Nursing is the largest healthcare profession in the country by a wide margin, with active registered nurse (RN) licenses approaching 6 million as of May 2026, more than live in most U.S. states. Because licensed nurses aren't all working nurses, this report focuses on the employed workforce.
However, understanding the nursing workforce is no simple matter.
- The nursing workforce is aging and retiring. At the same time, young nurses report the highest levels of burnout and are the most likely to leave their jobs.
- The demand for nurses nationwide exceeds supply. However, thousands of qualified nursing school applications are rejected every year due to limited classroom space, faculty, and clinical placements.
- Burnout has eased from its pandemic peak. However, about 40% of RNs still report plans to retire or leave nursing within the next 5 years—an increase from 28.7% in 2022.
- Nurses are better educated and more credentialed than ever. However, the settings that need them most—hospitals and long-term care—are the very settings nurses are leaving for better schedules and lower stress.
This report on nursing statistics helps stakeholders at every level of healthcare understand the current state of the workforce, which, in turn, can guide individual career decisions, management strategies, and larger policy shifts.
About the data: The data points in this article come from multiple national surveys and government reports conducted over different years. Where years differ, the source and survey year are noted. Figures may not always align perfectly across sources due to different methodologies and sample populations.
Key findings
- The U.S. employs more than 4.4 million licensed nurses across all license types, including nearly 3.4 million RNs (BLS, 2025).
- Nurse practitioners are the fastest-growing role, up 61% since 2019.
- HRSA projects a 9% national RN shortage by 2036—14% in non-metro areas.
- About 40% of RNs plan to retire or leave nursing within 5 years, up from 28.7% in 2022.
- Daily burnout more than doubled during the pandemic (11.8% in 2019 to 25.7% in 2021), with only partial recovery by 2024.
- 73% of RNs now hold a BSN or higher, up from 61% in 2015.
- Hospital RN turnover averaged 17.6% in 2025, costing the average hospital $5.19 million annually.
For a detailed breakdown of nurses by age, gender, race, and geography, see our report, Nursing Demographics: Who Are America's Nurses?
The nursing workforce includes three main license types:
- Registered nurses: The largest group, providing direct patient care, coordination, education, and leadership across virtually every healthcare setting
- Licensed practical/vocational nurses: Provide basic nursing care, often under RN supervision, and are concentrated in long-term care and home health settings
- Advanced practice registered nurses (APRNs): RNs with graduate-level education practicing in expanded roles—nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), certified nurse midwives (CNMs), and clinical nurse specialists (CNSs)
Size and overall structure of the nursing workforce
According to the U.S. Bureau of Labor Statistics (BLS), the U.S. nursing workforce employs more than 4.4 million people across license types.
Table 1: Number of nurses employed in the U.S. nursing labor market
Source: May 2025 Occupational Employment and Wage Statistics (OEWS) data (released 2026)
How many RNs vs. LPNs/LVNs are there?
RNs are by far the largest group, accounting for roughly 77% of the employed nursing workforce counted here.
LPNs/LVNs are the second-largest at approximately 648,000—a number that represents a long-term decline from the over 690,000 LPNs employed in 2019, reflecting a structural shift toward RN-level care in hospitals and outpatient settings.
Nurse practitioners, the fastest-growing advanced practice role, now number over 323,000, up sharply from 200,600 in 2019.
The BLS data also captures the adjacent direct-care workforce: 1,448,910 nursing assistants and 4,305,810 home health and personal care aides—roles that, while not licensed nursing positions, are essential to understanding total nursing workforce capacity and where care actually gets delivered.
Direct patient care roles
About 68% of RNs reported providing direct patient care in their primary position in 2024, down slightly from 73% in 2022. The remaining share work in non-clinical roles such as nursing education, administration, informatics, research, and policy.
For LPNs/LVNs, 88.4% were actively employed in nursing in 2024—the highest rate recorded since 2015—of whom 70.6% worked full-time.
Table 2: Growth of APRN employment
Source: BLS Occupational Employment and Wage Statistics, 2019 and May 2025
The APRN segment is growing faster than any other nursing category.
The BLS projects the APRN workforce to expand by approximately 35% from 2024 through 2034, driven by demand for primary and specialty care, expanded scope-of-practice laws, and the move toward team-based care models. CRNAs, who provide or supervise anesthesia in a majority of U.S. surgical cases, remain the highest-paid nursing role tracked by BLS.
