For years we’ve read that the US faces a looming shortage of nurses. Shortfalls in the hundreds of thousands of nurses are routinely predicted. These predictions have been good for nursing schools, which have used the promise of ample employment opportunities to more than double the number of nursing students over the last 10 years, according to CNN.

Yet somehow 43 percent of newly-licensed RNs can’t find jobs within 18 months. Some hospitals and other employers openly discourage new RNs from applying for jobs. That doesn’t sound like a huge shortage, then does it?

But the purveyors of the nursing shortage message have an answer for that. Actually two answers: one for the short term and another for the long term. The near term explanation is that nurses come back into the workforce when the economy is down. Nurses are female and tend to be married to blue collar men who lose their jobs or see their hours reduced when the economy sours, we’re told. Nurses bolster the family finances by going back to work –or they stay working when they were planning on quitting. There’s something to that argument even if it’s a bit simplistic.

The longer term argument is that many nurses are old and will retire soon, just when the wave of baby boomers hits retirement age themselves and needs more nursing care. Don’t worry, the story goes, there will be tons of jobs for nurses in the not-too-distant future. This logic comes through again in CNN’s story:

Demand for health care services is expected to climb as more baby boomers retire and health care reform makes medical care accessible to more people. As older nurses start retiring, economists predict a massive nursing shortage [emphasis mine] will reemerge in the United States.

“We’ve been really worried about the future workforce because we’ve got almost 900,000 nurses over the age of 50 who will probably retire this decade, and we’ll have to replace them,” [economist and nurse Peter] Buerhaus said.

I don’t buy this logic. And I stand by what I wrote almost a year ago in Nursing shortage cheerleaders: There you go again:

My issue with the workforce projections is that they don’t take into account long-term technological change, but simply assume that nurses will be used as they are today. I’ve taken  heat for writing that robots will replace a lot of nurse functions over time. People seem to be offended by that notion and have accused me of not having sufficient appreciation for the skills nurses bring.

So let me try a different tack. Think about some of the job categories where demand is being tempered by the availability of substitutes. Here are a few I have in mind that have similar levels of education to nurses:

  • Flight engineers. Remember when commercial jets, like the Boeing 727 used to fly with two pilots and a flight engineer? Those planes were replaced by 737s and 757s that use two member flight crews instead.
  • Junior lawyers and paralegals. Legal discovery used to take up many billable hours for large cases. Now much of it is being automated
  • Actuaries. Insurance companies used to hire tons of them, but their work can be done much more efficiently with computers

I don’t know exactly how the nursing profession is going to evolve but I do notice that the advocates for training more nurses are typically those who run nursing schools rather than prospective employers of nurses, such as hospitals.

If you want to be a nurse, go for it. But if you’re choosing nursing because you think it’s a path to guaranteed employment, think again.

David E. Williams is co-founder of MedPharma Partners LLC, strategy consultant in technology enabled health care services, pharma,  biotech, and medical devices. Formerly with BCG and LEK. He writes regularly at Health Business Blog, where this post first appeared.

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171 Responses for “The Nursing Shortage Myth”

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    • dtulip says:

      It is important for every single person who is considering a career in nursing to read these comments and pay close attention. It is my well researched experience and opinion, through 15 years in this god awful field that I am compelled to share the truth.

      There has been a long term planned and pre-meditated hoax to fool people into thinking that there is, was, and is going to be a nursing shortage. I was one of those unfortunate people who was conned by the team efforts of local colleges, media classified ads, news stories, magazine articles, local hospitals and nursing homes, recruiters, job boards on the internet, etc, who have all despicably participated in this magnificient bogus scheme to create a shortage of nurses through fiction without any fact at all.

      The truth is that there never was a shortage to begin with. The hoaxes were able to be considered by many, because the hospitals and nursing homes were all perpetuating this fraud on society by offering multi-thousand dollar sign on bonus programs, inflated pay rates with $5 and $10 differentials for nights and weekends, etc…

      The schemes and lies became known to me when I fell for every one of them. Sign on bonuses were only payable after 6 months. Inflated pay programs disappeared within weeks of being hired. Hospitals and nursing homes hired and fired people almost daily, before the ink was even dry on the applications.

      With the market completely and utterly clogged and saturated with nurses, you now have a pool of several hundred, and possibly several thousand applicants for each job. The jobs have now morphed from full time with benefits to per diem, low paying, no benefit jobs that come and go like toilet water in a fast food bathroom.

