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Projections for the Near Future

While the total number of RNs in the country has continued to grow, the growth rate of employed RNs has slowed considerably since the spread of managed care.51 The number of employed RNs grew significantly during the 1980s but then slowed during the 1990s, particularly in hospitals. This slowdown was directly related to the growth of managed care. A state-by-state analysis shows a strong correlation between RN growth rate and the spread of HMO plans: The RN workforce grew the least in states with high HMO enrollment.52

Because nursing has failed to attract many young workers, the profession is aging rapidly. Over the next two decades, a wave of RN retirements is projected to hit at exactly the time that the aging baby boom generation enters its own retirement period, creating massive new demand for nursing care.

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