By James X. Stobinski, Ph.D, RN, CNOR, CSSM(E), CNAMB(E)
This article starts with data provided by the American Association of Colleges of Nursing (AACN) in their Nursing Workforce Fact Sheet.1 The AACN updates this fact sheet periodically and there is much good news in the current, concise bullet points. In example, the outlook for nursing employment remains solid with projections of over 200,000 new RN positions to be created each year to the year 2031. The average salary for American RNs is nearly $78,000. We are also told that, as of 2022, 71.7% of the RN workforce holds a baccalaureate or higher degree as their highest level of education.1
The AACN Fact Sheet is a wealth of information on the American nursing workforce and dovetails nicely with the World Health Organizations report on the state of the world’s nursing workforce which was the focus of a previous column.2 As I reviewed the AACN data it also struck me that there is additional context underlying nursing workforce data and that there is connection to a concept that I spoke to in that previous column. With all the good news in the AACN Fact Sheet, we must also be aware that there are some countervailing forces impacting American nursing.
We have record employment in nursing, projections for strong future growth and also reports that enrollment in Bachelor of Science nursing programs have again increased in 2024 as have enrollments in RN – BSN programs.³ All of this good news is counterbalanced with widespread reports that a high percentage of nurses plan to soon leave their current position or leave the nursing profession entirely. While it is a net positive that more new nurses are entering the profession we must acknowledge that this may not alleviate current shortages. It is possible that those leaving the profession and the increased demand for nurses in American healthcare may still leave us with a net shortage.
Last month, I mentioned the term “reluctant staying” relative to American nursing. This term refers to nurses who remain employed despite experiencing dissatisfaction or burnout. Nurses continue in the profession because of financial necessity, lack of alternative job opportunities, or personal commitment and altruism. We all have known nurses who reluctantly, and perhaps unenthusiastically, remain in the profession. While these nurses do maintain vital staffing they frequently are not the best of our teams and may not be fully engaged in their every day work. These nurses count in the record total of working nurses, but these numbers can be deceiving. Other, less publicized factors also impact nursing.
We are experiencing a large-scale shift in the settings where healthcare is delivered to include far more ambulatory and home-based care. In perioperative nursing the proportion of ambulatory surgery is rapidly increasing; this requires new skill sets and precipitates workforce shifts. Perioperative nurses have a unique skill set that does not easily transfer to other nursing roles. This limits the mobility of these nurses and may narrow their employment choices. The closure of hospitals, especially in rural settings, continues at a steady pace. This may leave nurses in these settings with few options. Some of these nurses, if unable to make the transition to the ambulatory setting or move to a new location, may also leave the profession. There are opportunities for nurses who have the ability to adapt and perhaps move to a new specialty or work setting. Nurses lacking this capacity may become a reluctant staying nurse or perhaps leave the profession. These choices cloud the overall picture, and we are left with incomplete data on the total nursing workforce.
– James X. Stobinski, Ph.D., RN, CNOR, CSSM(E), CNAMB(E), is the director of hospital and ASC relationships with National Institute of First Assisting (NIFA). He is also a member of the Central Michigan University faculty.
References
1. American Association of Colleges of Nursing. Nursing Workforce fact sheet. (April 2024). https://www.aacnnursing.org/news-data/fact-sheets/nursing-workforce-fact-sheet?utm_content=%F0%9F%92%8C%20discover%20the%20number%20of%20rns%20licensed%20in%20the%20u%20s&utm_campaign=7%2f2%2f2025&utm_source=activecampaign&utm_medium=email
2. World Health Organization. (2025). State of the world’s nursing 2025: Investing in education, jobs, leadership and service delivery. https://iris.who.int/bitstream/handle/10665/381329/9789240110236-eng.pdf?sequence=1
3. Taylor, M. (2025, June 27). Nursing school enrollment on the rise: 7 notes. Becker’s Hospital Review | Healthcare News & Analysis. https://www.beckershospitalreview.com/quality/nursing/nursing-school-enrollment-on-the-rise-7-notes/?origin=BHRE&utm_source=BHRE&utm_medium=email&utm_content=newsletter&oly_enc_id=0705J2387567B1E
