Pennsylvania may be short 20,000 nurses by 2026

[NRSKarenRN, BSN, RN]

I plan on retiring in 2027 after a 50 year nursing career in PA.  Who will replace me?

In 2001, I helped speared a Million Nurse March in Philadelphia sponsored by Philadelphia and Delaware County chapters of PA States Nurses Association (PSNA) covered by our local TV + print networks -- just 40 nurses attended.   Philadelphia area nursing program Deans were contacted, but not interested in this event.  However, there was a doubling of nursing school enrollments by 2010,  partially related to our PSNA efforts. With social media today, could probably gather 100's + AN's reach.   BUT until nursing instructors salaries significantly raised, few nurses willing to accept this roles pay + MSN  degree is needed to teach per PA Board Of Nursing  regulations..  Additionally, hospital facility clinical space is in short supply and not  available in many areas.  

In Delaware County, PA (population of 575, 000+ residents, - 5th largest PA county),  Crozer Health System  was bought by a for-profit hedge fund company in 2016: Prospect Medical Holdings  who declared bankruptcy in Texas court in January 2025 after taking $400 million in profits.  Prospect was sued for breach of contract related to that sale and for mismanagement last year by former Pennsylvania Attorney Michelle Henry.  They already closed 2 hospitals within past 5 years.  Now closing their last 2 hospitals:  Crozer-Chester Medical Center and Taylor Hospital-- losing  our only Trauma and Burn center, along with home health + hospice, and 4 outpatient centers affecting 3000 staff out of work within 30 days, This leaves just TWO  hospitals for FIVE nursing programs for clinical scheduling and patient care learning experiences. This afternoon 4/22/25:  Bankruptcy judge approves the closure of Delaware County's Crozer hospitals expected by  May 2nd, 2025.

This time it's college administrators sounding the alarm about the lack of nurses.  In the April 2022 Health Affairs article A Worrisome Drop In The Number Of Young Nurses, nurse researchers documented how the total supply of RNs decreased by more than 100,000 in one year—a far greater drop than ever observed over the past four decades.

Who will be there when I need care as reaching end of life?

Philadelphia Inquirer 4/18/2025

Expert Opinion: Pennsylvania may be short 20,000 nurses by 2026

Authors: Kymberlee Montgomery is senior associate dean of nursing at Drexel University; Mary Ellen Smith Glasgow is a professor of nursing at Duquesne University.

The shortage is the result of long-standing issues in education, workforce retention, and care delivery. What's being done to address it and what more could be done?

Quote

Imagine nearly every seat in Philadelphia's Wells Fargo Center — over 20,000 seats — are empty. That's the scale of Pennsylvania's projected shortfall of registered nurses by 2026, according to the Hospital and Healthsystem Association of Pennsylvania.

Hospitals in the state report an average 14% vacancy rate for registered nurses. In rural areas it is much higher.

This shortage, of course, is not just in hospitals. It also affects long-term care facilities, outpatient clinics, and home health agencies, which compete with hospitals for a limited pool of registered nurses, licensed nursing professionals, and nursing support staff.....

What caused the shortage?

Education bottlenecks: Nursing schools in Pennsylvania and nationwide turn away thousands of qualified applicants each year due to faculty shortages, limited classroom space, and scarce clinical placements. More than 65,000 qualified applications were turned away from U.S. nursing programs in 2023 alone, according to a report from the American Association of Colleges of Nursing.

A key issue is the lack of preceptors. Preceptors are experienced nurses who teach students in real-world settings.

Aging workforce: More than a third of Pennsylvania's registered nurses are 55 or older. ...many nearing retirement

Burnout and attrition: The COVID-19 pandemic worsened already high levels of stress, burnout, and mental health strain for nurses. Many left the profession early due to emotional exhaustion, family and personal health concerns, unsafe staffing ratios, moral injury, and lack of institutional support..

Uneven distribution: While Pennsylvania may have a sufficient number of licensed nurses on paper, those nurses don't all still work in the profession. And among those that do, they are not evenly spread across roles or locations. Rural hospitals, long-term care centers, behavioral health settings, and maternal-child health units are experiencing acute shortages.

Cost to patients

For patients and their families, the consequences of the nursing shortage are delayed care, fewer interactions with providers, and less time for compassionate, personalized support....

Effect on nurses

Over 600,000 registered nurses across the U.S. plan to leave the workforce by 2027, according to a 2023 analysis by the National Council of State Boards of Nursing.

Many cite stress as their reason for leaving the profession. New graduates often leave within their first two years, feeling unprepared for the emotional and operational realities of practice....