Job outlook and projected nursing workforce shortages
The BLS projects approximately 189,100 annual RN job openings through 2034, accounting for both new positions and replacement of nurses who leave. However, demand is expected to outpace supply—HRSA projects a national RN shortage by 2036, with rural areas hit hardest. (See Shortages, vacancies, and staffing ratios for full projections.)
Which states have the highest and lowest nurse density?
Nurse density—measured as registered nurses employed per 1,000 total jobs in a state's economy (not per resident)—varies dramatically across the U.S., revealing meaningful structural differences in how states have built their healthcare workforces. According to the BLS, the national average is approximately 22.6 RNs per 1,000 jobs.
Table 3: States with the highest RN density (RNs per 1,000 jobs)
Source: BLS Occupational Employment and Wage Statistics
Table 4: States with the lowest RN density (RNs per 1,000 jobs)
Source: BLS Occupational Employment and Wage Statistics; includes District of Columbia.
What the density gap reveals
High-density states like West Virginia, South Dakota, and Delaware tend to have older populations with higher healthcare utilization, economies less diversified beyond healthcare, and, in some cases, a longstanding nursing education infrastructure.
Low-density states like Utah, Nevada, and California combine fast-growing general populations with economies where healthcare jobs are proportionally smaller relative to total employment—meaning the raw nurse count can be large while density remains low.
Importantly, low density does not always mean a shortage in absolute terms. California employs nearly 339,000 RNs (the most of any state), but its density of 18.6 RNs per 1,000 jobs is well below the national average, reflecting the state's large and diversified economy. Texas similarly employs over 271,000 RNs while ranking near the bottom on density.
LPN density follows a different pattern
LPN concentration is most pronounced in Southern and Appalachian states that rely heavily on long-term care settings. Louisiana leads at 9.1 LPNs per 1,000 jobs, followed by West Virginia (8.6) and Mississippi (8.5)—states with high rates of chronic illness and a care infrastructure built around nursing facilities.
At the low end, Alaska (0.9), Utah (1.0), Maine (1.2), and Hawaii (1.3) have minimal LPN presence, consistent with those states' reliance on RN-level care or different long-term care models.
What is the nurse-to-population ratio in the U.S.?
According to the United States Census Bureau, the U.S. population is approximately 342,614,900. Using BLS employment figures, the national nurse-to-population ratios are as follows.
Table 5: Nurse-to-population ratios by role
Source: BLS Occupational Employment and Wage Statistics
Taken together, the U.S. has roughly 1 licensed nurse for every 78 people—or approximately 1,287 licensed nurses per 100,000 population. RNs alone account for the largest share, at approximately 986 RNs per 100,000 people, or 1 RN for every 101 people.
These ratios reflect the total employed nursing workforce (not inactive licensed nurses) and vary significantly by state and region. Note that per-job density and per-population supply measure different things: a state with a large, diversified economy can rank low on nurse density while still maintaining adequate nurse supply relative to its population.
Work settings where nurses practice
Where nurses work shapes nearly everything else about their careers—pay, schedules, acuity levels, and burnout risk. The setting mix has also been shifting since the pandemic, with care steadily moving out of hospitals and into outpatient, home-based, and community settings.
Where do most nurses work?
Hospitals remain the dominant employer for RNs, though their share has declined. According to the 2024 National Nursing Workforce Survey (NNWS), the following are the main work settings for RNs and LPNs/LVNs.
Table 6: Primary practice settings, RNs vs. LPNs/LVNs (2024)
Source: 2024 National Nursing Workforce Survey; "Other" includes hospice, correctional facilities, public health, dialysis centers, community health, school health services, and occupational health. Percentages may not sum to 100% due to rounding and unreported settings.
This contrast reflects each license type's role: LPNs provide foundational nursing care in settings that rely heavily on long-term, supervised care, while RNs are concentrated in acute and ambulatory care environments where clinical complexity and independent assessment are required.
APRNs are primarily found in ambulatory and outpatient settings, including physician offices, specialty clinics, and community health centers, with a growing presence in hospital-based practices and telehealth.
Table 7: Specialty distribution among RNs
Source: 2024 National Nursing Workforce Survey; "Other" includes hospice, correctional facilities, public health, dialysis centers, community health, school health services, and occupational health. Percentages may not sum to 100% due to rounding and unreported settings.
