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How States Are Addressing the Nursing Shortage

Nina Chamlou
Updated December 2, 2022
    The pandemic has highlighted many ongoing issues in the nursing profession, especially the shortage of nurses. Review what states are doing to manage the deficit and address the issue looking forward.
    • Many hospitals are unprepared for another COVID surge due to inadequate staffing.
    • Certain geographic areas are at a higher risk of hospitals reaching capacity than others.
    • Some states are investing in hiring new nurses and expanding nursing programs.

    Since May 2022, COVID-19 cases and hospitalizations have risen in at least 40 states. With nurses quitting in record numbers, hospitals are unprepared for another potential surge in cases come fall and winter.

    Discover what states are doing to combat the nursing shortage and how these measures will affect nurses.

    Nursing Shortages Around the U.S.

    In March 2022, the American Hospital Association said the nursing shortage has become a “national emergency” and predicted the deficit of nurses in the U.S. to reach 1.1 million by the end of the year.

    Certain geographic areas are suffering nursing shortages more than others. According to data from the White House COVID-19 Response Team, West and East Coast states have the highest concentrations of sustained hotspots.

    Unsurprisingly, hospitals in major cities typically exceed capacity because viruses spread more quickly in urban areas.

    Most counties in the Rocky Mountain states and the western Plains, where populations are smaller and more spread out, have relatively low to moderate levels of cases.

    But shortages can also occur in rural areas. Hospitals in less populous places aren’t as prepared for influxes of patients. According to the Kaiser Family Foundation, rural hospitals typically have fewer intensive care unit (ICU) beds — about 1.7 per 10,000 people versus 2.8 in urban areas. This means they can become overwhelmed more easily than urban care centers with larger capacities.

    Additionally, nurses are typically paid more in cities, making it harder for rural hospitals to hire and keep new nurses during shortages.

    The following table shows where the most severe shortages of nurses will occur in terms of the greatest difference between projected supply and demand. You will notice that the list includes a mix of highly populated states and more rural states.

    Forecast of States Where the Most Severe Shortage of Registered Nurses Will Occur

    RankStateSupply (2030)Demand (2030)Difference
    3New Jersey90,800102,200-11,400
    4South Carolina52,10062,500-10,400
    7South Dakota11,70013,600-1,900
    9North Dakota9,9009,200700
    10New Hampshire21,30020,2001,100

    Sources: University of St. Augustine for Health Sciences, U.S. Health and Human Services

    How States Are Responding to the Nursing Shortage

    States are taking matters into their own hands to address the current shortage of nurses.

    General Staffing

    States received coronavirus relief money from the federal government to invest in education, housing assistance, small businesses, and healthcare. Some states have used the funding to boost hospital staffing, including Arizona, Idaho, and Utah.

    In 2020, Arizona allocated $85 million for hospital staffing and overtime expenses, including an additional 500 nurses. Idaho dedicated $5 million toward helping hospitals add additional staff. And Utah allotted $750,000 toward increasing staffing in its ICUs.

    More recently, Oregon has secured funding that includes $318 million to support nurses in Oregon and across the country. Michigan has also approved further funding, including $300 million to help healthcare providers attract and retain staff.

    Hiring Travel Nurses

    Many hospitals have also resorted to hiring travel nurses due to difficulty finding nurses willing to take full-time positions. However, since travel nurses receive higher wages than staff nurses, this has required additional federal funding in some states.

    • Hawaii received $95 million for travel healthcare workers.
    • Georgia paid more than half a billion dollars to one travel nurse agency alone.
    • Texas used $7 billion in federal funds to pay for temporary nurses and other healthcare workers.

    Demand for travel nurses reached a record high in 2021 and lessened after the wave subsided. But since cases have picked up in many areas of the country, demand has been rising since May, The New York Times reports.

    For instance, as of June 2022, the shortage of nurses in Massachusetts has more than doubled since 2019. UMass Memorial Health currently needs about 500 more nurses and other healthcare workers.

    Investing in Nursing Education

    In addition to meeting current staffing needs, some states plan to invest in nursing education.

