The Solution to the Nursing Shortage in the U.S. in 2023

The mounting challenge of a nursing shortage in the U.S. healthcare landscape is reaching a tipping point. According to a 2023 report from, a staggering 91% of nurses are convinced that the situation is deteriorating, while 79% claim that their workplaces are not sufficiently staffed. Hospital executives are equally concerned, with 90% citing the nurse shortfall as their primary operational dilemma.

The burnout induced by the COVID-19 pandemic is a major factor behind the exodus of nurses. Research from NCSBN, an entity overseeing nursing regulation, indicates that close to 100,000 registered nurses (RNs) left the profession within two years post-pandemic, attributing it to stress and early retirements. The forecast looks equally bleak; by 2027, another 610,388 RNs are considering exiting the workforce. In the immediate years, approximately one in five RNs is projected to either retire or switch careers.

Yet, the demand for nurses isn’t waning. The U.S. Bureau of Labor Statistics foresees an annual average of 203,200 RN job openings over the coming decade.

McKinsey’s estimations paint a grim picture for the near future. By 2025, the U.S. could experience a shortfall ranging from 200,000 to 450,000 nurses in direct patient care roles, translating to a 10-20% gap. The long-term outlook is even more troubling due to the aging population, particularly the baby boomers. By 2030, over 21% of Americans will be aged 65 or older, thus increasing the demand for healthcare services while the supply of nurses remains stagnant or even declines.

The repercussions for healthcare quality are disconcerting. Studies consistently reveal that a reduced nurse-to-patient ratio increases mortality rates, medication errors, infection rates, and incidents of pneumonia. Moreover, this places existing nurses under immense stress, perpetuating a vicious cycle of burnout that exacerbates the nursing shortage.

Increasing domestic nurse education is not a quick fix. As pointed out by the American Association of Colleges of Nursing, in 2021 alone, U.S. nursing schools had to turn away 91,938 qualified candidates due to limitations like faculty shortage, inadequate clinical sites, and budget constraints.

The option of encouraging more foreign-trained nurses to immigrate to the U.S. emerges as a viable solution. Countries like the Philippines and India produce a surplus of well-qualified nurses, aiming for them to work abroad and send money back home. Hospitals in the U.S. are already increasingly reliant on such professionals.

However, a bottleneck exists in the form of U.S. visa regulations. Only nurses who applied for green cards before June 2022 are currently eligible for visa interviews, creating an imbalance between demand and supply. Processing delays are likely to worsen the situation, possibly delaying the arrival of new nurses until at least 2025.

To prevent an unmanageable crisis, immediate intervention is required.

Currently, only 140,000 employment-based green cards are available yearly, which is insufficient to meet the growing demand.

Streamlining the immigration process for nurses is critical for mitigating the looming and ever-intensifying nursing shortage that puts the well-being of patients at significant risk. Congress must act swiftly to adjust green card limitations and clear visa backlogs to stave off a healthcare disaster.