Think about practically each seat in Philadelphia’s Wells Fargo Heart − over 20,000 seats − are empty. That’s the size of Pennsylvania’s projected shortfall of registered nurses by 2026, in keeping with the Hospital and Healthsystem Affiliation of Pennsylvania.
Hospitals within the state report a median 14% emptiness charge for registered nurses. In rural areas it’s a lot larger.
This scarcity, after all, is not only in hospitals. It additionally impacts long-term care services, outpatient clinics and residential well being businesses, which compete with hospitals for a restricted pool of registered nurses, licensed nursing professionals and nursing assist workers.
We’re a senior affiliate dean of nursing and scientific professor of nursing at Drexel College’s School of Nursing and Well being Professions in Philadelphia, and a dean and professor of nursing at Duquesne College’s College of Nursing in Pittsburgh.
We all know that the nursing scarcity in Pennsylvania, whereas not the worst within the U.S., is extreme and jeopardizes the well being care that sufferers obtain.
What brought on the scarcity?
Pennsylvania’s nursing scarcity is the results of long-standing points in schooling, workforce retention and well being care supply.
Training bottlenecks: Nursing faculties in Pennsylvania and nationwide flip away 1000’s of certified candidates every year as a result of school shortages, restricted classroom area and scarce scientific placements. Greater than 65,000 certified functions have been turned away from U.S. nursing packages in 2023 alone, in keeping with a report from the American Affiliation of Faculties of Nursing.
A key challenge is the shortage of preceptors. Preceptors are skilled nurses who train college students in real-world settings. A scarcity of preceptors straight limits what number of college students can full their schooling.
Growing older workforce: Greater than a 3rd of Pennsylvania’s registered nurses are 55 or older. This demographic actuality means many are nearing retirement.
Burnout and attrition: The COVID-19 pandemic worsened already excessive ranges of stress, burnout and psychological well being pressure for nurses. Many left the occupation early as a result of emotional exhaustion, household and private well being considerations, unsafe staffing ratios, ethical harm and lack of institutional assist.
Uneven distribution: Whereas Pennsylvania could have a adequate variety of licensed nurses on paper, these nurses don’t all nonetheless work within the occupation. And amongst people who do, they don’t seem to be evenly unfold throughout roles or areas. Rural hospitals, long-term care facilities, behavioral well being settings and maternal-child well being models are experiencing acute shortages.
One challenge is the scarcity of preceptors who prepare nursing college students in real-world settings.
Naville J. Oubre III/Southern College and A&M School through Getty Photos
Value to sufferers
For sufferers and their households, the implications of the nursing scarcity are delayed care, fewer interactions with suppliers and fewer time for compassionate, personalised assist. Overextended nurses face elevated workloads, elevating the chance of delayed interventions, treatment errors and insufficient affected person schooling. These components undermine high quality of care.
Restricted entry to nursing care can improve hospital deaths, infections and readmissions, cut back early detection of well being points, and gradual the response to life-threatening situations comparable to stroke, sepsis and cardiac arrest.
In Pennsylvania, sufferers could expertise longer emergency room wait occasions, delayed discharges or transfers to nursing properties or rehabilitation facilities, and repair disruptions in rural and underserved areas.
Impact on nurses
Over 600,000 registered nurses throughout the U.S. plan to go away the workforce by 2027, in keeping with a 2023 evaluation by the Nationwide Council of State Boards of Nursing.
Many cite stress as their purpose for leaving the occupation. New graduates usually go away inside their first two years, feeling unprepared for the emotional and operational realities of observe.
In Pennsylvania, the scarcity has created a suggestions loop. Understaffing will increase strain on those that stay. A 2023 Nationwide Council of State Boards of Nursing survey discovered that 41% of nurses underneath age 35 reported feeling emotionally drained.
In the meantime, some skilled nurses select to retire early or shift into nonclinical roles for higher schedules, slower tempo and improved high quality of life.
This turnover erodes institutional information, will increase prices for onboarding and additional time, and limits the capability to mentor incoming workers.
What’s being achieved
To assist handle the issue, Pennsylvania Gov. Josh Shapiro in March 2025 proposed a US$5 million Nurse Scarcity Help Program. If permitted by the Basic Meeting, this system would cowl tuition prices for nursing college students who decide to working in Pennsylvania hospitals for 3 years after commencement.
HB 390 can also be presently underneath evaluation within the Pennsylvania Basic Meeting. It goals to ascertain a $1,000 tax deduction for licensed nurses who function scientific preceptors.
To fulfill the rising demand for nurses, Pennsylvania hospitals are partnering with faculties and universities to broaden scientific coaching capability, streamline pathways into nursing and develop progressive schooling fashions comparable to hybrid and accelerated packages.
Hospitals statewide are additionally providing substantial sign-on bonuses, mortgage forgiveness packages, housing stipends and versatile scheduling to draw nurses.
To enhance nurse retention, well being care organizations have launched structured residency packages, mentorship networks and clear profession development pathways designed to cut back burnout and improve skilled satisfaction.
They’re additionally more and more utilizing digital nursing, telehealth companies and AI-driven administrative instruments to cut back nurses’ workloads, improve affected person interactions and handle staffing gaps.
And a few Philadelphia and Pennsylvania faculties provide refresher and license reactivation packages for retired or inactive nurses who need to rejoin the workforce. Duquesne affords a nurse school residency to extend the variety of high-quality nursing school.
What extra might be achieved?
Persevering with Title VIII Nursing Workforce Improvement Applications are one other resolution. These federal grants, reauthorized underneath the March 2020 CARES Act, assist fund nursing pathways and the provision of high-quality nursing look after sufferers nationwide.
On April 1, 2025, the Trump administration introduced plans to restructure the U.S. Division of Well being and Human Providers, and the longer term standing of those packages just isn’t but identified.
Analysis persistently demonstrates that care supplied by nurses who’ve earned a bachelor’s diploma or larger straight results in higher affected person outcomes, improved security and general well being. A dedication to shoring up the nurse pipeline in Pennsylvania is a dedication to bettering the well-being of people and communities throughout the state.