This contrast reflects each license type's role: LPNs provide foundational nursing care in settings that rely heavily on long-term, supervised care, while RNs are concentrated in acute and ambulatory care environments where clinical complexity and independent assessment are required.
APRNs are primarily found in ambulatory and outpatient settings, including physician offices, specialty clinics, and community health centers, with a growing presence in hospital-based practices and telehealth.
Table 7: Specialty distribution among RNs
Source: 2024 National Nursing Workforce Survey
RN specialty distribution shifted meaningfully between the 2022 and 2024 survey cycles.
The most notable trend is the decline in acute care/critical care as the dominant specialty—dropping from 16.5% to 13.9% between 2022 and 2024—alongside similar declines in med-surg and emergency/trauma. This likely reflects a combination of burnout-driven exits from high-acuity settings and a broader shift toward outpatient and community-based care.
Setting-specific workforce trends
The COVID-19 pandemic accelerated several structural shifts in where nurses work.
Hospital share is declining
Hospitals employed 57.5% of RNs in 2022; that share has dropped to 53.3% in the 2024 data. Some of this reflects deliberate workforce diversification; some reflects nurses choosing non-hospital settings for better schedules, lower stress, or more autonomy.
Home health and ambulatory care have grown
As care continues to shift out of hospitals—driven by cost pressures, technology, and patient preference—RN employment in outpatient and community settings has expanded. Ambulatory care is now the second-largest practice setting.
Travel nursing has diverging trends by license type
The 2024 NNWS—the first to track travel nurse status across consecutive survey cycles—shows RN and LPN/LVN travel nursing moving in opposite directions.
- RN travel nursing fell 0.9 percentage points—from 6.2% in 2022 to 5.3% in 2024—suggesting some moderation after the pandemic-era surge.
- LPN/LVN travel nursing rose 2.4 percentage points—from 4.7% in 2022 to 7.1% in 2024—reflecting growing demand for LPN-level care in post-acute and long-term care settings.
Healthcare settings rely on different staffing models
A hospital's staffing model looks nothing like a skilled nursing facility's, which looks nothing like a home health agency's. Setting determines acuity level, licensing requirements, shift structure, and the degree to which flexible coverage can fill gaps.
Hospitals managing high-acuity units need credentialed, specialty-trained RNs quickly; long-term care facilities often need a steady supply of LPNs and CNAs to maintain round-the-clock ratios. Platforms like Nursa enable facilities across all settings to access per diem clinicians who match specific unit requirements, helping stabilize staffing in real time.
Work schedules and employment patterns
Full-time employment among RNs has trended upward since 2020 (when it stood at 64.9%), a partial recovery indicator after the pandemic disruptions that forced many nurses onto reduced hours or out of work entirely.
Table 8: Full-time vs. part-time vs. per diem employment RNs vs. LPNs/LVNs (2024)
Source: 2024 National Nursing Workforce Survey; remaining shares include nurses in multiple positions or unreported arrangements
Despite working in very different settings, RNs and LPNs/LVNs show nearly identical employment arrangements—roughly 7 in 10 of each work full-time.
Hours worked per week
The majority of RNs—57.4%—work 32 to 40 hours per week across all nursing positions, according to 2024 NCSBN data. This has been remarkably stable across survey years (58.4% in 2015, 58.7% in 2020). However, the distribution of nurses working very long hours remains significant:
- 17.4% work 41–50 hours per week.
- 5.4% work 51–60 hours.
- 3.1% work 61 or more hours.
The share working 51+ hours per week (combining the 51–60 and 61+ hours groups) peaked sharply in 2022 (10.6%), reflecting pandemic-era mandatory overtime and chronic understaffing—a level that was down but not fully resolved by 2024 (8.5%).
Twelve-hour shifts are the dominant model in hospital nursing, meaning most RNs who work 36 hours per week are typically working three 12-hour days, often with several days off in between. This schedule structure creates flexibility but also concentrates physical and cognitive load in extended shifts, a factor associated with higher error rates and burnout.
Multiple nursing jobs and secondary employment statistics
According to the 2024 NNWS, 18% of RNs and 20% of LPNs/LVNs hold more than one nursing position. Reasons nurses cite for secondary employment include supplementing income, maintaining skills in a different setting, enjoying scheduling flexibility, and exploring career directions.
