Nursing Shortfall: The Hidden Opportunities in a Crisis

Welcome to NurseCafe. Steaming with wisdom, sweetened with support, and guaranteed to keep you more alert than hospital coffee ever could.

In today’s email:

• The Nurse Shortages Are Still Here: The lasting effects of COVID-19 have continued to drive an ever-increasing shortage of nurses.

• Around The Web: Our worst nightmare is coming true…

• Per Diem vs Travel: Per diem nursing may be replacing a lot of the travel assignments that were seen in 2024.

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WHAT’S HAPPENING

There are still not enough nurses

The Miami Herald reported that a McKinsey 2022 prediction of a nursing shortfall between 200,000 and 450,000 RNs by 2025 has proven accurate, with recent Department of Health and Human Services data confirming a national deficit of approximately 295,800 nurses. While RN supply increased by 1% between 2022-2025, demand grew three times faster at 3%.

Recent analysis from Vivian Health reveals this shortage isn't evenly distributed. By 2037, ten states will face the most severe shortages, with North Carolina and Washington topping the list at 22% shortfalls, followed closely by Maryland (20%), South Carolina and Michigan (both 19%).

The geographical disparity is striking. Rural areas are projected to experience a 13% shortage compared to just 5% in metropolitan regions. Even more telling is the contrast between states: while Wyoming expects an oversupply of 77% by 2037, Idaho's current 38% shortage will improve but still remain at 17%.

The JAMA Health Forum noted a post-pandemic recovery in nursing workforce numbers, with projections to reach 4.56 million nurses by 2025. However, even with gradual improvement, HHS and HRSA forecast that a national shortage will persist through 2037, though decreasing from 10% to 6% over that period.

What This Means for Nurses

For working nurses, these statistics tell a complex story. The continued shortage suggests sustained demand for nursing services, potentially maintaining higher compensation and flexible work arrangements. However, the uneven distribution reveals why some nurses report vastly different experiences depending on their location.

The shortfall also explains the increasing recruitment of international nurses, expansion of nursing education programs, and the growing emphasis on retention strategies in many healthcare systems. For nurses considering relocation, the state-by-state projections could serve as a valuable career planning resource and avoiding areas with oversupply while leveraging opportunities in high-demand regions.

For the profession as a whole, these numbers underscore the importance of addressing systemic issues that contribute to shortages: burnout prevention, workplace safety, career advancement opportunities, and competitive compensation will remain critical priorities for healthcare organizations seeking to maintain adequate staffing.

Sources: Department of Health and Human Services, Health Resources and Services Administration, Vivian Health, JAMA Health Forum, McKinsey & Company

AROUND THE WEB

☕️ Coffee prices are rising: This one hits us where it hurts…

🤖 Ai is helping SNFs screen referrals: ExaCare is a company looking to streamline referrals.

❤️ We all could use this kind of support: A father & daughter read her NCLEX results together.

🚗 Taxes for 2024 are almost due: Did you track all your mileage for deductions while working independently with an agency?

Is per diem replacing travel assignments

Healthcare staffing is undergoing a significant shift as per diem nursing rapidly replaces travel nursing nationwide. This trend, accelerated in the post-pandemic landscape, reshapes how facilities address staffing shortages and how nurses approach their careers.

"We have essentially been able to replace travel labor with [per diem], and that typically is better from almost every metric," notes Seth Lovell of SSM Health, highlighting how their per diem nurses are familiar with systems and often work near full-time hours without the premium costs.

Industry projections reflect this surge, with per diem staffing expected to reach $5.4 billion in revenue by year-end and climb to $5.7 billion in 2025. Digital platforms from companies like ShiftMed, CareRev, and Incredible Health have accelerated adoption by seamlessly connecting nurses to available shifts.

For nurses, the appeal is clear: maintain your home base while enjoying flexible scheduling that accommodates family responsibilities, education, or secondary income streams. The ability to pick up shifts at facilities you're already familiar with offers both professional comfort and the variety many seek.

While shift cancellations remain a challenge—nurses often register with multiple competing facilities—the industry continues to adapt with innovative solutions.

As we near the end of March 2025, per diem's ascendance appears firmly established, offering a win-win that balances hospital cost control with the scheduling freedom nurses increasingly demand in today's healthcare landscape.

QUOTE OF THE WEEK

"The trained nurse has become one of the great blessings of humanity, taking a place beside the physician and the priest." - William Osler, one of the founding professors of Johns Hopkins Hospital.

That’s it for this week’s newsletter. If you have any feedback or story you would like covered, reply to this email. We read every response. 🤓 

See you next Monday! ☕️