Comparing the baseline supply and demand projections suggests that the U.S. had a shortage of approximately 168,000 FTE RNs in 2003, implying that the current supply would have to increase by 9 percent to meet estimated demand. By 2020 the national shortage is projected to increase to more than 1 million FTE RNs (Exhibit 23), if current trends continue, suggesting that only 64 percent of projected demand will be met (Exhibit 24).

The supply and demand projections most likely bound the range of the actual number of FTE RNs who will be employed over the projection horizon. As the nursing shortage becomes more severe, market and political forces will create pressures that will increase supply, decrease demand, or both.

As illustrated in the appendix, State-level shortages will vary substantially over time and across States. As the nurse shortage in any particular State becomes too severe, market forces will create financial incentives for nurses to migrate to States with more severe shortages.

Exhibit 23. Projected U.S. FTE RN Shortages, 2000 to 2020

Exhibit 24. Projected U.S. FTE RN Supply, Demand, and Shortages