This secondary job trend has practical implications for facilities: nurses working multiple positions may gain broad clinical exposure, but managing fatigue and scheduling conflicts across employers requires careful coordination.
How schedules affect workforce stability
Long hours, mandatory overtime, and rigid scheduling are among the most consistently cited drivers of burnout and intent to leave among the nursing workforce. HRSA's analysis of 2022 NSSRN data found that inadequate staffing—which often forces overtime—was the second most common reason nurses left their jobs after burnout, and the fourth most common reason for leaving the profession altogether.
Per diem work models, which give nurses more control over when and where they work, have emerged as a meaningful retention tool. Facilities that integrate flexible staffing—through internal float pools, agency relationships, or per diem platforms—report better ability to cover demand surges without burning out their core staff.
Nurse job satisfaction, burnout, and intent to leave
How nurses feel about their work is the leading indicator behind nearly every other trend in this report—turnover, vacancy rates, and the migration toward flexible settings all start here. The data below tracks satisfaction, burnout, and intent to leave across recent survey cycles.
Overall job satisfaction
Job satisfaction remains broadly positive among nurses, but has declined meaningfully since the pre-pandemic period. The 2022 NSSRN found that while 80% of RNs reported overall job satisfaction in 2021, the share expressing some degree of dissatisfaction nearly doubled from 11% in 2017 to 19.9% in 2021. The decline was sharpest among hospital-based RNs and among nurses with direct patient care responsibilities.
What percentage of nurses report burnout?
Burnout has emerged as the defining nursing workforce challenge of the post-pandemic era, and the statistics are stark:
- 82% of RNs who had been in the same position for at least a year reported feeling burned out at some point in their career (2022 NSSRN).
- 88.8% of those nurses said their burnout increased during the pandemic (2022 NSSRN).
- 45% of RNs and 45% of LPNs/LVNs experienced feelings of burnout at least a few times a week in 2022 (State of the U.S. Health Care Workforce, 2024).
For the full year-by-year burnout trajectory from 2019 through 2024, see “Burnout and the COVID-19 pandemic” below.
The 2024 NNWS found some moderation. The share of RNs reporting they felt "at the end of their rope" a few times per week or every day dropped from 29.4% in 2022 to 22.2% in 2024—meaningful progress, but still far above pre-pandemic norms. Reported workload increases also declined: 36% of RNs said their workload had increased in the prior two years in 2024, compared to 62% in 2022.
Burnout varies by age
According to the 2022 National Sample Survey of Registered Nurses Snapshot:
- 93% of RNs aged 34 and younger reported feeling burned out at some point.
- 85% of RNs ages 35–54 reported feeling burned out.
- 71% of RNs aged 55 and older reported feeling burned out.
This age gradient matters enormously for workforce planning: the nurses most likely to leave due to burnout are also those with the most career years ahead of them.
Factors associated with burnout
National surveys consistently point to the same cluster of drivers:
- Inadequate staffing: Too many patients per nurse for safe, attentive care
- Workload and overtime: Extended shifts, mandatory overtime, insufficient recovery time
- Moral distress: Being unable to provide the care patients need due to systemic constraints
- Limited schedule control: Inflexible scheduling, last-minute shift changes, short-staffing cascades
- Workplace safety concerns: Exposure risk, violence, and inadequate protective protocols
- Administrative burden: Documentation requirements that consume time nurses would rather spend on patient care
Intention to leave jobs or the profession
The forward-looking indicators are sobering. As of the 2024 NNWS, about 40% of RNs reported plans to retire or leave nursing within the next 5 years—an increase from 28.7% in 2022.
- 21.9% plan to retire.
- 18% plan to leave nursing for other reasons.
Over 40% of LPNs/LVNs reported the intent to retire or leave nursing in the next 5 years in the 2024 survey.
The most commonly cited reasons for leaving nursing jobs in the 2022 NSSRN were burnout, inadequate staffing, and a stressful work environment. For nurses leaving the profession entirely, the most common reasons were retirement, burnout, and stressful working conditions.
The 2026 NSI report, which surveys hospital operations directly and covers calendar-year 2025 data, shows the financial consequences. The average annual hospital cost of RN turnover is $5.19 million, and replacing a single RN costs hospitals an average of $60,090. Every 1% change in RN turnover costs or saves the average hospital approximately $295,000 per year.
