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

Nursing has been an in-demand profession for years, with nearly every major hospital hiring for one of healthcare’s most important roles. In 2019, it ranked as the third-most in-demand job of any profession in the United States, and this trend shows no signs of slowing down.

As the baby-boom generation continues to age and overall population numbers increase, the demand for nurses continues to grow — especially in times of crisis like 2020’s COVID-19 outbreak. However, the gap between available jobs and people graduating nursing school continues to expand.

To best understand the shortage on a national scale, we gathered the most recent available data on the number of nurses in each state from the Bureau of Health Workforce database and compared it to state populations to illustrate the deficit on a state-by-state basis. The table below provides a ranking of states, starting with those with the lowest nurse-to-state population ratios.

	TOTAL NURSES (2018)	STATE POPULATION (2019)	NURSES PER 1,000 POPULATION
USA total	3,956,080	328,055,000	12.06
South Carolina	40,600	5,149,000	7.89
Nevada	28,400	3,080,000	9.22
California	365,500	39,512,000	9.25
Texas	279,000	28,996,000	9.62
Georgia	108,600	10,617,000	10.23
Washington	78,100	7,615,000	10.26
Arizona	75,600	7,279,000	10.39
Rhode Island	11,000	1,059,000	10.39
Virginia	89,800	8,536,000	10.52
Idaho	18,800	1,787,000	10.52
Utah	33,900	3,206,000	10.57
Montana	11,500	1,069,000	10.76
New Jersey	97,100	8,882,000	10.93
Oregon	46,500	4,218,000	11.02
New Mexico	23,200	2,097,000	11.06
Oklahoma	44,200	3,957,000	11.17
Maryland	68,300	6,046,000	11.3
Colorado	66,100	5,759,000	11.48
North Carolina	120,600	10,488,000	11.5
Louisiana	54,000	4,649,000	11.62
Arkansas	36,700	3,018,000	12.16
New York	238,300	19,454,000	12.25
Illinois	157,400	12,672,000	12.42
Florida	272,400	21,478,000	12.68
Alabama	62,700	4,903,000	12.79
Nebraska	25,000	1,934,000	12.93
Tennessee	92,000	6,833,000	13.46
New Hampshire	18,400	1,360,000	13.53
Kentucky	61,000	4,468,000	13.65
Michigan	137,500	9,987,000	13.77
Mississippi	41,300	2,976,000	13.88
Alaska	10,200	732,000	13.93
Hawaii	20,000	1,416,000	14.12
South Dakota	12,500	885,000	14.12
Iowa	46,180	3,155,000	14.64
Kansas	42,900	2,913,000	14.73
Connecticut	52,600	3,565,000	14.75
West Virginia	26,600	1,792,000	14.84
Indiana	97,200	6,484,000	14.99
Pennsylvania	193,200	12,802,000	15.09
Missouri	92,900	6,137,000	15.14
Wisconsin	88,500	5,822,000	15.2
Ohio	184,000	11,689,000	15.74
Minnesota	89,000	5,640,000	15.78
Maine	21,500	1,344,000	16
Massachusetts	111,500	6,950,000	16.04
Delaware	15,800	974,000	16.22
North Dakota	12,500	762,000	16.4
Vermont	11,000	624,000	17.63
Washington DC	13,000	706,000	18.41
Wyoming	11,500	579,000	19.86

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Major cities tend to perpetually need more nurses, with most city hospitals offering dozens if not hundreds of open positions. According to data from the Bureau of Labor Statistics, the following five states have the lowest local concentrations of nurse employment vs. national nurse employment:

• Washington D.C. (.67 location quotient)
• Dallas, Texas (.82 location quotient)
• Los Angeles, California (.88 location quotient)
• Houston, Texas (.88 location quotient)
• New York City, New York (.89 location quotient)

Mid-sized cities tend to maintain the highest location quotients of local nurse employment to national nurse employment:

• Greenville, North Carolina (2.25 location quotient)
• Ann Arbor, Michigan (2.05 location quotient)
• Sioux Falls, South Dakota (1.98 location quotient)
• Durham-Chapel Hill, North Carolina (1.95 location quotient)
• Gainesville, Florida (1.94 location quotient)

From the BLS data: The location quotient is the ratio of the area concentration of occupational employment to the national average concentration. A location quotient greater than one indicates the occupation has a higher share of employment than average, and a location quotient less than one indicates the occupation is less prevalent in the area than average.

Larger areas tend to suffer more from nursing shortages due to the population density of major metros. Simply put, there are not enough new nurses graduating nursing school to properly manage the volume of people who need any level of medical care within most large cities.

The American Association of Colleges of Nursing attributes the national shortage to four main reasons:

• Nursing school enrollment is not keeping pace with projected demand. Even though enrollment is up, it’s not keeping pace with the increase in need for nursing services.
• We lack the necessary number of nursing school faculty members. Without enough teachers, thousands of people interested in joining the nursing workforce are unable to do so without degrees.
• The rate of retirement for nurses is growing rapidly, as over half of the RN workforce is currently over 50 years old.
• An aging population in the United States continues to drive more demand than ever seen for nursing services.

Original Source: https://nursejournal.org/articles/the-us-nursing-shortage-state-by-state-breakdown/