Desperate Times Call for Strategic Measures: A Nursing Pipeline Reality Check

Nearly half the nursing workforce might be gone in five years. Here's how CNOs should prepare.

Despite being one of the fastest growing industries for employment in the United States, the healthcare workforce has taken some serious hits, especially since the COVID-19 pandemic.

In nursing, the stakes are particularly high, due to record levels of burnout, workplace violence, staffing shortages, and major gaps in education pipelines. In 2026, the country is projected to be short about 8% of registered nurses (RN), which is a gap of about 263,870 RNs. According to 2025 data, the national nurse faculty vacancy rate sits at 7.2%.

The National Council of State Boards of Nursing (NCSBN) published their 2026 Environmental Scan report that details the current state of the workforce, education, technology, legislation, and public protection as they relate to nursing. CNOs must equip themselves with data to fully understand these challenge areas so they can strategically plan to address them at a systemic level, rather than applying temporary, short-term solutions.

Retention crisis

CNOs are already on high alert about the nursing shortage when it comes to recruitment, but the retention prospects in the industry are equally as concerning. The report shows that approximately 40% of all nurses plan to leave nursing or retire within the next five years. Out of these respondents, 19-22% are planning to retire while 18-23% plan to leave.

The report cites stress, burnout, and workload as the biggest reasons beyond retirement. However, there are positives in the report too, according to Carol Timmings, interim editor of the NCSBN Journal of Nursing Regulation.

"One of the things that we did see is that certainly the workforce overall has stabilized back to pre-pandemic levels…the age distribution of nurses in the workforce is also back to pre-pandemic levels," Timmings said. "Having said that, the prediction or projection that 40% will leave within the next five years speaks to the continued volatility of the workforce."

These numbers are especially concerning for rural health systems, many of which are already financially vulnerable and at risk of closing. To Timmings, the key to nurse retention in rural healthcare is having competitive salaries and solutions in place to help with the isolation that comes with working in rural settings.

"There is opportunity across the systems to network more, to link rural health care facilities with more urban [systems, and to] bring in more simulated or telehealth solutions," Timmings said.

Professional development programs and the mobility to work across state lines are also imperative, Timmings explained. The Nurse Licensure Compact is an NCSBN initiative that helps nurses receive multi-state licensure, which gives nurses more freedom and flexibility to work and live where they want while still supporting rural communities.

State of education

Despite interest in nursing school and a steady rise in enrollment, the NCSBN report shows that it still won't be enough to meet industry demands. Nursing programs reported 4,856 unfilled seats in the past year, which according to Timmings is because of faculty shortages and lack of corresponding clinical placement availability.

"That results in an overall capacity issue at many nursing academic institutions," Timmings said. "This is also resulting in fewer nursing programs, particularly at that entry level, and so it all culminates at a very concerning point which is the entrance of the nursing pipeline."

The report sites noncompetitive salaries, lack of necessary teaching experiences and specialty mix, and a limited pool of PhD faculty as contributing factors to that 7.2% faculty vacancy rate. CNOs will have to come together to address this issue on a broader scale, Timmings explained.

"This calls for innovation," Timmings said. "Regulatory bodies approve nursing programs and so [we need] our educators and regulators working hand in glove."

To help increase the number of PhD-prepared nursing faculty, the report suggests CNOs partner with their corresponding institutions to help reformat PhD core education to fit the needs of health systems and collaborate with them on tuition reimbursement programs.

Call to action

For CNOs who are trying to address these issues and more, Timmings emphasized that collaboration and partnership are more important than ever.

"We may be in different vantage points where we see the impact of the issue, but I think coming together to reach outside of the health care facility walls and look at solutions together is my word of wisdom," Timmings said. "Whether you're reaching out to other CNEs, or nursing educators, or nursing regulators, or looking at your associations where we can advocate and advance policy solutions, get the conversation going."