Updated October 29, 2026. First published May 15, 2026. 5 min read.
Short answer: The U.S. registered nurse (RN) workforce has recovered in size, and federal projections show the national shortage narrowing through 2038. Hospitals are not capturing that recovery. The hospital share of RN employment fell from 60.3% to 57.8% after the pandemic, hospital RN turnover rose to 17.6% in 2025, and the average hospital still has 43 unfilled RN positions and needs 78 days to recruit an experienced RN.
Key takeaways
- National supply is recovering. A 2024 JAMA Health Forum study projects the RN workforce growing from 3.35 million (2023) to about 4.56 million (2035).
- Hospitals are getting a smaller share. The hospital share of RN employment fell from 60.3% to 57.8%, driven by a drop in hospital employment among RNs over 40.
- The shortage is uneven. HRSA projects an 8% national RN shortage in 2028, narrowing to 3% by 2038, with nonmetro areas at 24% in 2028 versus 5% in metro areas.
- Hospital turnover is rising again. NSI reports hospital RN turnover of 17.6% for 2025, up from 16.4%.
- Filling one RN role still takes 78 days. That is five days faster than the year before, and still two and a half months of vacancy.
Is the U.S. nursing shortage over in 2026?
Not for hospitals. At the national level, the picture is improving. The Health Resources and Services Administration (HRSA) National Center for Health Workforce Analysis, in its December 2025 projections, estimates that RN supply will meet 92% of demand in 2028, 94% in 2033, and 97% in 2038. That leaves a projected shortfall of 108,960 full-time-equivalent RNs in 2038.
The same projections show the gap is uneven. In 2028, nonmetro areas face a 24% RN shortage while metro areas face 5%. By 2038, California (22%), North Carolina (20%) and Georgia (20%) have the largest projected state shortages.
So the useful question in 2026 is no longer "how many nurses exist?" It is "where do they work, and how fast can a hospital bring one in when a position opens?"
Where did the nurses go after the pandemic?
In 2021, the U.S. RN workforce shrank by more than 100,000 in a single year. It then recovered. Auerbach, Buerhaus, Donelan and Staiger, writing in JAMA Health Forum in February 2024, found that the number of RNs in 2022 and 2023 was about 6% higher than in 2018 and 2019.
The same study found that growth did not reach hospitals proportionally. The share of RNs working in hospitals fell from 60.3% to 57.8%. Hospital RN employment grew only 1.6%, and the shift came from a decline in hospital employment among RNs aged 40 and older.
Because total RN employment grew while the hospital share fell, the growth landed outside hospitals. The study documents the drop in hospital share. It does not track each nurse's destination. The nurses did not disappear. Experienced nurses are working in settings other than hospital inpatient units, and that is the supply hospitals depend on most.
Peter Buerhaus, a leading nurse workforce researcher, described the risk as a "qualitative shortage of nurses": not enough nurses with the knowledge and skill needed to care for a growing number of older, sicker hospital patients.
How many nurses plan to leave?
Headcount recovery does not mean retention is solved. The National Council of State Boards of Nursing (NCSBN) 2024 National Nursing Workforce Study, based on more than 800,000 nurses and reported in April 2025, found:
- More than 138,000 nurses left the workforce since 2022.
- Nearly 40% of RNs say they plan to leave the field within five years. About 22% intend to retire and 18% plan to leave for other reasons, mainly stress and burnout. NCSBN estimates this is about 1.6 million nurses.
- The median nurse age returned to 50, and researchers noted that the return of experienced nurses after 2022 may be temporary, depending on revised retirement timelines.
These figures measure intent, not departures, so they are a risk indicator rather than a forecast. They still explain why hospitals cannot treat a recovered headcount as a solved problem.
What do hospital RN numbers look like in 2026?
The 2026 NSI National Health Care Retention & RN Staffing Report (March 2026, calendar year 2025 data) gives the operating picture inside hospitals:
| Measure | 2026 NSI figure |
|---|---|
| Hospital RN turnover | 17.6% (up from 16.4%) |
| RN vacancy rate | 8.6% (new formula, not directly comparable to prior years) |
| Time to recruit an experienced RN | 78 days (down from 83) |
| Unfilled RN positions per average hospital | 43 FTEs |
| Average cost of turnover per bedside RN | $60,090 |
| Cost of each 1% change in RN turnover | About $295,000 per year |
| Average travel nurse cost | $91.23 per hour, versus $59.46 per hour for a staff RN including benefits |
NSI also reports that 73.5% of hospitals projected lower travel staff use, yet travel and agency staffing remained a top strategy for covering shortages.
