Nurse.org’s Nursing Workforce Benchmark: Where the Nursing Staffing Crisis Is Worst
This article introduces Nurse.org’s Nursing Workforce Benchmark, a new research series analyzing nursing workforce strain across all 50 states using hospital staffing surveys, state workforce projections, and federal shortage designations.
Ask most nurses whether there’s a staffing crisis and you’ll get a complicated answer. They’ll tell you that there are plenty of nurses. There are just not enough who are willing to keep working under the conditions they’re being asked to accept. Mandatory overtime. Unsafe ratios. Pay that doesn’t reflect the responsibility nurses carry.
That pushback is showing up in the data. In Nurse.org’s 2026 State of Nursing Survey, 23% of nurses said they were likely to leave the profession within the next year, up from 15% in 2025. 43% said they were considering leaving the bedside entirely. And 41% said the main reason they were still in nursing was financial — not because the work felt sustainable, but because they couldn’t afford to leave.
The Nurse.org Nursing Workforce Benchmark brings together hospital staffing reports, state workforce studies, and government shortage designations. State by state, source by source. What it found is that the strain is real and uneven, easing in some states as pandemic-era vacancy rates recede, persistent or worsening in others, and in too many states invisible because the public data to see it simply isn’t there.
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The table below ranks 30 states by documented nursing workforce strain, from where the evidence of a crisis is strongest to where it’s real but less severe. 20 states couldn’t be ranked because no publicly accessible employer data exists to measure them; that gap is covered in the section below.
Confidence tiers reflect data quality: High means multiple independent sources confirm the strain; Medium means one strong source points to it.
Nurse.org’s Nursing Workforce Benchmark: State Rankings by Shortage Severity
| Rank | State | Score | Confidence | Primary Signal |
|---|---|---|---|---|
| 1 | California | 84.1 | High | 61,141 projected RN shortage by 2033; largest workforce nationally |
| 2 | North Carolina | 80.9 | High | 12,500 RN shortage by 2033; 10,000 deficit even with 10% more graduates (NC DHHS) |
| 3 | Wisconsin | 79.1 | High | 18% projected gap; 12,200 RN shortfall by 2050 (WI DWD state forecast) |
| 4 | Virginia | 72.8 | High | 291% shortage growth above 2023 baseline by 2038 (RAND/VHWDA) |
| 5 | Louisiana | 72.2 | High | 17.5% vacancy; 4,579 open positions documented |
| 6 | Texas | 71.8 | High | 16.4% vacancy (2024); state-commissioned data (DSHS) |
| 7 | Alaska | 67.2 | Medium | 20% hospital RN vacancy (AHHA 2025); 143 days to fill; 29% in long-term care |
| 8 | Arizona | 66.8 | Medium | Projected 28,100 RN shortage (HRSA NCHWA); figure reflects HRSA analysis published in 2024 |
| 9 | Pennsylvania | 66.5 | Medium | 19% statewide RN vacancy (HAP 2025); 21% rural |
| 10 | Maryland | 66.4 | High | 16.1% vacancy; 5–6 points above the national average since 2021 (MNWC FY2024) |
| 11 | Washington | 66.3 | Medium | 13,000+ RN shortfall cited in WA DOH Hospital Staffing report |
| 12 | Tennessee | 64.1 | Medium | 8,500 projected RN shortfall by 2035 (THA) |
| 13 | New York | 64.0 | High | 12% vacancy; 14,000+ annual openings projected |
| 14 | South Carolina | 58.2 | Medium | 8,210 projected RN shortfall by 2035 |
| 15 | Oklahoma | 57.4 | Medium | 17.0% vacancy; 38.6% Med/Surg specialty rate (OHA 2024) |
| 16 | Georgia | 56.8 | Medium | 21% projected shortfall by 2035 (HRSA NCHWA) |
| 17 | Oregon | 55.0 | Medium | Record-high licensed supply (~73,000 RNs); chronic vacancies in LTC, rural, and community settings driven by retention — 30%+ first-year turnover (OCN, 2024) |
| 18 | Nebraska | 53.7 | Medium | 3,238 projected RN shortfall (NE Center for Nursing) |
| 19 | Minnesota | 53.4 | Medium | 11.1% vacancy (2024); down from 14.7% (2023) |
| 20 | New Mexico | 50.9 | Medium | 3 converging projections; 8,000+ RN/LPN gap by 2030 |
