Top 10 States in Most Need of Nurses

Much has been made of the current and future shortage of qualified, experienced nurses in the healthcare system. All over the US, states are expecting the next decade to bring a mass wave of retirements as Baby Boomer and older Gen-X nurses retire, while the supply of trained professionals coming out of nursing school is often barely adequate to keep up the current patient:nurse ratio – much less account for a growing and aging population. In some states the situation is dire, but the states that have nothing to worry about are few (and nurse burnout is real).

However, for nurses, the shortage represents an opportunity. In areas where the shortage is most acute, jobs may be plentiful for nurses who are in a position to relocate (areas with shortages can be the highest paying states and cities for nurses). In turn, nurses who already live in states with a shortage can leverage the shortage to their benefit, earning higher degrees to advance in their career, or making changes that earn them a higher pay. TopRNtoBSN isn’t telling nurses to flock to states where there is a shortage, but we do encourage nurses to do everything in their power to enhance their careers – whether it’s an advanced degree, an in-demand specialization, becoming a travel nurse, or a change of career to nursing.

Behind Our Numbers

The stats TopRNtoBSN used to determine the states with the greatest need for nurses come from the federal Department of Health and Human Services 2017 report, “Supply and Demand Projections of the Nursing Workforce: 2014-2030.” In this report, the HHS made predictions of the upcoming demand for nurses in relation to rates of graduation from nursing programs to determine how close each state will be to reaching their need for nurses. The estimate, for many states, is not good – in fact, far from the required number of trained nurses. Others will be barely hanging on by 2030.

For each state, editors have listed the actual number of nurses expected in the workforce by 2030, and the percentage of need met; a negative number signifies a shortage.

1. Alaska

The need for nurses in the state of Alaska is one of the leading states with a nursing shortage, as the number of vacancies for the position continues to grow and the graduation numbers diminish. In 2018, Alaska was also leading in a senior population, the demographic that requires the most healthcare, adding to the demand for nurses. (That’s part of what makes Alaska one of the highest-paying states for nurses.)

Alaska colleges, specifically in Anchorage and Fairfax have decided to combat the nursing shortage by offering incentives to licensed nurses who move to the area and take advantage of the vacancies. These incentives and bonuses include everything from tuition coverage to loan forgiveness and housing, which can be quite difficult in a state like Alaska that has a need for nurses. Alaska is also working to allow updated prescription privileges to all the Advanced Nurse Practitioners (ANPs) living within the state, making healthcare much more accessible to patients. These programs will encourage nurses to move to more remote areas and be available for patients in these areas.

Nurse Supply: -5400
By Percent: -22.70%

2. South Carolina

On the other side of the United States, South Carolina is experiencing a severe need for nurses. As their population continues to grow tremendously with retired baby boomers, the healthcare industry is having a difficult time attempting to keep up. Over the last decade, South Carolina has experienced an influx of transplant retirees moving to the Grand Strand area and requiring medical care.

In order to fight against the shortage problem, many employers in South Carolina have taken to offering tuition coverage for nursing education in exchange for employment contracts. Assuming the financial responsibility eliminates student debt for these nursing students and guarantees employment following graduation. The South Carolina Board of Nursing is also aligning with institutions that offer nursing programs to go into high schools and encourage graduating seniors to consider nursing as a career. Getting nurses in the field as early as possible is essential for the state to prevent the shortage from continuing in the years to come.

Nurse Supply: -10,400
By Percent: -16.60%

3. South Dakota

South Dakota is a state that has recently come across the need for nurses. According to several news outlets, the state is falling behind in competitive salary options, allowing nurses to move outside of the state for better employment. As the population in the area continues to age, the lack of nurses in South Dakota and those graduating into the field throughout the state is on a rapid decline. While the state is still graduating students into the industry, the number leaving the state is much higher than those enrolled in the program.

In conjunction with the South Dakota Center for Nursing Workforce, the state of South Dakota is working to make the nursing field a competitive industry for employee retention and recruiting nurses for the industry. Comparing salaries to neighboring states for a salary study has been utilized in an attempt for medical facilities to determine the proper salary requirements needed to minimize the demand for nurses.

