Healthcare delivery systems rely on a well-prepared and adequately sized registered nurse (RN) workforce. The U.S. RN workforce decreased by more than 100,000 in 2021 during the COVID-19 pandemic—a far greater single-year drop than observed over the past four decades. The implication for the longer-term growth of the RN workforce is unknown.

Auerbach, et al. (2024) sought to describe recent trends in RN employment through 2023 and forecast the growth of the RN workforce through 2035.

The final sample included 455,085 RN respondents aged 23 to 69 years. After a sharp decline in 2021, RN employment recovered, and the total number of FTE RNs in 2022 and 2023 was 6% higher than in 2019 (3.35 million vs 3.16 million, respectively). Using data on employment, education, and population through 2022, the size of the RN workforce was projected to increase by roughly 1.2 million FTEs to 4.56 million by 2035, close to pre-pandemic forecasts. Growth will be driven primarily by RNs aged 35 to 49 years, who are projected to compose nearly half (47%) of the RN workforce in 2035, up from 38% in 2022.

In this study, the rebound in the total size of the US RN workforce during 2022 and 2023 indicates that the earlier drop in RN employment during the first 2 years of the COVID-19 pandemic was likely transitory. Updated forecasts of the future RN workforce are very close to those made before the pandemic.

As the authors note, "The number of employed RNs (full-time equivalents [FTEs]) in the U.S. nearly tripled from 1.1 million in 1982 to 3.2 million in 2019, an increase from 5.0 to 9.6 RNs per 1000 U.S. residents. However, during the COVID-19 pandemic, the RN workforce has been in flux, and its continued growth is uncertain. The extensive needs of the first 2=two years of the pandemic in 2020 and 2021 placed extraordinary demands on healthcare workers and organizations, particularly for nurses who were often at the center of this crisis. Shortfalls in RN staffing in elective, acute, and long-term care services were widely reported, as were reports of RN burnout, furloughs, early retirement, and workplace dissatisfaction."

Auerbach DI, et al. Projecting the Future Registered Nurse Workforce After the COVID-19 Pandemic. JAMA Health Forum. 2024;5(2):e235389. doi:10.1001/jamahealthforum.2023.5389