| 21 | New Jersey | 50.1 | Medium | 13.4% RN vacancy (2021, NJHA); HRSA projects 24,450+ shortage by 2036 |
| 22 | New Hampshire | 47.5 | Medium | 16.8% RN vacancy (2025, NHHA) |
| 23 | Missouri | 46.2 | Medium | 10.9% RN vacancy (CY2025, MHA); RN turnover 18.9% |
| 24 | Kentucky | 45.4 | Medium | 11.5% RN vacancy (CY2024, KHA), down from 16.5% (2023) |
| 25 | Florida | 40.9 | Medium | 10% RN vacancy (FHA 2025) |
| 26 | Maine | 40.8 | Medium | 10.1% RN vacancy (2026, MHA) |
| 27 | Mississippi | 37.0 | High | 8.8% vacancy (2025); recovered from 24.5% (2022) |
| 28 | Kansas | 34.9 | Medium | Combined RN+LPN+CNA vacancy only (KHA; 2,055 FTE); no RN-specific rate available |
| 29 | Massachusetts | 33.6 | Medium | 10% vacancy (MHA Nov 2025) |
| 30 | Hawaii | 28.7 | Medium | 10% RN vacancy (HSCN 2026); 1,043 open positions |
Source: Nurse.org Nursing Workforce Benchmark. All figures reflect the most recent publicly available data at time of analysis.
North Carolina: The Pipeline Paradox
If you’ve heard that training more nurses will solve the staffing crisis, North Carolina’s data complicates that argument. The state projects a shortage of 12,500 RNs by 2033, according to a 2024 NC DHHS commissioned report. What makes it striking is what the analysis found when it modeled the most common policy response: even a 10% increase in nursing graduates would still leave a deficit of more than 10,000 RNs. Training more nurses is necessary. It isn’t enough to close a gap this large.
Virginia: The Steepest Trajectory
Virginia ranks #4 on the Benchmark, with the steepest projected trajectory of any state in the dataset. A RAND Corporation study commissioned by the state projects the nursing shortfall will grow 291% above its 2023 level by 2038 if nothing changes. The same study found that a combination of targeted interventions could eliminate the shortage through 2030. Virginia’s story is what acceleration looks like, and what could prevent it.
Maryland: Persistent Above the National Average
Maryland ranks #10 on the Benchmark with a 16.1% hospital RN vacancy rate. What makes it notable is the trend. According to the Maryland Nursing Workforce Center FY2024 Fact Sheet, Maryland has run 5-6 points above the national average every year since 2021. The pandemic peak was 18.8% in FY2022. The national rate has recovered to roughly 10%. Maryland’s has come down but remains elevated. That persistence, not a spike but a new sustained level, is the signal worth watching.
Oklahoma: A Specialty-Level Signal
Oklahoma’s statewide RN vacancy sits at 17.0%, which alone places it in the upper tier of the dataset. The figure that stands out is specialty-level: 38.6% RN vacancy in Medical/Surgical units, the highest single-specialty rate found in the Benchmark dataset. Med/Surg is the backbone of hospital nursing, and the pipeline tells a concerning story: the number of nurses holding Med/Surg certification has fallen 13% since 2021, according to the Nurse.org Nursing Certification Index.
Mississippi: What Recovery Looks Like
Mississippi sits toward the lower end of the ranked table at #27, and that’s exactly right. Its current vacancy rate of 8.8% reflects genuine improvement, not a data gap. Three years ago, Mississippi’s vacancy rate was 24.5%, one of the worst in the country during the pandemic peak. Statewide RN vacant positions fell from 3,038 in 2022 to 1,091 in 2025, nearly 2,000 real positions filled. The recovery is visible because the Mississippi Hospital Association has tracked the same data continuously for nearly two decades. That’s not a single data point. It’s a verified trend.
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Why 20 States Couldn’t Be Ranked, and What That Tells Us
20 states don’t appear in the ranked table. That’s not an oversight.
To be ranked, a state needed either a hospital-reported vacancy rate or a state workforce study. Without at least one of those, a ranking would be built on government shortage classifications alone, which tell us where resources are thin but not how many nursing positions are going unfilled.
