Why Licensed Nurses Leave the Workforce and What Could Bring Them Back

This article is part of Nurse.org’s Nursing Workforce Benchmark, a new research series analyzing nursing workforce strain across all 50 states. This article examines the nurses who hold a license but aren’t working in nursing: who they are, why they left, and what it would take to bring some of them back.

Every state has nurses who hold an active RN license but aren’t working in nursing. The raw number sounds promising. If you could bring even some of them back, the staffing crisis would ease. But the data from four states with unusually detailed public records tells a more complicated story. The gap between licensed and not-working isn’t a reserve of available nurses. It’s a mix of permanent exits, career changes, and a smaller contingent: nurses who left because of conditions and might return if those conditions changed.

That last group is the one worth understanding.

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What the data from four states actually shows is a gap that breaks into distinct categories.

Nurse.org Nursing Workforce Benchmark: Where Non-Working Licensed RNs Are

Source: Nurse.org Nursing Workforce Benchmark. California: HCAI 2024. Texas: TX BON FY2024. Michigan: MDHHS/MPHI 2024. North Carolina: NCBON August 1, 2026. *California licensed total not cited; the employed-RN figure is the reliable reference point.

California’s breakdown is the most detailed, and it sets realistic expectations for every state. Of approximately 60,000 California-resident nurses not working in nursing:

• More than 40% are retired, not coming back regardless of conditions
• 7% say they won’t return, not retired. Just done.
• 18% are actively seeking nursing work or plan to return soon
• 18% are undecided, people who haven’t closed the door but haven’t opened it either

That leaves roughly 35%, about 21,000 nurses statewide, who are either actively seeking nursing work or say they plan to return. That’s a real number. It’s not the 59,485 the raw gap suggests. And most of those 21,000 nurses left for reasons that are, in principle, addressable.

The nurses most likely to come back are the ones who didn’t choose to leave nursing. They chose to leave an environment that had become unsustainable.

In Nurse.org’s 2026 State of Nursing Survey, 43% of nurses said they were considering leaving the bedside entirely, and 41% said the main reason they were still in nursing was financial. Only 8% said staffing on their unit had improved over the past year, while 42% said it had gotten worse. These are the conditions that push people out. They’re also the conditions keeping potential returners away. 

The nurses who left look at those same conditions and make a different calculation. They’re not waiting for a better job posting. They’re watching to see if the conditions change.

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Mississippi offers the clearest data on what recovery actually looks like. Its vacancy rate fell from 24.5% in 2022 to 8.8% in 2025. Statewide vacant RN positions dropped from 3,038 to 1,091, nearly 2,000 real positions filled in three years.

Nurse.org Nursing Workforce Benchmark: Mississippi RN Vacancy Recovery, 2019-2025

Source: Nurse.org Nursing Workforce Benchmark. Mississippi Hospital Association Hospital Nursing Workforce Survey, 2019-2025.

Mississippi’s recovery didn’t happen because new nurses appeared from nowhere. It happened because conditions changed. Vacancy rates dropped, stabilization efforts took hold, and the cycle of short-staffing driving more departures began to reverse. The Mississippi Hospital Association has tracked this data continuously for nearly two decades. That continuity is why the recovery is visible and verifiable.

Calling inactive licensed nurses back requires understanding why they left. Retirement is permanent. Career change is largely permanent. But the nurses who left because of working conditions are watching the same conditions they left: mandatory overtime, inadequate staffing, lack of support for new graduates, wages that didn’t reflect the scope of responsibility. The nurses who are still showing up, shift after shift, under conditions that too many of them describe as unsustainable, deserve better data than most states currently produce.

The nurses who have left and might return are looking at the same conditions and making the same calculation. The pool is real. It’s just not as large as the license count implies. Bringing them back requires changing what they left.

Read more from the Nursing Workforce Benchmark series:

🤔 If you’ve left nursing or know a nurse who has, what would it actually take to bring them back? Share your perspective in the comments below.

Methodology 

California figures from HCAI Survey of California Registered Nurses (2024). The California licensed RN count is not cited; the employed-RN figure (355,249) is the reliable reference point. Texas: TX BON FY2024 Annual Report. Michigan: MDHHS/MPHI 2024 Nurse Licensure Data. North Carolina: NCBON dashboard (August 1, 2026). Mississippi recovery data: Mississippi Hospital Association Hospital Nursing Workforce Survey, published annually since 2007. All figures reflect the most recent publicly available data.

Source: Nurse.org Nursing Workforce Benchmark.

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