The stubborn shortage of nurses has created abundant job opportunities, but barriers to entry and declining job satisfaction threaten efforts to improve recruitment and retention. What can nurses do for themselves and, in the process, help secure a better future for nursing?
Beverly Malone, Ph.D., RN, FAAN
President and CEO, National League for Nursing
With the stubborn nursing shortage, it is no wonder that job opportunities are abundant for anyone with a passion for healing to join America’s most trusted healthcare professionals.
How abundant? The Bureau of Labor Statistics projects an average of 194,500 job openings for registered nurses each year through 2033, a 6% growth rate, which exceeds the national average for all occupations. The wage outlook for RNs is also bright, with a median annual pay in May 2024 of $93,600, compared with $49,500 for all U.S. workers.
Yet, for so many of us who have long championed the rewards of nursing, barriers to entry and workplace challenges thwart the best efforts of nursing leadership and public policy experts to recruit and retain a diverse, competent nursing workforce. The resulting shortage in nursing occupations is expected to continue at least through 2036, according to the latest findings by the Health Resources & Services Administration.
Dismantling barriers to entry
We must find ways to reverse the biggest barrier to entry: a nurse faculty shortage that strains the capacity of nursing education programs to admit more qualified applicants. With a master’s degree required to teach, 17% of applicants to M.S.N. programs were denied entry in 2023, according to the National League for Nursing’s Annual Survey of Schools of Nursing.
That same study revealed that 15% of qualified applicants to B.S.N. programs were turned away, as were 19% of qualified applicants to associate degree in nursing programs. At the same time, a shrinking number of clinical nurse educators in teaching hospitals, plus budget cuts to academic medical centers, have decreased the placement sites for nursing students to complete clinical requirements for their degrees and licensure.
Along with taking steps to address the gaps in the pipeline, we must improve retention by focusing attention on the issues that impede job satisfaction and accelerate retirements, which place even greater pressure on the nurses who remain.
Key to improving the work environment must be a serious commitment to empowering nurses with strategies and resources to battle conditions like burnout, bullying and violence, unacceptable staff-to-patient ratios, and communications breakdowns — all factors that nurses have cited as reasons for leaving the workforce.
Making legislative change
Another strong avenue for change exists through legislative channels. Nurses at every level of experience can tap into the power of their voices by contacting federal and state lawmakers to influence public health and budgetary policies that support nursing workforce development. In our outreach to lawmakers, we can seek to help them craft bills that address nursing’s most pressing needs.
In fact, the Title VIII Nursing Workforce Reauthorization Act of 2025 is just such a bill. This legislation would extend the federal programs that provide most of the financial support for the recruitment, education, and retention of nurses and nurse faculty. Reauthorizing these programs is vital to strengthening nursing education programs and preparing the next generation of nurses.
Also, a year ago, a pair of bills was introduced in the House of Representatives aimed at curbing the nursing shortage. One sought to increase the number of visas available to foreign nurses who would be assigned to rural and other underserved communities throughout the country, where shortages are most acute. The other bill, the Stop Nurse Shortage Act, was designed to expand BA/BS to BSN programs, facilitating an accelerated pathway into nursing for college graduates.
While both bills failed to gain passage into law in the last Congressional session, they could be reintroduced or included in other legislation in the future. Nurses must remain persistent and vigilant in pursuit of our vision for nursing’s future.