Some of those 20 states almost certainly have significant workforce challenges. Ohio, Illinois, and West Virginia all show strain signals on available data. But without a clean, publicly reported vacancy figure, putting a rank next to their name would imply a precision we don’t have.
West Virginia is the clearest illustration. The state has more registered nurses per 1,000 jobs than any other state in the country, according to BLS occupational data. It still couldn’t be ranked. West Virginia has no publicly accessible hospital-reported vacancy rate. The 2022 WV Nursing Shortage Study Commission Report documents the data gap directly. The workforce strain that nurses in West Virginia experience every shift is, in effect, invisible to anyone looking at the numbers.
The states that have invested in public workforce data, like Mississippi, Louisiana, Maryland, and Texas, can see their workforce clearly. The states that haven’t can’t. That gap is itself a finding.
Nurse.org’s Nursing Workforce Benchmark: States That Couldn’t Be Ranked
| State | Why Unranked |
|---|---|
| Alabama | Hospital association survey not publicly accessible |
| Arkansas | Primary source (ACN 2024) does not contain a verifiable RN shortage projection, only RN workforce growth |
| Colorado | Projected shortage figures unverifiable from public primary source |
| Connecticut | Licensure and workforce census data only |
| Delaware | Licensure and workforce census data only |
| Idaho | Adequacy model output only; not a measured employer vacancy rate |
| Illinois | Licensure and workforce census data only; no hospital staffing data |
| Indiana | Licensure and workforce census data only |
| Iowa | Projection data only; no hospital staffing figures |
| Michigan | MHA publishes data but no computable vacancy rate (no denominator in 2025 survey) |
| Montana | Licensure and workforce census data only |
| Nevada | Hospital association reports exist but no statewide RN vacancy rate is published publicly |
| North Dakota | Combined nursing vacancy only; no RN-specific rate available |
| Ohio | No hospital staffing survey found in public sources |
| Rhode Island | No hospital staffing survey found in public sources |
| South Dakota | No hospital staffing survey found in public sources |
| Utah | Licensure and workforce census data only |
| Vermont | No publicly accessible statewide RN vacancy rate or workforce projection identified |
| West Virginia | No publicly accessible hospital vacancy rate; turnover data only. See WV Nursing Shortage Study Commission Report |
| Wyoming | Most recent public survey predates 2010 |
Source: Nurse.org Nursing Workforce Benchmark.
The number next to a state’s name is a proxy. It reflects what the data shows, not everything nurses already know about what’s happening on the floor.
Vacancy rates measure empty positions. They don’t measure the nurse who stayed but is working a double. They don’t measure the new graduate pushed into independent practice two weeks into orientation. They don’t capture what it feels like to be a charge nurse covering two units because there’s no one else.
What the rankings can tell you: where the documented evidence of strain is strongest, and where the data to even measure it doesn’t exist. Both are worth knowing.
Read more from the Nursing Workforce Benchmark series:
🤔 What does staffing look like in your state right now? Share your experience in the comments below.
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How the Nurse.org Nursing Workforce Benchmark Measures Workforce Strain: The Benchmark measures the strength of publicly available evidence of nursing workforce strain in each state. It is not a count of nurses or a projection of future need.
Three scored data layers:
- Hospital staffing reports (47%): Hospital-reported open RN positions as a share of total budgeted positions, from state hospital association surveys and state-commissioned studies. Sources graded A (multi-employer or state-commissioned) or B (hospital association survey).
- State workforce projections (41%): State-commissioned or peer-reviewed studies projecting RN supply and demand.
- Federal shortage designations (12%): HRSA Health Professional Shortage Area designations. A supporting indicator, weighted lower than employer-side data.
Coverage rule: States with at least one scored layer are ranked. 20 states could not be ranked because no publicly accessible primary data could be found — a finding in itself.
Confidence tiers: High = Grade A employer-side data from multiple independent sources. Medium = one strong source points to strain. Low = federal records only.
Methodology developed and maintained by Nurse.org research staff. The Benchmark will be updated as new state data is published. Rankings and scores will change as hospital associations release new workforce surveys and state projections are revised.
8/6/26 update: Revised following source review. Pennsylvania updated to #9 based on HAP 2025 data. Oregon signal updated to reflect OCN characterization of the state’s nursing workforce.
Nurse.org Analysis
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Published on
August 6, 2026
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