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The balance in the current supply and demand for nurses varies both within and among states, and the predicted shortage is defined by several new variables. Some of these are unique to nursing, while others are also driving the projected declines in other licensed professions. The breadth and combination of factors is what makes this nursing shortage uniquely challenging.

The Factors Behind the Uneven Distribution and Shortage of Nurses

The predicted nursing shortage is characterized by a complex array of factors that, when combined, point to a serious and stubborn shortage.

The current average age of registered nurses in New York State is 47--two years older than the national average, and only two years below the average retirement age. This indicates that an exodus of nurses is on the horizon.

As the country's 78 million "baby boomers" age, more Americans will be retiring than joining the work force. By the year 2020, the total population of New York is projected to grow by 7%--while the population over 65 is projected to grow by 24%. As a result, shortages are predicted in a number of health professions (and in the work force in general). Shortages in other healthcare professions are likely to further contribute to the burdens facing available nurses.

The female population has been the traditional source of nursing staff (almost 95% of RNs are women), yet women today are much more likely to work as professionals in business, government, and health sectors that once had been virtually closed to them. These rewarding career options offer alternatives to a nursing career.


As career options increase, so too does the perception of nursing as a less desirable career choice. Stressful working conditions--night and weekend shifts, the risk of exposure to contagions, less time for patient care, and pressure to do more with less--have undercut the perception of nursing as an attractive career choice. According to the results of a national survey conducted by the American Nurses Association (ANA), nurses themselves question their career choice (see chart).

While the nursing profession has a higher percentage of minority representation than most other licensed professions, minorities are still underrepresented among nurses, particularly RNs. Nationally, 72% of the general population is non-minority white, but 87% of RNs are non-minority white. As the nation becomes increasingly diverse, the nursing work force does not reflect that diversity in race, ethnicity or gender. It currently draws from only a portion of the population.


In predicting the impact of managed care, the healthcare industry moved to contain costs through consolidations, layoffs, and financial reengineering. The resulting staff changes and the movement of patients to home care and ambulatory settings also caused some nurses to leave the nursing work force voluntarily or otherwise--and they are not returning now as demand escalates.

The cutbacks also caused fewer people to apply to nursing programs, and fewer faculty were hired. Recent data from the National League for Nursing indicate declines in enrollments in all types of entry-level nursing programs. A study by the American Association of Colleges of Nursing found that enrollments in entry-level baccalaureate nursing programs decreased by 4.6% in 1999 and by another 2.1% in 2000--the fifth and sixth consecutive drops.

The lack of faculty limits the number of nurses that educational programs can produce. In turn, fewer nurses are then available to choose an academic career, further increasing the faculty shortage. In this way, the shortage perpetuates itself. Nurses with graduate degrees are also now more likely to have multiple opportunities in healthcare, including administrative, entrepreneurial, clinical research, and other financially rewarding positions.    continue