      In addition to these sad facts, the surplus of nurses has caused a downward spiral of acceptable pay rates. Anything outside of acute care has become almost minimum wage. “Techs” are replacing nurses left and right, LPNs must perform RN work, and RNs are forced to act as Supervisor, med/treatment nurse, unit clerk, CNA and receptionist all at the same time. No matter how hard you work, someone has a complaint, and you are kicked out the door without the batting of an eye. They can do this to avoid paying benefits, and to continue their habit of finding someone who will work even cheaper.

      In 15 years I have endured the worst hell anyone can imagine, still have nursing school loans, and will be filing for bankruptcy within the next few months. If you care about your metal and physical well being, never consider nursing as a career, ever! I have had interviews on occasion that were brazen and humiliating at the same time. Every employer has the upper hand and will use it to literally erase your qualifications, under the guise (and hoax) of “too many short term jobs” , “nursing experience not recent enough,” “You need three years minimum on a med/ surg unit”, “your last job was less than 1 year” and the list goes on and on and on. Its demoralizing and pathetic. At this point I’d rather work a cash register at Sears than endure even one more day of this garbage.

  2. Melissa says:

    I wrote about this problem back in 2009, from

    ” I have experienced some new caveats to our current situation that I believe may be of interest. I graduated May 2008 with my BSN in Northern California and did everything by the book (hundreds of apps, spoke with managers, thank you notes, ACLS, BLS, professional resume, LTC, SNF, etc.) and was unable to locate employment. When an offer was made, my children and I relocated to a rural town four hours away. Sadly, after four months of orientation, I was told I “failed orientation” and they needed an experienced RN. My children and I moved again. Recently I applied to a Versant New Grad Residency. I made it through their first round of interviews but was told that I was no longer a “New Grad” due to my previous four months of experience!

    So, not only am I not experienced enough to work as a staff nurse, but I am no longer considered a New Grad! So, where do I fit in? I feel that if I cannot get into a New Grad program I will have the same unstructured learning demands and unrealistic expectations placed on me similar to my first failed hospital experience. It also appears that the longer it takes for me to find employment, the more reservations the employers have towards me.

    I have researched my situation. It appears my peers from nursing school are experiencing similar situations., an all-nurses Web site, further elaborates that my situation is happening all over the U.S.A. to new nursing graduates.”

    • Deborah says:

      Dear Melissa,

      I have been a nurse for 33 years and still can remember coming out of nursing school and people not wanting to hire me because I “had no experience”. Finally, a hospital gave me a break and I had four weeks of orientation in the ICU and then was subjected to sink or swim tactics. I understand your dilemma and have a few suggestions:
      1. Take a job that will pay the bills preferably with the hospital you want to work for and offer to come in on your off time to improve your nursing and organizational skills.
      2. Take a job as an RN in a doctor’s office utilizing managerial skills. These circumstances may be a sign that you are not best suited to bedside nursing.
      At the end of my career, I have been placed in a terrible position of working contract work and having to travel for contracts while still having a son and disabled husband to care for. I am too expensive with all my experience to hire and am unable to get any benefits with this job. Always remember that no position will last forever and put 10% aside for emergencies from each paycheck. God bless you and yours!

    • Josh says:


      Just don’t put down on applications you have that 4 months experience if you’re trying to get in to a new grad program.

  3. Ms. Shelly says:

    It is near impossible for new grads to find enjoyment in our area. We are saturated with nursing schools with more in a 200 mile radius than some states have. Of the three hospital systems in that radius only one has a new grad residency program and they hire MAYBE 150 nurses a year for this program. However, there are approximately 2700 new graduates in that same year. One of the other systems will occasionally hire new nurses, but it is rare and there is no formal training… it’s sink or swim. The only area in nursing that is growing and has somewhat of a shortage is home health, both for PDN and skilled visit nurses. Problem there is that the pay is no where near hospital pay and often there are no benefits. Also, there is still a stigma that these nurses are second rate in comparison to acute care RNs. You spend thousands to get a degree to work 1-2 years in home care making the same money people without degrees are earning hoping that some hospital will eventually take a chance on you since you have experience. Then you wind up in am even worse situation because hospitals now don’t want to take a chance on you because you haven’t used acute skills since school so you are worse than a new grad in their eyes. I was one of the lucky ones, but have seen this over and over. When hospitals are able to pick and choose and continue to boost their minimum requirements, please tell me how that equivocates to a shortage?

