876 | 7.60 |
| Hawaii | 11,800 | 1,440,196 | 8.19 |
| Idaho | 13,680 | 1,939,033 | 7.06 |
| Illinois | 129,390 | 12,582,032 | 10.28 |
| Indiana | 67,350 | 6,833,037 | 9.86 |
| Iowa | 34,050 | 3,200,517 | 10.64 |
| Kansas | 30,520 | 2,937,150 | 10.39 |
| Kentucky | 44,970 | 4,512,310 | 9.97 |
| Louisiana | 43,790 | 4,590,241 | 9.54 |
| Maine | 14,610 | 1,385,340 | 10.55 |
| Maryland | 49,790 | 6,164,660 | 8.08 |
| Massachusetts | 94,100 | 6,981,974 | 13.48 |
| Michigan | 101,470 | 10,034,113 | 10.11 |
| Minnesota | 63,800 | 5,717,184 | 11.16 |
| Mississippi | 29,370 | 2,940,057 | 9.99 |
| Missouri | 70,440 | 6,177,957 | 11.40 |
| Montana | 10,020 | 1,122,867 | 8.92 |
| Nebraska | 19,870 | 1,967,923 | 10.10 |
| Nevada | 23,970 | 3,177,772 | 7.54 |
| New Hampshire | 13,510 | 1,395,231 | 9.68 |
| New Jersey | 78,340 | 9,261,699 | 8.46 |
| New Mexico | 15,910 | 2,113,344 | 7.53 |
| New York | 190,470 | 19,677,151 | 9.68 |
| North Carolina | 104,300 | 10,698,973 | 9.75 |
| North Dakota | 11,300 | 779,261 | 14.50 |
| Ohio | 130,370 | 11,756,058 | 11.09 |
| Oklahoma | 30,320 | 4,019,800 | 7.54 |
| Oregon | 37,400 | 4,240,137 | 8.82 |
| Pennsylvania | 137,970 | 12,972,008 | 10.64 |
| Rhode Island | 11,190 | 1,093,734 | 10.23 |
| South Carolina | 44,030 | 5,282,634 | 8.33 |
| South Dakota | 14,360 | 909,824 | 15.78 |
| Tennessee | 60,840 | 7,051,339 | 8.63 |
| Texas | 231,060 | 30,029,572 | 7.69 |
| Utah | 22,830 | 3,380,800 | 6.75 |
| Vermont | 6,930 | 647,064 | 10.71 |
| Virginia | 69,510 | 8,683,619 | 8.00 |
| Washington | 64,920 | 7,785,786 | 8.34 |
| West Virginia | 21,110 | 1,775,156 | 11.89 |
| Wisconsin | 61,100 | 5,892,539 | 10.37 |
| Wyoming | 5,070 | 581,381 | 8.72 |
Factors Contributing to the National Nursing Shortage
The nursing shortage in the U.S. is driven by multiple interconnected factors, each compounding the problem. According to StatPearls, the primary contributors include:
1. Lack of Educators and Schooling
Nursing school enrollment has not kept pace with the projected demand for nurses. This discrepancy is exacerbated by a shortage of nursing school instructors. With insufficient educators, thousands of potential nurses are unable to obtain the necessary degrees to enter the workforce. This bottleneck in the educational pipeline prevents the profession from expanding to meet healthcare needs.
2. High Turnover
Nurse turnover has been steadily increasing for years. New graduates often enter the profession with expectations that are not met, leading to early departures. Additionally, experienced nurses frequently face burnout due to demanding workloads, prompting many to leave the profession. This high turnover rate reduces the stability and continuity of care within healthcare settings, further straining the existing workforce.
3. An Aging Workforce
A significant portion of the current nursing workforce is nearing retirement age. Over half of registered nurses (RNs) are over 50 years old, and the rate of retirement is accelerating. This trend is resulting in a substantial loss of experienced nurses, creating a gap that new graduates cannot quickly fill. The aging workforce not only diminishes the number of available nurses but also depletes the pool of mentors and seasoned professionals who play crucial roles in training and supporting new nurses.
These factors create a cyclical challenge: the lack of educators limits new nurse entry, high turnover depletes the workforce, and the aging population increases retirements. Addressing these issues requires a comprehensive approach, including investment in nursing education, support for current nurses to reduce burnout, and strategic planning to manage the retirement wave. Without such measures, the nursing shortage will continue to impact healthcare delivery across the nation.
The above data reveals a stark disparity in the nurse-to-population ratio across different states in the U.S., underscoring the ongoing nursing shortage crisis. Factors such as insufficient numbers of nurse educators, the increasing exit of nurses from the workforce, and the rising demand for healthcare services collectively exacerbate the situation. States with lower nurse-to-population ratios are particularly vulnerable, facing intensified challenges in meeting healthcare needs.
Addressing this shortage requires a multifaceted approach: increasing the capacity of nursing schools, providing support and incentives to retain existing nurses, and implementing policies to attract new professionals into the field. Legislative actions and strategic investments are crucial to breaking the cycle of overwork and burnout. By understanding the specific needs and disparities among states, policymakers and healthcare organizations can develop targeted strategies to mitigate the nursing shortage and ensure adequate healthcare provision for all Americans.
This comprehensive analysis of the nurse-to-population ratios highlights the urgency of addressing the nursing shortage. It serves as a crucial resource for stakeholders at all levels to drive meaningful change and foster a more sustainable and resilient healthcare system.
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