In Pennsylvania, the shortage has created a feedback loop. Understaffing increases pressure on those who remain....Meanwhile, some experienced nurses choose to retire early or shift into nonclinical roles for better schedules, slower pace, and improved quality of life.

This turnover erodes institutional knowledge, increases costs for onboarding and overtime, and limits the capacity to mentor incoming staff....

What's being done

To help address the problem, Gov. Josh Shapiro in March proposed a $5 million Nurse Shortage Assistance Program. If approved by the General Assembly, the program would cover tuition costs for nursing students who commit to working in Pennsylvania hospitals for three years after graduation.

HB 390 is also currently under review in the Pennsylvania General Assembly. It aims to establish a $1,000 tax deduction for licensed nurses who serve as clinical preceptors.....

What more could be done?

Continuing Title VIII Nursing Workforce Development Programs are another solution. These federal grants, reauthorized under the March 2020 CARES Act, help fund nursing pathways and the availability of high-quality nursing care for patients nationwide.

On April 1, the Trump administration announced plans to restructure the U.S. Department of Health and Human Services, and the future status of these programs is not yet known....

 

[Suzanne123]

Perhaps hospital conglomerates should stop firing RNs for not having a vaccine and/or not having a BSN. Hershey Medical Center fired me after 25 years of being RN for not having my BSN.Wait for it, as a PRN employee I received zero percent teased tuition and hours are not guaranteed. I have no empathy for the nursing shortage. These massive systems don't value nurses, force us to do things with our blood, sweat, and tears to reward themselves with bonuses, they don't want to pay, they call you off so you can't bonus pay, etc. And God forbid you actually get the week of vacation or day off that you want. We are treated like solve labor, it's worse than ever.

[kpilk]

How about letting your LPNs back into hospitals? 

[IntegrativeRN]

Heartbreaking issue all around! Burns me up to read about this Prospect conglomerate basically burning hospitals to the ground, nurses in the process, and creating a shortage of precepting sites to the point desperately needed new nurses can't even be accepted to schools who can't secure sites to teach them. Maddening! Is this happening elsewhere or is this just a Pennsylvania issue at the moment? I'm on the VA/NC border, left patient care in 2015 due to a health event and am considering coming back to active patient care seemingly umpteen bajillion years later. I'm on allnurses taking the temp of the profession as a whole and it's daunting! 1) A lot less nurses commenting these days shows me a cool off in passion for the profession 2) reading what is to come, & the issues facing current and prospective nurses...just mind boggling. Nursing never was for the faint of heart, but it is going to take exceptional grit and solutions to unravel the crisis already unfolding. 

[FolksBtrippin, BSN, RN]

 Philly has gotten so unsafe lately, that I won't work in the community there. I witnessed a shooting and was blown off by 911 dispatch. Meanwhile, cops are ready and available to tow your car at a moment's notice. The last time I worked in Philly, some dumb manager opened my desk drawer and confiscated everything in it to prove to me that I should lock my drawer. Meanwhile, patient safety, accurate charting, etc, meant nothing. That was my last day.

I don't get mandatory PTO, state disability, etc like I do in NJ. I don't work in Philly anymore because it just isn't worth it. 

And as far as nursing schools not having educators, have you seen the pay for nursing educators? It's abominable. Who wants to live on that?

[kbrn2002, ADN, RN]

Suzanne123 said:

Perhaps hospital conglomerates should stop firing RNs for not having a vaccine and/or not having a BSN. Hershey Medical Center fired me after 25 years of being RN for not having my BSN.Wait for it, as a PRN employee I received zero percent teased tuition and hours are not guaranteed. I have no empathy for the nursing shortage. These massive systems don't value nurses, force us to do things with our blood, sweat, and tears to reward themselves with bonuses, they don't want to pay, they call you off so you can't bonus pay, etc. And God forbid you actually get the week of vacation or day off that you want. We are treated like solve labor, it's worse than ever.

The giant health care companies are going to be the downfall of not only nursing but the populations they serve. I'm seeing this develop now where I live. Every hospital/clinic with the exception of one income based community care clinic are part of the two provider systems in my area. They can both spend multiple millions of dollars on expanding. New construction, renovation of older properties, parking ramps, etc. But they sure can't invest a dime in nursing wages, benefits or improved ratios and working conditions.

Plus the poor patients have to work their way an ever increasing level of confusion and hold times because every call is routed through a short staffed call center just to schedule an appt with a provider that will likely be months down the road. If there is a need to see a provider sooner the call center just directs the patient to the already overloaded urgent care or ER which even with decent insurance is always a more expensive option than an office appointment,