    • dtulip says:

      I have also had this experience. 15 years in the field, and regarded as useless, because my acute care skills were not recent enough. However, hospitals in my area hire new grads almost exclusively, keep them 3 months, and fire them.

      Nurses in PA are recycled to the point of looking like swiss cheese, and the persons conducting the interviews penalize you for the experience that you have gained. The job market is saturated, which is precisely the way they want it.

      The domino effect of such a surplus in the job market has been able to prop up employment profiteering in regard to the education industry, the background check industry, the CPR/American Red Cross Industry, TB Tests, and pre-emplyment physicals.

      All of these industries are booming due to the glut and surplus of nurses looking for work. When you think about has disgusting and fraudulent the “shortage ” is, one can understand it better, because jobs are being born, and profits are being made with the piles of nurses who are continually looking for work.

  4. bittboo says:

    Ms Shelly, I think you and a few others are missing a key point- there is not a nursing shortage EVERYWHERE. You’re talking about YOUR area. Well, in MY area, nurses get hired very easily because there is indeed a shortage. Saturated with nursing schools? Of course there’s no shortage in your area! If more new grads were willing to take home care and nursing home positions, they would have their one year experience and could build upon that experience in one of the areas were there are shortages. Like many other fields, you may have to move to get the job you want as a nurse.

    • homeless RN says:

      I live in phila pa. Grad RN 2011. I have applied for everything here. Even home care wants 1 year of experience at low pay. Im feeling really desparate right now and feel depressed. I would travel nurse but they say not to do it if you are a new nurse. Any suggestions are welcome

    • Caroline says:

      May I ask what area you live in, or if you are aware of any areas in a similar situation? I am in an accelerated BSN program now and will be graduating in about a year. I am definitely looking to move and I’m very flexible, but I am still unsure of where to look for the best opportunities.

  5. Melissa says:

    Bittboo – sadly hospitals here do not “count” long term care experience. They want acute care experience.

  6. Grace says:

    According to the Bureau of Labor Statistics, nursing jobs are growing. In particular, one of the most common nursing job is that of a registered nurse. They’re expected to grow 19% over the next decade, which is faster than the average of about 11% for all occupations.

    I like to believe that the BLS has no connection with nursing schools. With that said, the outlook looks pretty good to me.

  7. Elnora says:

    Interesting Read

  8. Maria says:

    Even with 5 years experience in the US and another 10 outside of the US it is a handicap race to find a good job. There are jobs where companies “drain” your energy for low pay and expect a factory like output. It is really disheartening to realize that investing in a BSN degree can bring you more heartache than joy, especially when you are a truly compassionate nurse. I think there is a lot of hype so the schools can make the money and keep on producing more nurses. I have not seen the shortage and I am a nurse in Florida that has worked in Tennessee and I now am looking to relocate. Be sure to do your research before you move and see that you have plenty of options available.

  9. Larry V says:

    The RN to BSN program in California is a SCAM. There is NO evidence to support that an RN who obtains a BSN will be a better nurse. All the BSN program is is a bunch of extra show boat classes that have little to do with real life nursing. For example, Psychology 100 will not make you a better nurse. Nor will taking Chemistry. Or Speech. What is needed to protect lives in the hospitals is teaching nurses to get the hell off their cell phones, Facebook and pay attention to their patients. What is needed is for nurses to WASH their hands. Wash their hair. Practice basic infection control. Patients don’t care if their nurse knows the difference between a prokaryote and an Eukaryote. Patients don’t give a rip if the nurse knows Chemistry as it has NO real life application to patient care from a nurse. Nor does a patient remain safer if an RN has a piece of paper that says they are a BSN. IT’s a complete SCAM. What the state of California, in particular, the California Board of Nursing needs to realize is that they are out of touch with reality. If they want to make a real difference they should remove Chemistry, psychology, speech and all the BS diversity classes from the BSN (bull shit nursing) degree and include How to Wash Your Hands So You Don’t KIll the Patient with MRSA 101, Why it’s important to stay the hell off your cell phone and care for your patient 102, Why you shouldn’t be talking about your patient because it’s a HIPPA violation 103, Why you shouldn’t wear long nails because they poke through gloves and you can harbor S. aureus under your dirty artificial nails…104. And then add How to Care More About Your Patients than How Much You Get an Hour 105, then add a class called “HOW TO BE COMPASSIONATE” 106. Lastly, a class called, “Diversity is more than just talking about blacks, mexicans and gays, let’s talk about how to respect the elderly, handicapped and mentally ill patients since we don’t know what the hell to do with them when they’re in our hospitals and we end up giving them IM injections of antipsychotics instead of proper medical treatment, 107. Boom. There’s your BSN. Nobody cares if you have streak plated a Mannitol Salt Agar. Nobody gives a damn if an RN knows what KOH means. Nobody will ever ask an RN if they can quote statistical research to them. And clearly, no patient will ever ask an RN about their LYMPH system, because the second they do, the RN will refer the patient to speak to their MD. Quit wasting RN’s time with these BS classes and get REAL. Maybe if the people at the California Board of Nursing would exist their dusty offices and get back into the field they will recall that not one patient will ever give a sh^% about whether or not an RN has a BSN because all they care about is good care and that is not delivered by simply getting a BSN.