Average staff RN turnover in hospitals reached 17.6% in 2025, with a wide range of 5.6% to 40% across facilities. First-year RN turnover is even higher at 22.7%, reflecting the mismatch between new hire expectations and the realities of understaffed units.
Workforce implications
Burnout and turnover create a self-reinforcing cycle:
- Nurses leave
- Vacancy rates rise
- Remaining nurses work harder
- Burnout worsens
- More nurses leave
The average hospital RN vacancy rate stood at 8.6% in 2025 (2026 NSI report), and the average time to fill a vacant RN position was 78 days—about 2.5 months during which patient loads are carried by an already-strained team.
Education levels in the nursing workforce
Educational attainment among RNs has risen steadily and substantially over the past decade.
What percentage of nurses have a BSN or higher?
According to the 2024 NNWS, 73% of RNs now hold a baccalaureate degree or higher as their highest nursing credential, up from approximately 61% in 2015.
In terms of initial qualifying education, 51.5% of RNs in 2024 entered with a BSN or higher—up from 41.8% in 2015—while the share entering with an associate degree has declined from 38.5% to 34.2% over the same period.
How do education levels differ between RNs and LPNs?
The contrast is stark. While 73% of RNs hold at least a BSN, 82% of LPNs/LVNs report a vocational or practical nursing certificate as their first credential, and 75% hold that same certificate as their highest level of nursing education. Similar differences are observed in RN vs. LPN pay.
How does education level affect nursing roles and pay?
Education level shapes both the scope of practice and earnings.
Table 9: RN median annual earnings by education level
Source: 2024 National Nursing Workforce Survey
The difference between an ADN and a master's degree represents more than $25,000 in annual earnings. Beyond RN pay, higher education opens access to leadership, advanced practice, education, and research roles that are essentially closed to nurses without graduate preparation.
Is the push for BSN-prepared nurses changing the workforce?
Yes. The push toward BSN preparation is measurably reshaping the workforce. Magnet Recognition—a prestigious designation from the American Nurses Credentialing Center that signals high-quality nursing care—requires hospitals to demonstrate progress toward a BSN-educated nursing staff and requires nurse managers and leaders to hold at least a baccalaureate degree in nursing. Many large health systems now formally prefer or require BSN preparation for bedside roles and require all nurse managers and nurse leaders to hold a baccalaureate or graduate degree in nursing.
This institutional pressure, combined with tuition assistance programs, has driven a significant wave of RNs returning for their BSN or entering directly with one.
The Institute of Medicine's landmark “Future of Nursing” report called for 80% of the RN workforce to hold BSNs or higher by 2020. While that target has not been fully met, the workforce is moving steadily in that direction—from about 61% in 2015 to 73% in 2024.
Ongoing education and the ADN-to-BSN bridge
According to “Schools of Nursing See Enrollment Increases Across Most Program Levels, Signaling Strong Interest in Nursing Careers,” published in May 2026, 92,447 RNs are enrolled in RN-to-BSN degree-completion programs—an increase of 2% from the previous year, marking the first uptick following 5 consecutive years of decline. Many work full-time while completing these programs, most of which are offered online. These programs do not require the clinical hours of pre-licensure programs, focusing instead on professional development, evidence-based practice, leadership, and informatics.
For a deeper look at nursing school enrollment, program types, application trends, and NCLEX data, see our report, Nursing School Statistics: Inside the Education Pipeline.
Certifications and specialized training
Specialty certification is increasingly recognized as a mark of advanced competency.
Specialty certifications
As of 2021, 81.9% of RNs held at least one skill-based certification, according to the 2022 National Sample Survey of Registered Nurses. The most common were life support (70.3%) and resuscitation (37.1%)—largely baseline requirements for clinical practice—while true specialty credentials like trauma nursing (6.8%) and critical care (4%) remain far less common.
Professional nursing organizations credential nurses across a range of specialties—including the American Association of Critical-Care Nurses for critical care and the Oncology Nursing Society for oncology—while the American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association, serves as the profession's primary broad credentialing body, offering more than 25 specialty certifications.
The 2024 NNWS found that the proportion of RNs holding an APRN credential reached 13% in 2024, the highest level recorded in NCSBN's tracking history.
