The Oncoming Nurse Workforce Shortage in North Carolina

Blog | November 9, 2021

By Brieanne Lyda-McDonald


The pandemic has been overwhelming for health care workers, and nurses have borne a heavy burden of caring for the sick and dying. A recent survey of acute and critical care nurses by the American Association of Critical Care Nurses found that:


  • 92% believe the pandemic has depleted nurses at their hospitals and, as a result, their careers will be shorter than they intended
  • 66% feel their experiences during the pandemic have caused them to consider leaving nursing


The dire issues of burnout and fatigue brought on by the pandemic add to the existing risk of serious nursing workforce shortages in coming years. A new analysis by the Cecil G. Sheps Center for Health Services Research, in partnership with the NC Board of Nursing and Strategic Modeling Analysis & Planning, points to the potential shortage of nearly 12,500 registered nurses and over 5,000 LPNs by 2033.


The new analysis, called NC Nursecast, is a “web-based, interactive workforce model that forecasts the future supply and demand for Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) in North Carolina. NC Nursecast gives policy makers, legislators, educators, professional organizations, employers, and other nursing stakeholders the data they need to understand and plan for the future.”


While the largest shortfalls, numerically, will be in hospitals, supply of RNs for nursing homes, extended care, and assisted living facilities will fall short of demand by nearly 31% in 2033 according to the NC Nursecast analysis. This comes as the aging population will be growing in coming decades.


So, what are we to do? Many might suggest that an increase in new training programs is the solution. Despite concerns that the pandemic would dissuade people from enrolling in nursing programs, the American Association of Colleges of Nursing found that enrollment in baccalaureate-level registered nursing programs rose by 5.6% in 2020. Yet, with that increase, over 80,000 qualified applicants were turned away from nursing programs, mostly due to “shortage of clinical sites, faculty, and resource constraints.” And of those, 16% were for masters and doctoral programs, an important pipeline for potential nurse faculty.


Similarly, “faculty and preceptor shortages in North Carolina, along with limited clinical site availability and physical space capacity, constrain the number of students that can be admitted to nursing programs.”


In other words, we won’t be able to train our way out of the oncoming issue of a nurse workforce shortage. As Dr. Erin Fraher, director of the Program for Health Workforce Research & Policy, puts it, “Expanding enrollment in nursing programs is important, but we also must focus on retention—cherishing our existing workforce—and recruiting nurses back into the profession.”


The lasting impacts of the pandemic – and the toll it has taken on our health care workers and system – are far from realized. Policy makers, health systems, educators, and many other nursing stakeholders will need to think deeply about how to solve the problem and avoid a potential crisis.