    • StacyRN says:

      Wow, I tend to disagree on the relevance of chemistry and psychology. As a PICU nurse, chemistry was vital to adequate understanding of fluid & electrolyte therapies, CVVH, etc. Psychology is present in therapeutic communication with patients and families. While I can appreciate your points about being attentive, using hygiene to prevent infection, and diversity, I think a broad educational base is important to a well-rounded nurse. Additionally, I think care managment and leadership skills (the valuable parts of BSN education) will only increase in demand. It’s not for everyone, but it’s definitely not a waste of time for many nurses who may have different nursing aspirations.

    • kate says:

      Right on Larry I agree 100%

    • susan says:

      Larry…You are SO right!…I have been saying this for years…esp when I had to take statistics…still a nightmare since it had NOTHING to do with what I needed to know..You put it excellently!!! Lets face it…when it comes to all those useless subjects….it is to make us pay more $$$$$…..not smarter….Social skills, and possibly finishing school would be a more useful class…and I bet the patients would tell you that first….If I had my way to do it again…I would DEFINITELY be an LPN…and do home care visits….They are not allowed to do admits, ROC, D/C and all the other time-consuming…no pay jobs only an RN can do…..I would rather do two visits at $30 ea than one admit for 55-70….or actually even $100+ it is not worth it….Now I have even offered to just do revisits with an LPN pay…and it is a no go….The industry is so repressed…there is no $$….no benefits like the big companies are paying these smart college grads that do NOT go into nursing….

    • dtulip says:

      excellent points , Larry…..the BSN hoax is just another way to make nursing schools rich on the backs of people who dont know the facts.

    • carol sessomes says:

      you speak a lot of truths–these dynamics you spoke of have been forever present and to add to the mayhem there are R N bullies who love to see nurse grads struggle at the expense of the patient – despite all of these horrible facts there are some really good /intelligent nurses out there and you sound like one of them do not give up— you are desperately needed and others like you!!!!

  10. Scott says:

    I went back to school, did a year of pre-reqs and got a scholarship to an LVN program 350 miles from home. So we moved and I graduated. Went back home to find out that hospitals only hire LVN’s as ward clerks or Techs. Only Option was LTC. 30-45 patients, not nearly enough CNA’s to provide quality of care. Forced into double shifts.(Do it or loose your job). $16.50/hr no differentials, no benefits. Working as a nurse with no insurance for my family. Luckily my son qualified for medicaid. I went back to school got an AS in general studies that covered the pre-reqs for my transition to RN. Another year in nursing school and I got my RN. Unable to find a job. Applied everywhere, was told that my LVN experience did not count. I called the hospital where I did clinicals and asked if they would hire me. They did so I made the 108 mile (one way) commute to the hospital to work PRN for $35/hr. I was feeling like I made it. Again, no benefits and worse off because my son no longer qualified for medicaid and still no insurance for all of us. I began applying everywhere with the intent to find a full time job with benefits and working whatever shifts I could get. I finally got an interview 300 miles from home in a correctional facility. On the phone the interviewer said that they really liked my resume and loved the fact that I was an LVN. Got a job offer that included relocation money and a sign on bonus. $19.38/hr ($540/month for insurance) CRAZY. There is no way that we could get by on that having to rent an apartment and basic living costs. We are not fancy people. My car is 12 years old. All kinds of people were saying you have to go where the jobs are. And Alaska is where you can make it. Spoke with the recruiter in Anchorage who stated the wage would be $26/hour and the state legislator has removed some basic benefits (no retirement). Over $800/month for insurance. I am now in a BSN transition. I am doing this with the intent of going on to a masters degree. Working part-time in the Nursing home and taking whatever PN days I can get from the hospital. WHERE ARE THE JOBS? We can move.