Alongside certifications, licensure flexibility is expanding the reach of nurses' qualifications. The share of RNs holding multistate compact licenses reached 36% in 2024, up from 30% in 2022. For most holders, this facilitates telehealth delivery and travel or per diem nursing across state lines.
Transition-to-practice programs
Nurse residency programs—structured, supervised first-year programs for new graduate RNs—are widely credited with improving retention and clinical readiness. The American Association of Colleges of Nursing (AACN) advocates for post-baccalaureate residency programs as a core retention strategy. Research consistently links residency completion to lower first-year turnover, higher confidence scores, and faster development of clinical competence. The NSI data showing 22.7% first-year RN turnover underscores the significant stakes in that critical onboarding window.
Certifications and staffing flexibility
Specialty certifications determine where a nurse can safely and legally practice. An RN without critical care experience or orientation cannot safely cover an ICU; an OR nurse's skills do not translate directly to a behavioral health unit. This credential specificity makes staffing matching both more complex and more consequential.
Digital staffing platforms like Nursa are designed to address these credentialing requirements—prioritizing per diem clinicians whose training and certifications most closely align with a facility's unit needs and surfacing those results first. While the final matching decision rests with the facility, this credentialing-aware approach helps ensure that the most qualified available clinicians rise to the top—a capability that becomes increasingly important as acuity rises and specialty gaps widen.
Shortages, vacancies, and staffing ratios
Nursing supply problems show up in three related measurements: long-term shortage projections, current vacancy rates, and the ratios nurses actually experience at the bedside. Each tells a different part of the story.
Current estimates of nursing shortage statistics
The scale of projected shortfalls varies across sources and methodologies, but the directional story is consistent.
Table 10: Projected nursing shortages by 2036 (HRSA)
Note: Metro and non-metro data not available for LPNs/LVNs
Separately, the BLS anticipates approximately 189,100 RN job openings and 54,400 LPN job openings annually through 2034.
These figures represent the gap between supply (nurses actively working) and demand (positions that need to be filled), assuming current workforce patterns hold. If burnout drives higher-than-expected exits, or if retirements accelerate, shortfalls could worsen.
How does nurse supply differ between urban and rural areas?
Rural and non-metro areas face the steepest projected gaps—14% vs. 8% in metro areas by 2036. Rural facilities also contend with smaller hiring pools, longer recruitment timelines, and greater difficulty attracting specialty-credentialed nurses.
Vacancy rates and hard-to-staff roles
Hospital RN vacancy rates stood at an average of 8.6% based on 2025 data (2026 NSI survey, covering 527 hospitals and 262,405 RNs). At the specialty level, certain roles are persistently harder to fill:
- Telemetry RNs: Average 87 days to fill
- Med-surg RNs: Average 83 days to fill
- Critical care (CCRN) RNs: Average 77 days to fill
- PCU RNs: Average 75 days to fill
- ER RNs: Average 70 days to fill
Staffing ratios and nurse workload
California is the state with the most comprehensive legally mandated, unit-specific minimum nurse-to-patient ratios (e.g., 1:2 in ICU, 1:5 in med-surg). Oregon has adopted a similar model. Most other states use a "sufficient staffing" standard, committee-driven models, or required staffing plans without hard numerical floors.
Starting January 1, 2026, the Joint Commission introduced National Performance Goal 12 (NPG 12), which now requires accredited hospitals to demonstrate adherence to internal nurse staffing policies as a condition of accreditation—and, therefore, of Medicare/Medicaid participation. This effectively makes safe staffing a baseline accreditation requirement for the vast majority of U.S. hospitals.
Nurses consistently report that the ratios they experience in practice fall short of what they consider safe. With a national average RN vacancy rate of 8.6%, many units are operating below their own planned staffing levels—meaning the gap between target ratios and bedside reality is structural, not perceptual.
System-level responses
Facilities have deployed a range of strategies to manage short-term gaps while working toward longer-term solutions:
- Travel and agency nurses: Average travel nurse fees are $91.23 per hour (or ~$189,758 annually)—compared to $59.46/hour for staff RNs, including benefits. Over 70% of hospitals reported plans to decrease travel/agency usage (NSI 2026).
- Wage increases: 77% of CFOs surveyed by Nursa in 2023 said they had increased starting wages for nurses by 20% or more in the prior two years—yet high turnover continued. The same survey documents rising reliance on nurse contract labor.
