The U.S. Nursing Shortage: A State-by-State Breakdown

The U.S. Nursing Shortage: A State-by-State Breakdown

To comprehend the nationwide nursing scarcity, examine the latest data revealing the quantity of nurses in each state in relation to state populations. The demand for nurses is consistently increasing due to the rising nursing deficits across the nation. Factors such as insufficient educators, burnout, and an aging workforce contribute to the overall nursing shortage at a national level.

The healthcare deficit emerges when comparing the number of employed nurses in each state to its population.

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Nursing has been a sought-after profession for years, with almost every major hospital seeking candidates for one of healthcare’s crucial roles. As per the U.S. Bureau of Labor Statistics (BLS), approximately 195,400 job openings for registered nurses are estimated between 2021 and 2031. A significant portion of these openings is anticipated to stem from the necessity to replace workers who switch to different careers or exit the workforce, possibly due to retirement.

As the baby-boom generation grows older and total population figures increase, the demand for nurses continues to rise, particularly exacerbated by the impacts of the COVID-19 pandemic. This demand has fostered the expansion of the travel nursing sector, which, in turn, has compounded the shortages of nurses across the United States.

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To gain a comprehensive understanding of this shortage on a national level, we have gathered the most up-to-date data available on the count of registered nurses employed in each state, sourced from the U.S. Bureau of Labor Statistics as of August 2022. We have then compared this data to state populations in order to highlight the deficit on a state-by-state basis. The subsequent table presents a ranking of states, commencing with those exhibiting the lowest nurse-to-state population ratios.

U.S. Nurse-to-State Population Ratio

Chart

Map of United States of America with 2 data series.
End of interactive chart.
Location Employed Registered Nurses (2021) State Population (2020) Nurses Per 1,000 Population
United States 3,047,550 331,449,281 9.19
Utah 23,760 3,271,616 7.26
Georgia 78,290 10,711,908 7.31
Texas 217,630 29,145,505 7.47
Hawaii 11,110 1,455,271 7.63
Virginia 66,980 8,631,393 7.76
Idaho 14,400 1,839,106 7.83
Nevada 24,590 3,104,614 7.92
Oklahoma 31,510 3,959,353 7.96
Arizona 57,260 7,151,502 8.01
New Mexico 17,030 2,117,522 8.04
Washington 62,470 7,705,281 8.11
California 324,400 39,538,223 8.20
Alaska 6,060 733,391 8.26
Maryland 51,550 6,177,224 8.35
New Jersey 77,980 9,288,994 8.39
Wyoming 4,890 576,851 8.48
Florida 187,920 21,538,187 8.72
Arkansas 26,320 3,011,524 8.74
Montana 9,640 1,084,225 8.89
Oregon 37,780 4,237,256 8.92
Colorado 51,680 5,773,714 8.95
Tennessee 62,250 6,910,840 9.01
South Carolina 46,160 5,118,425 9.02
Louisiana 42,870 4,657,757 9.20
New York 188,300 20,201,249 9.32
New Hampshire 12,890 1,377,529 9.36
Connecticut 34,320 3,605,944 9.52
Kentucky 43,540 4,505,836 9.66
Mississippi 29,140 2,961,279 9.84
Indiana 66,800 6,785,528 9.84
Kansas 28,980 2,937,880 9.86
Rhode Island 10,860 1,097,379 9.90
Alabama 49,780 5,024,279 9.91
North Carolina 104,810 10,439,388 10.04
Illinois 129,260 12,812,508 10.09
Michigan 102,480 10,077,331 10.17
Iowa 32,650 3,190,369 10.23
Nebraska 20,660 1,961,504 10.53
Maine 14,380 1,362,359 10.56
Wisconsin 62,860 5,893,718 10.67
Ohio 129,270 11,799,448 10.96
West Virginia 19,800 1,793,716 11.04
Vermont 7,210 643,077 11.21
Missouri 69,240 6,154,913 11.25
Pennsylvania 149,270 13,002,700 11.48
Delaware 11,760 989,948 11.88
Minnesota 69,000 5,706,494 12.09
Massachusetts 88,270 7,029,917 12.56
North Dakota 11,810 779,094 15.16
South Dakota 14,140 886,667 15.95
District of Columbia 11,540 689,545 16.74

Local Nurse Employment vs. National Nurse Employment

Major urban areas consistently exhibit a high demand for nurses, with city hospitals offering numerous job openings. The following lists present the states with the lowest local concentrations of nurse employment compared to national nurse employment.

States With the Lowest Local Concentrations of Nurse Employment

1. Utah (Location Quotient: 0.71)
2. Washington D.C. (Location Quotient: 0.81)
3. Texas (Location Quotient: 0.82)
4. Georgia (Location Quotient: 0.83)
5. Virginia (Location Quotient: 0.83)

Metropolitan Areas With the Highest Concentrations of Local Nurse Employment

1. Rochester, MN (Location Quotient: 3.66)
2. Bloomsburg Berwick, PA (Location Quotient: 3.04)
3. Morgantown, WV (Location Quotient: 2.52)
4. Durham — Chapel Hill, NC (Location Quotient: 2.25)
5. Ann Arbor, MI (Location Quotient: 2.20)

(Source: BLS)

From BLS data: The location quotient indicates how the area’s occupational employment concentration compares to the national average. A value greater than one indicates a higher share of employment in the occupation, while a value less than one indicates lower prevalence.

Larger areas grapple more with nursing shortages due to higher population density in major cities. The shortage arises from inadequate nursing school enrollment to manage the medical care demand in most large cities.

Factors Contributing to the National Nursing Shortage

As per a study in the National Library of Medicine, several factors contribute to the national nursing shortage, including:

– Lack of educators and schooling: Nursing school enrollment hasn’t matched projected demand, and there’s a shortage of nursing faculty. Insufficient teachers prevent many interested individuals from entering the nursing workforce without degrees.
– High turnover: Nurse turnover has consistently risen. Some nursing graduates find the profession different from their expectations, while others experience burnout and leave.
– Aging workforce: A significant portion of RNs is over 50 years old, resulting in a growing rate of retirement.

State legislators, hospitals, and schools are addressing the nursing shortage and taking measures to prevent future deficits.

Sources

Bernstein, L. (2021). As covid persists, nurses are leaving staff jobs — and tripling their salaries as travelers. https://www.washingtonpost.com/health/covid-travel-nurses/2021/12/05/550b15fc-4c71-11ec-a1b9-9f12bd39487a_story.html

Haddad, L, et al. (2022). Nursing shortage. https://www.ncbi.nlm.nih.gov/books/NBK493175/

Nursing shortage. (2020). https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage

U.S. Bureau of Labor Statistics, Occupational Outlook Handbook. (2021). Registered nurses. https://www.bls.gov/ooh/healthcare/registered-nurses.htm

U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics. (2021). Registered nurses. https://www.bls.gov/oes/current/oes291141.htm

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