Curtis Anderson on Why the Nursing Shortage Isn't One

Nursa CEO Curtis Anderson has argued since 2023 that the nursing shortage is a participation problem rather than a supply problem, a framing TIME echoed in July 2026.
The licensure gap supports the claim: more than 5.9 million active RN licenses existed in the U.S. in 2025 against roughly 3.4 million employed registered nurses.
Raising pay has not reversed attrition, as 77% of surveyed CFOs increased starting wages by at least 20% over 2 years while 86% of health systems still lost 10% or more of their nursing staff.
Anderson borrows from customer retention logic, arguing that reengaging clinicians who left is more efficient than recruiting new ones, and that treating nurses as a cost center rather than a revenue contributor keeps leaders from seeing it.
He limits flexible staffing to settings with standardized workflows such as skilled nursing, long-term care, med-surgical, and behavioral health, and recommends posting 5% to 7% of the schedule in advance instead of activating per diem coverage only after a shift goes unfilled.

On July 30, 2026, TIME ran a headline that would have read as contrarian a few years ago: “Stop Saying There’s a Nursing Shortage.” Nursa founder and CEO Curtis Anderson has been saying it since the founding of the staffing platform in 2019.

“Dissatisfaction within the nursing field is the main cause of what appears to be a nursing ‘shortage,’” he told RamaOnHealthcare in October 2023. “Plenty of capable, hard-working nurses still want to remain in practice—but only under the right conditions.”

A 90-year-old problem with a 1930s answer

Anderson stretches the timeline of the nursing shortage until the pandemic looks like a footnote.

Nursing shortages began taking shape before World War II and have challenged hospitals for more than 90 years, he wrote in Becker's Hospital Review in August 2023. His complaint was that the industry keeps reaching for the same remedy.

Unless leaders “go beyond solutions suggested in the 1930s,” he cautioned, “like incentivizing students to attend nursing school rather than incentivizing nurses to remain in the workforce,” they will be hard-pressed to make a sustainable difference.

The nurses did not go anywhere

The argument has sharpened since, but the core claim has not moved. Writing in Forbes in June 2026, Anderson described a nursing workforce that is hiding in plain sight.

“When qualified clinicians leave the bedside, they don’t disappear into thin air, and many of them keep their licenses active,” he wrote. “They’re just not participating in the way the system expects. And when organizations perceive that as a supply problem, they might end up spending heavily on recruiting pipelines while the talent they need quietly opts out.”

The gap is measurable. Anderson highlighted that there were more than 5.9 million active registered nurse licenses in the U.S. in 2025, according to the National Council of State Boards of Nursing, compared with roughly 3.4 million registered nurses employed that year, per the U.S. Bureau of Labor Statistics.

Two conversations, 3 years apart

Anderson tends to argue this point with anecdotes rather than projections, and he has been sharing the same anecdote for years.

In 2023, he recalled getting into an Uber and learning his driver was a nurse. “He didn’t leave the bedside because he stopped wanting to be a nurse,” Anderson said. “He left because of the way he’d been treated.”

In McKnight’s Long-Term Care News in April 2026, he pointed to 3 nurses in his own community:

One working behind the counter at a Hallmark store
One at a quick-service restaurant
One selling insurance

All held active licenses. None had worked a bedside shift in months. Two told him they missed it.

“Many licensed nurses are still out there,” he wrote. “They simply are not working at the bedside.”

Reengagement instead of recruitment

Anderson’s diagnosis has long been about accounting as much as it is about staffing. “Warped views of nurses as cost centers rather than crucial care team members have contributed to the state we find the industry in,” he said in 2023.

TIME’s reporting arrived at the same place. The story quotes University of Pennsylvania nursing professor Karen Lasater on how physicians bill for their services, making their revenue contribution legible to administrators, while nurses get treated as a labor expense instead.

His prescription draws on customer retention, and it lands because operators already accept the logic elsewhere in the business.

“Most leaders know and understand the basic premise that it’s more efficient to reengage a churned customer than to acquire a new one, but they fail to see the same with labor,” he argued in Forbes.

A survey Nursa commissioned in late 2023 suggests why pay alone has not solved it. Among 203 health system executives, 77% of CFOs said they had raised starting wages for nurses by at least 20% over the previous 2 years. In the same period, 86% of health systems still lost 10% or more of their nursing staff.

“Nurses are voting with their feet,” Anderson told Skilled Nursing News in July 2026. “Flexibility is no longer an optional add on, as much as it is a requirement for their career. It’s not a numbers problem. It’s an engagement problem.”

Where he draws the line

Anderson does not present flexible staffing as a universal fix, and he names the exceptions himself.

Highly specialized acute care settings such as labor and delivery, neonatal intensive care, and some ICU contexts depend on tight team cohesion and institution-specific protocols, he wrote in Forbes. Skilled nursing, long-term care, med-surgical, and behavioral health are better natural fits because workflows are more standardized. He is equally direct about the most common criticism of flexible staffing.

“Patients have indicated they prefer continuity [of care],” he acknowledged to Skilled Nursing News. “They want to see the same name and faces. The counter to that is that turnover and burnout are real, so then it becomes a conversation about opportunity.”

The question he keeps asking

Anderson’s most concrete advice is to stop treating per diem staffing as an emergency valve.

Rather than activating flexible coverage only when a shift goes unfilled, he argues facilities should build it into workforce planning from the start, posting a predictable share of shifts in advance and rebooking the clinicians who perform well. His suggested figure is 5% to 7% of the schedule, posted ahead of need to absorb call outs.

From there, Anderson’s argument reduces to a few questions for anyone responsible for filling shifts.

Are you designing your workforce with rigidity?
How long has it been since you examined your assumptions around traditional full-time roles?
When was the last time you evaluated the full range of people who might contribute if the terms were different?

His answer has been consistent since 2023. As he put it in Forbes, “The workforce isn't waiting to be grown… The organizations that learn to see a participation problem for the potential that it holds, rather than solely as a shortage problem, can build something that lasts.”

Read Anderson’s full case: “The nurses are still there. Why aren't they at the bedside?”

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