- Float pools and per diem platforms: Internal float pools and external per diem platforms like Nursa provide rapid-response coverage for last-minute shifts across specialty areas, reducing reliance on high-cost travel contracts.
- Cross-training and upskilling: Some facilities have invested in accelerated cross-training to give nurses the competencies to work across adjacent units, improving staffing flexibility without adding headcount.
Workforce trends since the COVID-19 pandemic
Every trend covered so far—settings, schedules, burnout, education—was bent to some degree by the events of 2020 and 2021. This section looks at what the pandemic did to the workforce directly, and which of those changes appear to be permanent.
Shifts in workforce participation
The COVID-19 pandemic caused the largest documented disruption to the nursing workforce in decades. Between March 2020 and December 2021:
- 43.5% of employed RNs (approximately 1.7 million nurses) experienced some form of employment change.
- 195,292 RNs (5% of those employed) left the workforce entirely—either for non-nursing jobs or retirement.
- Of those who left, 43.3% intended to return, while 19.5% said they would not return, and 37.2% were uncertain.
The most common employment disruption was temporary floating to a different unit or department (19.7% of nurses). Nearly a quarter of the workforce experienced employer-driven disruptions, including forced leave, furloughs, or layoffs.
Rise of travel nursing and flexible work
Before the pandemic, travel nurses represented roughly 1% of the RN workforce. By 2021–2022, as hospitals scrambled to fill vacancies left by burned-out and departing nurses, that share exceeded 5% (2022 NSSRN). Travel nurses are typically younger than staff nurses: only 13% of travel RNs are over age 55, compared to a workforce median age of 50 for all nurses.
The growth in per diem and platform-based jobs reflects a broader trend toward flexibility and autonomy among nurses seeking to shape their own schedules and earnings. More than half (51%) of RNs actively pursue supplemental income beyond their base salaries, according to the Medscape RN/LPN Compensation Report 2025. The most common method is working extra shifts, overtime, weekends, or holidays (55%)—the very coverage gaps that per diem platforms are built to fill.
Other income strategies include:
- Acting as preceptors (27%)
- Taking on-call shifts (24%)
- Assuming charge nurse responsibilities (23%)
- Working a second non-nursing job (22%)
- Teaching (14%)
Nurse staffing platforms like Nursa sit squarely within this landscape—offering nurses a direct mechanism to pick up additional shifts on their own terms, often at higher hourly rates than staff positions, without the long-term commitments of a second employer.
Burnout, mental health, and the COVID-19 pandemic
The data on nurse burnout shows a clear trajectory:
- 2019 (pre-pandemic): 11.8% of RNs reported daily burnout; 50.5% rarely or never felt burned out.
- 2020–2021 (pandemic peak): Daily burnout jumped to 25.4–25.7%; the combined share working under weekly or daily burnout exceeded 50%.
- 2022: Burnout remained elevated; approximately 45% of RNs experienced burnout every day or multiple times per week; only about 11% never experienced it.
- 2024: Burnout decreased; 35.4% of RNs reported feeling burned out from work either every day or a few times per week; 15% reported no burnout from work.
The causes of burnout were not purely pandemic-related. Burnout had been rising for years before COVID-19. The pandemic amplified and accelerated pre-existing problems: inadequate staffing ratios, administrative overload, moral distress, and physical exhaustion.
63% of nurses who were tested for COVID-19 during the pandemic reported at least one positive result—a stark reminder of what frontline nursing required during those years.
Lasting impacts on staffing models
The pandemic accelerated structural changes that are now permanent features of the nursing landscape:
- Telehealth integration:In 2024, 26% of RNs and 21% of LPNs/LVNs used some form of remote communication to provide patient care. Among those nurses, the telephone was still the most common method, though electronic messaging and video calls continued to gain ground (2024 NNWS). Multistate compact licenses increasingly facilitate cross-border telehealth delivery.
- Flexible staffing as standard practice: PRN and platform-based nursing have moved from a peripheral staffing option to a core component of how facilities manage demand variability.
- Workforce expectations have shifted: Nurses—particularly younger nurses who entered or advanced during the pandemic—place higher value on schedule control, flexibility, and institutional support for wellbeing. Facilities that adapt their staffing models to meet those expectations show stronger retention.
Frequently asked questions about the nursing workforce
What is the job outlook for registered nurses?