    Part of the reason there is currently a shortage of nurses is because nursing programs have limited capacities. If universities had larger budgets for hiring additional instructors, they could accept more students into their nursing programs. Then, the number of new nurses would increase.

    • Arizona recently passed House Bill 2691, which allocates up to $15 million toward a nurse education investment pilot program.
    • Washington introduced similar legislation in 2022. It distributed $38 million to create and expand nursing programs throughout the state.
    • Montana is funneling $3.9 million in funding from the U.S. Health Resources Services Administration into Montana State University’s nursing college and its partners.
    • Connecticut also recently announced its decision to use $35 million in federal funding to fuel healthcare education.
    • The State University of New York (SUNY) partnered with ECMC Hospital in Buffalo, NY to offer up to 50 students $1,500 per year to cover student expenses that federal and state grants won’t cover.

    3 Ways That Efforts to Reduce Nursing Shortages Affect Nurses

    So, how might these changes affect nurses and nursing students?

    Better Wages

    The pandemic has marked an incredibly challenging time for nurses. But it has also drawn more attention to issues nurses have long advocated for, such as the pursuit of higher wages.

    Many nurse unions have successfully negotiated higher nursing salaries since the pandemic. And a 2022 survey of more than 2,500 nurses reflects this. It found that the median registered nurse’s (RN’s) salary increased from $73,000 in 2020 to $78,000 by the end of 2021 — a 7% increase.

    By comparison, RN salaries only increased by an average of about 1.3% per year from 2008 to 2014.

    It appears that some healthcare employers recognize the value of their nurses. However, whether or not the wage boost will remain after the pandemic is yet to be seen.

    Better Staffing Ratios

    A major issue related to the nursing shortage is insufficient nurse-to-patient ratios. Since most states don’t mandate hospitals to maintain sufficient nurse-to-patient ratios, many have been understaffed for years. So when COVID-19 hit, hospitals were ill-prepared and nurses suffered.

    Many healthcare facilities that have received COVID-19 relief funding have improved their staffing ratios. However, the cash is drying up, and it’s unclear whether these new ratios will remain.

    Still, the pandemic has brought the issue of staffing ratios into the public eye, which has increased pressure on lawmakers and hospitals to do more to solve the ongoing problem.

    Some states have finally begun to adopt legislation that holds healthcare facilities to minimum staffing standards, including Arkansas, Connecticut, Massachusetts, New York, and Rhode Island. Hopefully, this trend will continue to gain traction, and more states will follow.

    Increased Ease of Entry Into Nursing Programs

    Getting accepted to a nursing program can be extremely competitive. Each year, thousands of qualified applicants are rejected. Some of the most competitive schools have acceptance rates as low as 2.5%.

    In light of the ongoing shortage of nurses, many wonder why nursing schools are rejecting potential students. It’s not just because schools have high standards; it’s also because of limited capacity. Many universities say they don’t have the budget to hire more nursing instructors.

    States that have funneled COVID-19 relief funds into their universities’ nursing programs should have more room for incoming students in upcoming enrollment periods, meaning entrance into nursing schools will become less competitive.

    What Should You Do Next?

    New opportunities and avenues to enter the field of nursing are emerging. Since the situation is constantly evolving, your best bet is to continuously check your local news and the web pages of nursing schools to discover any changes in legislation, jobs, and increased program capacity.

    Additionally, many nursing programs are introducing accelerated nursing programs across the country. Universities in Indiana, Illinois, Nebraska, Florida, Mississippi, Pennsylvania, Utah, Washington, and California have all announced plans to introduce fast-track nursing programs.

    If you have recently graduated and are looking for work, be aware of your value. Due to the ongoing shortage of nurses, you have significant leverage when negotiating salary. So, you don’t have to settle for the first offer.

    You may also consider applying to travel nursing agencies. These organizations will help place you at healthcare centers in need of staff. While working as a travel nurse is less predictable regarding the longevity of contracts, it is a good way to gain experience and maximize your income.