Nurse Supply: -1900
By Percent: -14%

4. New Jersey

Another state on the Eastern Seaboard is finding the nursing staff depleting is New Jersey. A state that for many years employed older nurses from the baby boomer generation are finding these nurses retiring across the state quickly, and not enough recent graduates are available to cover these positions. The fact remains that the need for nurses in New Jersey is centered around residents finding interest in the career and having enough complete the requirements for licensure before the remaining Baby Boomer nurses retire.

The New Jersey State Nurses Association believes that the best way to close the gap is to evaluate nursing programs from other states, allowing licensure to transfer in to New Jersey. By determining which states offer a similar program that the Board is willing to certify, they are recruiting nurses in this area and encouraging them to relocate to New Jersey. Many medical facilities are willing to offer these individuals incentives such as relocation costs in exchange for their employment.

Nurse Supply: -11,400
By Percent: -11.20%

5. Texas

The massive state of Texas is no stranger to the need of nurses, especially in Central Texas. With a shortage of approximately six percent of the nurses they need, the state is suffering a shortage due to retired Baby Boomer residents, which has dominated the Texas population demographically for the last few decades. Due to this shortage, the state of Texas is looking to attract students to the nursing career field.

With a number of new nursing programs growing throughout the state of Texas, the state is looking to increase interest in the field, as well as maintain a competitive salary across the state. Online nursing programs offer students the ability to enhance their degree as well as their salary, all while maintaining employment. Many of the employers in the state are recruiting students to pursue their education by offering tuition assistance in exchange for an employment commitment upon graduation.

Nurse Supply: -15,900
By Percent: -5.90%

6. Georgia

The state of Georgia also has a demand for nurses. Like other states with a shortage, they are experiencing many retired Baby Boomers, and they are also seeing the number of nursing graduates decline over the last few years. While the shortage is not currently at a rate that matches other states on the list, this continued trend could have the state short more than 2000 nurses over the course of the next decade. Macon County is the leading areas for nursing shortages at this time in Georgia.

The medical industry in Georgia is looking to take the recruiting to the local high schools. With many nurses seeking retirement and a population that will require intensive medical attention, looking for younger individuals for the career field will help wedge the gap. Many are teaming with guidance counselors to offer information about a nursing career, and provide incentives for these students who agree to work with them after they graduate. These incentives include tuition assistance, bonuses, and housing if needed.

Nurse Supply: -2200
By Percent: -2.20%

7. Arizona

While the need for nurses in Arizona is not in the negative, Arizona is on the verge of a shortage according to the Arizona Nurses Association. As the population in Arizona continues to grow with retirees seeking the warmer and dryer climate, they are coming to the state much faster than Arizona can recruit nurses for their healthcare.

In order to keep the state from suffering a shortage with a need for nurses, the Arizona Nurses Association has worked with the legislation in the state to improve the authority in place by the Advanced Nurse Practitioners who are working throughout the state. In addition to this legislation, nurses from other states are being recruited to move to Arizona with the promise of stable employment and a competitive salary, preventing the need for nurses. As long as their nursing license was acquired by taking the required NCLEX-RN, and they have a similar program completion requirement, Arizona is working with these nurses to license them within their state.

Nurse Supply: +1200
By Percent: +1.20%

8. Montana

Montana is another state that does not have a current shortage, but the fact that the nursing supply is not even two percent ahead, the potential for an upcoming shortage is on the horizon. Many of the residents in Montana are entering into retirement or considering it in several years. With most of the state a rural area and minimal higher education institutions, the opportunity for attending a nursing program is not as prominent for residents as it is in other states. The areas suffering from the highest shortage make up several counties along the Canadian border and down the western border.

In order to prevent a new demand for nurses in Montana, the state is recruiting nurses across the nation and even some international nurses to come to the area for work. The Montana Nurses Association are also looking to recruit Millennials to the field so that they can begin their careers and the potential shortage averted in the approaching years.

Nurse Supply: +200
By Percent: +1.70%

9. Massachusetts

The state of Massachusetts is in its early stages of a nursing shortage. Based on the number of nurses graduating over the last few years, the negative trend has recently turned positive in terms of nurses. The ratio for nurses to patients has been improving as medical facilities across the state begin hiring more nurses. In more rural areas away from the larger cities like Boston, these small towns find themselves shorter on healthcare team members.