The U.S. Bureau of Labor Statistics projects approximately 189,100 RN job openings annually through 2034, with the RN workforce expected to grow 5% over that period. HRSA projects demand will outpace supply, with a 9% national RN shortage by 2036—more severe in rural and non-metro areas.
How many nurses work part-time vs. full-time?
As of the 2024 NNWS, 68.9% of employed RNs work full-time, 11.1% part-time, and 7.7% per diem. LPN/LVN employment patterns are similar, with 70.6% working full-time.
What percentage of nurses report burnout?
Among RNs in the same position for at least a year, 82% reported experiencing burnout at some point in their careers (2022 NSSRN). About 40% of RNs and LPNs reported plans to leave or retire within 5 years (2024 NNWS). Daily burnout—the most severe frequency—more than doubled from 11.8% of RNs in 2019 to 25.7% in 2021, with partial moderation by 2024.
How facilities and nurses can use workforce statistics
Workforce data is only useful if acted upon. The healthcare statistics throughout this report—vacancy rates, burnout levels, intent-to-leave projections, education trends, and specialty distributions—offer a shared foundation for both the organizations that staff nursing teams and the nurses building careers within them.
For facilities, national benchmarks provide a clear point of comparison. A turnover rate above the national average of 17.6%, or a vacancy rate exceeding 8.6%, signals where to focus:
- First-year retention
- Specialty recruitment
- Scheduling reform
Rising intent-to-leave figures point to the same conclusion—proactive engagement and structural changes matter more than reactive wellness initiatives once a nurse has already decided to go.
For nurses, the same data informs career decisions. Education trends in nursing show a documented earnings progression at each step up the credential ladder, and the growing accessibility of tuition assistance and online bridge programs has made that progression more attainable than in years past.
Job satisfaction also varies meaningfully by setting. Hospital-based RNs report sharper declines in job satisfaction—from 89.0% to 77.2% between 2017 and 2021—and a higher likelihood of considering leaving their position than nurses in ambulatory, home health, or community roles. For some nurses a setting change, instead of an exit from the profession, may be a more sustainable response to chronic burnout.
Underlying both perspectives is a common theme: rigid, all-or-nothing staffing models leave little room to absorb the shortages, turnover, and demand fluctuations documented by this data. Per diem and platform-based work has emerged as a structural response to that gap.
Where the nursing workforce goes from here
The data throughout this report points to a workforce in transition: growing overall, but aging; better educated, but more burned out; increasingly drawn to settings and schedules that offer flexibility and control. The structural pressures—projected shortages through 2036, persistent vacancy rates, and the high cost of turnover—are not resolving on their own.
What is changing is how the industry responds. Staffing models built on rigid, all-or-nothing employment are giving way to more adaptive approaches: internal float pools, cross-training, telehealth-enabled care, and per diem platforms that let facilities fill gaps in real time while giving nurses control over when and where they work.
The next several survey cycles will show whether the post-pandemic moderation in burnout holds, whether intent-to-leave translates into actual exits, and whether flexible work becomes the profession's new baseline.
Sources:
- 2024 National Nursing Workforce Survey (NNWS)
- 2022 National Nursing Workforce Survey (NNWS)
- State of the U.S. Health Care Workforce—Data from the 2022 NSSRN
- Job Satisfaction Among Registered Nurses—Data from the 2022 NSSRN
- Experience of Nurses Working During the COVID Pandemic—Data from the 2022 NSSRN
- 2022 National Sample Survey of Registered Nurses Snapshot
- Nursing Education and Training: Data from the 2022 NSSRN
- Nursing Shortage Fact Sheet
- Nursing Faculty Shortage Fact Sheet
- The Impact of Education on Nursing Practice
- Schools of Nursing See Enrollment Increases Across Most Program Levels, Signaling Strong Interest in Nursing Careers
- Occupational Employment and Wage Statistics (OEWS), 2025 data—National nursing professions
- Occupational Outlook Handbook: Registered Nurses
- Occupational Outlook Handbook: Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners
- Occupational Employment and Wages, May 2020
- State of the World's Nursing 2025
- U.S. and World Population Clock
- Paycheck Pulse: Medscape RN/LPN Compensation Report 2025
- Active RN Licenses By State Statistics
- HRSA: Workforce Projections
- The Joint Commission: NPG12 Safe Staffing