  11. Scott says:

    If anyone has any advice on where is a good place to move to get a nursing job with benefits. Please let me know. I am not interested in reports or statistics about how nurses are in demand. I think that they are skewed.

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  13. Scott says: ———————Thanks I would prefer to work in corrections but I am not picky.

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  17. Looking for more says:

    Tired of Being a CNA? Nurse assistants are overworked, underpaid, unappreciated and expected to always do more for less. Might be time to find something else to do. Here’s a place that you can vent, hear others with the same experiences and maybe find a better job:

    Hope it helps

  18. David says:

    New RN then be flexible and move to get experience. Too many student nurses I work with say they will not move for a job. Well then you can be unemployed for a long time. In places that pay well like around cities like San Francisco, Boston and San Diego. Cities with a lot of nursing schools and places where people want to live are also hard to find a job. No medical student gets to stay home and learn, so lose your fear and spread your wings, and move for a job. Look online and start applying

  19. Carrie says:

    All you nurses that can’t find jobs come to Houston! Wages are good, low cost of living, awesome town and plenty of jobs for you and your spouse.

    • Caroline says:

      Thanks for the advice, I graduate in a year from an accelerated BSN and have been hoping to move to the Houston area from where I am now in PA! Glad to know that the outlook is good.

  20. Jeremy says:


    I got an ASN in Orlando Florida. A hotbed of people wanting to work and live here. Big time health care. Big time fun and play. Not great on salaries compared to the north, but oh well….one can make $75k per year as a waiter in a decent restaurant as opposed to $50 k per year as an accountant, but oh well…

    I have an ASN. only 5 years ago from a local community college. No hospital opportunities upon graduation. Found a job in 3 months for a private practice internal medicine doctor. $25 per hour. Then salary. In a year became a hospital rounding nurse. On call, etc etc. Great benefits. No relocation. Then left for greener pastures…

    Went to a staffing company. They found me $60 per year in less than a month as an infusion nurse. No BSN required. Tons of benefits. Retirement, health care, free Disney passes etc etc…

    Then came the pharmaceutical companies. I now work for two of them. Fancy dinners every night. Made $10k last year in nursing focus groups. tons of perks…just got a BSN…no difference in my life, except in will pay dividends down the road as a traveling speaking for said pharm companies. I just stayed in times square on their dime in manhatten for a week..paid me over $1000 plus all expenses…just went to San Fran…same deal…Now going to the Hyatt in Orlando for $79 per hour…

    Point is, if you haven’t figured out how to market yourself and keep waiting for a handout, you are no different than those 400 pound patients you see on disability with high blood pressure and diabetes in poverty on a daily basis, if you are even employed….

    Make your own way, don’t go into nursing for a sure thing/job…go into it because you are someone who can take an opportunity a run with it…good Lord people, quit whining and get a life…

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  22. Janet Betz says:

    I feel that the problem with Nurses finding jobs has to do with several years ago when there was a shortage and they put Nurses on 12 hour shifts.There are many more men in Nursing as well as females.i do think some of that has to go with only working three days a week.I have been a Nurse for 50 years and have worked all three shifts, done total care Nursing and have done Nursing using the computer.I still like the total care Nursing were you do everything for the patient.I did work at one hospital that used little computers that one wore around their waist.The Nurse would document as she /he cared for the patient,then would down load the information every two hours in the big computer.I really think Nurses should work eight hour shifts instead of twelve, the care is better and we are dealing with human beings not cars or clothes.Mistakes are not fixed as easy once they happen.Putting Nurses back on eight hour shifts would open more jobs,cause less errors and Nurses going into Nursing because they want to care for the sick, not for the hours .

  23. Pancho says:

    California Board of Nursing is a mess and a front for Lord knows what….disorganized is too nice of a word for this FAIL of an agency. So many incompetent people working there. Nobody answers phones. Always on breaks. In meetings. Out to lunch (even when they’re back from lunch). Half the state agency staff is on Facebook the entire day not doing their job. Total joke. No wonder the BSN requirements keep changing, nobody is manning the ship. California nursing schools are now being told, “OOPS, we goofed, your students no longer need CHEMISTRY to be BSNs…” Oh, reallllllyyyy…well thank you very much after 5900 of us already took chem as a “requirement” and now, suddenly we don’t need it…GET YOUR ACT TOGETHER CA BOARD OF NURSING. QUIT ripping students off. Quit wasting RN’s time and money on this idiotic BSN (Bull S^%$ nurse degree)

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