About 800,000 nurses planning to leave the profession by 2027, data show

Nearly 100,000 registered nurses were estimated to have left the field during the COVID-19 pandemic and almost 800,000 intend to follow them out by 2027, according to a survey analysis released Thursday by the National Council of State Boards of Nursing (NCSBN).

Responses to the poll of more than 50,000 nurses suggest a net nursing workforce decline of 3.3% in the past two years, and a 2.7% decline in registered nurses (RNs) specifically, according to data published in the Journal of Nursing Regulation.

“The data is clear: the future of nursing and of the U.S. healthcare ecosystem is at an urgent crossroads,” Maryann Alexander, chief officer of nursing regulation at NCSBN, said in an accompanying release.

Of particular concern to NCSBN’s researchers were the recent and planned departures of nurses who were relatively new to the field. RNs with 10 or fewer years of experience accounted for almost 41% of the total drop-off of practicing RNs, they wrote. Another 15.2% said they planned to leave in the next five years, resulting in a net decline of 188,962 nurses.

On the other end of the spectrum, 44.8% of RNs with over 10 years of experience said they will likely leave in the next five years. This would subtract another 610,388 RNs from the workforce, according to the researcher's nationally weighted estimate.

Comparable declines also came among the survey’s support nurse respondents. Per the data, 4.2% (or an estimated 33,811) of licensed practical nurses/licensed vocational nurses left the workforce in the past two years—an issue compounded by “considerable and somewhat unprecedented disruptions” to prelicensure nursing education programs during the past few years.

The departures are likely tied to feelings of burnout and exhaustion reported by many of the responding nurses, researchers wrote.

Sixty-two percent of the sample said their workload had increased during the pandemic and others reported feeling emotionally drained (50.8%), fatigued (49.7%) or burned out (45.1%) at least a few times each week, according to the survey results. Free responses solicited from the nurses also frequently mentioned keywords related to COVID-19 stress (20.2%), unsafe staffing or work environments (23.2%), underappreciation (22.6%) and compensation (17.5%).

“The pandemic has stressed nurses to leave the workforce and has expedited an intent to leave in the near future, which will become a greater crisis and threaten patient populations if solutions are not enacted immediately,” NCSBN’s Alexander said. “There is an urgent opportunity today for health care systems, policymakers, regulators and academic leaders to coalesce and enact solutions that will spur positive systemic evolution to address these challenges and maximize patient protection in care into the future.”

NCSBN fielded its 2022 National Nursing Workforce Survey via direct mail outreach for a six-month period beginning April 11, 2022. About half of the respondents were RNs and many self-identified as female (92.5%), non-Hispanic (95%) and white (79.9%). The average age was 51 years and the median level of experience was 19 years.

NCSBN said the survey data subset used for the analysis was weighted to create a nationwide estimate of the departures and trends. The group also noted that its findings are in line with other warnings from industry analysts and warrant prompt attention from policymakers.

“Should some of the projections derived from this analysis and mirrored by government data and market research come to pass, the outlook for the U.S. healthcare system could be dire,” NCSBN’s researchers wrote. "Fortunately, projected intent to leave or retire is not static but rather a manipulable outcome depending on policymakers’ future decisions.”