Future of the Nursing Workforce: National- and State-level Projections, 2012-2025
The Future of the Nursing Workforce: National- and State-Level Projections, 2012-2025 presents projections on the supply and demand of registered nurses (RNs) and licensed practical/vocational nurses (LPNs) for the U.S. in 2025.
Using baseline data from 2012 and the Health Resources and Services Administration’s (HRSA) Health Workforce Simulation Model, this brief presents national- and state-level projections on the supply of and demand for registered nurses (RNs) and licensed practical/vocational nurses (LPNs) for the entire U.S. in 2025. State-level differences in demographics and the labor market will result in considerable variation in the size and adequacy of the nursing workforce across the country.
Nationally, the change in RN supply between 2012 and 2025 is projected to outpace demand.
- Approximately 2.9 million RNs were active in the workforce in 2012. Consistent with standard workforce research methodology, the Health Workforce Simulation Model assumes that the RN demand in 2012 equals the RN supply.
- Assuming RNs continue to train at the current levels and accounting for new entrants and attrition, the RN supply is expected to grow by 952,000 full-time equivalents (FTEs) – from 2,897,000 FTEs in 2012 to 3,849,000 FTEs in 2025 – a 33 percent increase nationally.
- The nationwide demand for RNs, however, is projected to grow by only 612,000 FTEs – from 2,897,000 FTEs in 2012 to 3,509,000 FTEs in 2025 – a 21 percent increase.
- The number of new graduates that entered the workforce has substantially increased from approximately 68,000 individuals in 2001 to more than 150,000 in 2012 and in 2013.
- While not considered in this study, emerging care delivery models, with a focus on managing health status and preventing acute health issues, will likely contribute to new growth in demand for nurses, e.g., nurses taking on new and/or expanded roles in preventive care and care coordination.
Substantial variation at the state level is observed for RN supply and demand.
- Projections at the national level mask a distributional imbalance of RNs at the state level.
- Sixteen states are projected to experience a smaller growth in RN supply relative to their state-specific demand, resulting in a shortage of RNs by 2025; ten of these states are in the West, four are in the South, and two are in the Northeast region.
- States projected to experience the greatest shortfalls in the number of RNs by 2025 are Arizona (with 28,100 fewer RNs than needed) followed by Colorado and North Carolina (each with 12,900 fewer RNs than needed).
- Growth in supply is expected to exceed demand growth in the remaining 34 states, including all of the Midwestern states.
The LPN supply is also projected to outpace demand at the national level.
- Approximately 730,000 LPNs were active in the workforce in 2012. Consistent with standard workforce research methodology, the Health Workforce Simulation Model assumes that the LPN demand in 2012 equals the LPN supply.
- Assuming LPNs continue to train at the current levels and accounting for new entrants and attrition, the LPN supply is expected to grow by 260,900 FTEs – from 730,000 FTEs in 2012 to 990,900 FTEs in 2025 – a 36 percent increase nationally.
- Using current health care utilization patterns, the demand for LPNs is projected to grow by only 28 percent by 2025. The demand for LPNs is projected to grow by 201,000 FTEs – from 730,000 FTEs in 2012 to 931,000 FTEs.
- Similar to the RNs, emerging care delivery models will likely contribute to new growth and demand for LPNs. Since it is too early to determine the impact, this report reflects the demand for the traditional role of the LPNs.
Projected changes in supply and demand for LPNs between 2012 and 2025 vary substantially by state.
- Projections at the national level mask a distributional imbalance of LPNs at the state level.
- Twenty-two states are projected to experience a smaller growth in the supply of LPNs relative to their state-specific demand for LPN services resulting in a shortage of LPNs by 2025. Ten of these states are in the West, five are in the South, five are in the Northeast, and two are in the Midwest.
- Maryland, North Carolina, and Georgia are each expected to fall short by between 7,000 to 8,000 LPNs of their respective 2025 projected demands, whereas Ohio and California each are projected to have an excess of between 20,000 to 25,000 LPNs.
The Evolving Role of the Nursing Workforce
- The rapidly changing health care delivery system is redefining how care is delivered and the role of the nursing workforce.
- Supply and demand will continue to be affected by numerous factors including population growth and the aging of the nation's population, overall economic conditions, aging of the nursing workforce, and changes in health care reimbursement.
- Research to model the demand implications of trends in care delivery is ongoing and health workforce projection models will be updated as needed.