In order to maintain this positive trend in the need for nurses, the Massachusetts Nurses Association often highlights and recruit nurses for the more rural areas, leveling out the shortage and continuing the positive trend ahead. Also, more specialized nurses are being requested by medical facilities, which encourage them to move to Massachusetts where they can receive a competitive salary for their specializations.

Nurse Supply: +2000
By Percent: +2.20%

10. Illinois

Illinois is not currently the one of the states suffering a dangerous nursing shortage, but it is on the verge of losing its current ratio of efficient staff due to the retiring of the specialized nurses in the coming decade. These specialized nurses are simply not available for those who are retiring, making their replacement one that can shift the entire trend regarding a need for nurses. Cities such as Mt. Vernon and Rockford find themselves in need of specialized nurses.

Based upon a 2018 survey implemented by the Illinois Nursing Workforce Center, it was decided that recruitment for the nursing industry would begin with those recently graduated from high school, and focus on whom the local demographic would like to represent them. Also, the Illinois Nursing Workforce Center is working with currently licensed nurses to take their education a step forward and gain the necessary certifications needed to fill the positions across Illinois.

Nurse Supply: +3600
By Percent: +2.60%

How Do Experts Define the Nursing Shortage?

One of the leading concerns in the healthcare industry is the ongoing nursing shortage by state in at least twenty percent of US states. According to the Department of Health and Human Services, the nursing shortage is initially defined based upon the supply of nursing currently registered in each state, and the demand of them based upon the jobs available and the population of that state. They also take into consideration the current number of students enrolled in nursing school for that state, determining what that gap is between the number of potential graduates and what jobs are available. All of these figures combined to give an overall number for experts to determine as the shortage. When the demand for nurses is higher than the number of jobs available, then a shortage number is determined for that state and determine the highest demand for nurses by state.

Experts also take this shortage definition a step further to determine the shortage of nurses by state into the future by determining how many nursing students are graduating annually over the last few years and at what percentage that number is growing. Comparing that annual percentage with the average of the annual shortage of nurses by state gives an overall shortage projection of anywhere from five to ten years based upon current trends in both nursing schools and postings for nursing positions. This nursing shortage is determined for both the Registered Nurses (RNs) in each state and Licensed Practical Nurses (LPNs). These projected shortages are just as important as current shortage numbers so that these states can work to reverse these projections, filling the gap and increasing their numbers in the nursing field.

How are At-Risk States Dealing with the Nursing Shortage?

At-risk states dealing with the nursing shortage are using nursing shortage solutions in order to close the gap in their shortage areas. Nursing shortage solutions such as loan forgiveness and incentives to attend nursing school are being utilized in states across the nation. Employers are working with local institutions to offer programs that inspire current employees to attend nursing school, or guarantee employment as well as cover some cost for external candidates while in nursing school. The elimination of student debt and guaranteed employment encourage students to take on nursing school.

The nursing shortage in Texas is being addressed due to a shortage in faculty to offer enough nursing programs (such as online RN to BSN programs) to match the needs of the state. According to the Texas Center for Nursing Workforce Studies, the current shortage will continue to grow considering the number of aging Texans who reside in the state and their anticipated need for healthcare. They are working to bring in more nursing faculty to the state so that more programs can be implemented, encouraging more nursing graduates.

The nursing shortage in Arizona is related completely to the continued growth of retired baby boomers moving to the state for a warmer climate. As this demographic continues to increase, so does the need for nurses. According to the Arizona Nursing Association, they are working with employers across the state to offer incentives to those who may be interested in the profession to attend and graduate from a program at minimal cost in exchange for working with them for a specific number of years.

The nursing shortage in Georgia is one of the worst in the country. In an attempt to gain nurses in the state, hospitals and employers are reaching out to local high school seniors across the state in an attempt to encourage their paths into the nursing field. Georgia is not only facing the need to care for their baby boomer generation, but they are facing the retirement of veteran nurses and need these positions filled quickly. Scholarships are also being dispersed across the state to encourage students into these nursing programs according to the Georgia Nursing Leadership Coalition, while many colleges have established online RN to BSN programs in Georgia to meet the need for training.

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