Why does filling a hospital RN role still take 78 days?
NSI reports the 78-day number but does not break it into stages. What follows is Boundee's reading of where the time sits, not a finding from the report.
Sourcing and screening improved. That is where hospitals invested, and it is plausibly where the five days came from. After a candidate clears screening, the next steps belong to a clinical leader: review the candidate, decide on an interview, process the result, and approve the offer. A nurse manager's day is organized around patient care, so each of those decisions competes with staffing call-outs and bedside coverage.
We call the wait that builds up at those steps hiring decision latency. It is different from a sourcing problem because no additional candidates fix it. The candidate is already there. The pipeline is waiting.
A longer vacancy has a cost beyond the open role. The nurses who remain cover the gap, workload rises, and the next person considers leaving. With each 1% of turnover costing the average hospital about $295,000 a year, vacancy length and retention are linked costs.
What can hospitals control while supply recovers?
Hospitals cannot change where nurses choose to work. They can change how long a qualified candidate waits. Three practices tend to help:
- Measure time to decision at each stage, not only total time to hire. The 78-day average hides which stage is slow.
- Set and track response-time expectations for hiring managers, such as how quickly a candidate review or offer approval should be answered.
- Bring the request to the manager's workflow, on mobile and outside the ATS inbox, so a decision takes a minute rather than waiting for the unit to stabilize.
Related reading: Why nurses are still leaving in 2026, 78 days to hire an RN: what the 2026 NSI report says, The offer approval bottleneck, and Hospital labor costs and what hiring speed can change.
Frequently asked questions
Is there still a nursing shortage in the U.S. in 2026?
Yes, though it is narrowing nationally. HRSA projects RN supply will meet 92% of demand in 2028 and 97% by 2038, with the largest gaps in nonmetro areas and states such as California, North Carolina and Georgia. Hospitals continue to report an average of 43 unfilled RN positions (NSI 2026).
Why are nurses leaving hospitals even though the RN workforce has grown?
Total RN employment grew, but the hospital share fell from 60.3% to 57.8% (JAMA Health Forum, 2024). Hospital RN turnover was 17.6% in 2025 (NSI), and nearly 40% of RNs told NCSBN they plan to leave the field within five years, citing retirement, stress and burnout.
How long does it take to hire an experienced RN?
The average is 78 days, down from 83 the year before (NSI 2026 report).
How much does it cost when a hospital loses an RN?
The average cost of turnover for a bedside RN is $60,090. Each 1% change in RN turnover costs or saves the average hospital about $295,000 a year (NSI 2026).
What is a qualitative nurse shortage?
It is a shortage of nurses with the specific experience hospitals need, even when the total number of nurses is growing. Peter Buerhaus used the term to describe a gap in experienced nurses able to care for increasing numbers of older hospital patients.
What is hiring decision latency?
It is the time a candidate waits between completing one hiring step and a decision-maker acting on the next. In hospitals, it usually sits with clinical leaders who review candidates and approve offers while running a unit.
Sources
- Auerbach DI, Buerhaus PI, Donelan K, Staiger DO. "Projecting the Future Registered Nurse Workforce After the COVID-19 Pandemic." JAMA Health Forum. 2024;5(2):e235389. https://doi.org/10.1001/jamahealthforum.2023.5389
- Brandeis University Heller School. "Post-Pandemic Recovery in the U.S. Registered Nurse Workforce." February 2024. https://heller.brandeis.edu/news/items/releases/2024/auerbach-donelan-nurse-workforce-study.html
- HRSA National Center for Health Workforce Analysis. Nurse Workforce Projections, 2023-2038. December 2025. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/nursing-projections-factsheet.pdf
- NSI Nursing Solutions, Inc. 2026 NSI National Health Care Retention & RN Staffing Report. March 2026. https://www.nsinursingsolutions.com/documents/library/nsi_national_health_care_retention_report.pdf
- Becker's Hospital Review. "40% of nurses eye exit by 2029: 5 findings from NCSBN's new workforce report." April 17, 2025. https://www.beckershospitalreview.com/workforce/40-of-nurses-eye-exit-by-2029-5-findings-from-ncsbns-new-workforce-report/
- Buerhaus PI. "No Silver Bullet: Diagnosing Hospital Workforce Crisis." Hospitals In Focus, Federation of American Hospitals. 2022. https://fah.org/podcasts/no-silver-bullet-diagnosing-hospital-workforce-crisis-with-peter-buerhaus