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

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

To gain insight into the widespread nursing shortage, let’s examine the latest data that compares the number of nurses in each state with the respective state populations. The persistent demand for nurses is on the rise, exacerbated by the increasing occurrence of nursing shortages nationwide. This shortage is influenced by several factors, including limited educators, burnout among nurses, and an aging workforce, all contributing to the larger issue of inadequate nursing staffing.

The employment figures of nurses in each state, when contrasted with the state’s population, reveal a shortfall in healthcare resources. Nursing has remained a high-demand profession for a considerable time, with major healthcare institutions frequently recruiting for this vital role. According to the U.S. Bureau of Labor Statistics (BLS), there is a projected average of approximately 195,400 job openings for registered nurses from 2021 to 2031. Many of these openings are anticipated due to the need to replace nurses who transition to different careers or retire from the workforce.

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As the generation of baby boomers ages and the overall population continues to grow, the necessity for nurses escalates, particularly highlighted by the impact of the COVID-19 pandemic. This increased demand has led to the expansion of the travel nursing sector, which in turn has intensified the prevailing nursing shortages across the entire United States.

To comprehensively grasp the extent of this shortage at the national level, we have collected the most recent data available on the count of registered nurses employed in each state as of August 2022, and we have compared this data with the respective state populations. This comparison enables us to illustrate the shortfall in nursing resources on a state-by-state basis. The subsequent table presents a ranking of states, beginning with those exhibiting the lowest nurse-to-state population ratios.

U.S. Nurse-to-State Population Ratio

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

Comparing Local Nurse Employment to National Nurse Employment

It’s a common trend that major cities consistently require a larger number of nurses, often featuring numerous job openings in city hospitals. Below are lists highlighting states with the lowest local concentration of nurse employment and metropolitan areas with the highest local concentration of nurse employment in comparison to the national average.

States with Low Local Concentrations of Nurse Employment:

– Utah (Location Quotient: 0.71)
– Washington D.C. (Location Quotient: 0.81)
– Texas (Location Quotient: 0.82)
– Georgia (Location Quotient: 0.83)
– Virginia (Location Quotient: 0.83)

Metropolitan Areas with High Concentrations of Local Nurse Employment:

– Rochester, MN (Location Quotient: 3.66)
– Bloomsburg Berwick, PA (Location Quotient: 3.04)
– Morgantown, WV (Location Quotient: 2.52)
– Durham — Chapel Hill, NC (Location Quotient: 2.25)
– Ann Arbor, MI (Location Quotient: 2.20)

Source: U.S. Bureau of Labor Statistics (BLS)

According to BLS data: The location quotient measures the ratio of the local concentration of occupational employment to the national average concentration. A location quotient above one indicates a higher employment share than the national average, while a location quotient below one indicates less prevalence in the area compared to the national average.

Larger urban areas tend to face more significant nursing shortages due to the higher population density found in major metropolitan regions. In essence, there aren’t enough new nursing graduates to adequately handle the volume of individuals in need of various levels of medical care within these populous cities.

Contributing Factors to the National Nursing Shortage

A study published in the National Library of Medicine highlights various factors contributing to the nationwide nursing shortage, including:

– Insufficient educators and educational programs: Nursing school enrollment has not matched the projected demand, and there’s a shortage of faculty members in nursing schools. This scarcity of teachers prevents many individuals interested in pursuing nursing from obtaining the required degrees.
– High turnover rate: Nurse turnover has been steadily increasing for years. Some nursing graduates enter the workforce and find that the reality of the profession differs from their expectations. Others experience burnout and leave the field.
– Aging nursing workforce: A significant portion of registered nurses (RNs) are over 50 years old, leading to a growing rate of retirements.

Addressing the Nursing Shortage

Efforts to address the nursing shortage are underway, including actions by state legislators, hospitals, and educational institutions to counter the shortage and prevent future deficits.


Bernstein, L. (2021). As covid persists, nurses are leaving staff jobs — and tripling their salaries as travelers.

Haddad, L, et al. (2022). Nursing shortage.

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U.S. Bureau of Labor Statistics, Occupational Outlook Handbook. (2021). Registered nurses.

U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics. (2021). Registered nurses.

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