When Rachel McKeown decided to enter the nursing program at Greenville Technical College (GTC) in upstate South Carolina in 2021, she had no worries about being accepted.
She had proven herself in both the inpatient and outpatient centers of the campus hospital and was in good shape in terms of grades and ability.
What wasn’t in good shape was the number of available slots for qualified nursing students—and McKeown had no choice but to wait and see.
Luckily, everything worked out and she graduated on schedule in December 2024.
But for every Rachel McKeown, there are countless others who have either left the profession, are expected to leave in the coming years, or are likely to be turned away from entering it due to academic funding, limited openings, and availability of instructors.
And in the next decade, in the aftermath of the 2020 COVID-19 pandemic, the nursing shortage is not only expected to become a global health emergency but also for the first time in U.S. history could soon turn regular access to health care into something akin to musical chairs.
“Prior to the pandemic, the global shortage of nurses was estimated at 5.9 million,” Rebecca Jester, professor of nursing at the Institute of Health at the University of Wolverhampton, England, said in a 2023 report for the National Institutes of Health in Bethesda, Maryland.
Past Indicative of Near Future
A major portion of this gap is expected to happen in the United States, as the nursing numbers in disciplines continue to dwindle at alarming rates.“A sustained reduction in the number of younger-age RNs would raise ominous implications for the future workforce.”
He added that the past two years of pandemic stress may have had longer-term impacts in a number of previously overlooked areas.
“Although it is difficult to disentangle the contributing factors, these likely include early retirements, pandemic burnout and frustration, interrupted work patterns from family needs such as childcare and elder care, COVID-19 infection and related staffing shortages, and other disruptions throughout healthcare delivery organizations,” he said.
McKeown is one who could fit nearly every facet of Auerbach’s observations.
For example, if you had encountered her on campus at any given time during the past three years, she might have appeared like any other student attending classes and taking notes, with an eye to her future, but away from campus, one of McKeown’s major hurdles was “juggling being a full-time student, a part-time employee, and a wife and [a] mother to three young children.”
“There are pictures of me at softball games and school programs where I am sitting and studying in the background,” she told The Epoch Times via email.
“I had to learn how to manage my time and school work wisely in order to complete assignments, prepare for clinicals/simulations/demos, and then study for tests—I learned to carry flashcards with me everywhere.”
GTC department chair Tracy Hudgins indicated that while students like McKeown are always in demand, limited academic seats in nursing programs everywhere are an element of the current and expected nursing shortage.
“Some data show that failed retention in the healthcare system is the largest cause,” she told The Epoch Times via email.
States, Surpluses, and Deficits
Nightingale College, an accredited nursing school in Salt Lake City, Utah, projects that the need for RNs by 2036 in the Palmetto State will reach 63,830 but that the supply will be only 50,260. This would be a shortage of 21 percent.And South Carolina is far from alone in this outlook.
States projected to have the highest nursing shortage include Georgia (29 percent), California (26 percent), Washington (26 percent), New Jersey (25 percent), North Carolina (23 percent), and New Hampshire (23 percent).
Other states, however, are predicted to have surpluses: Nightingale College foresees Minnesota with an additional 10,520, Utah with an extra 6,180, and North Dakota and South Dakota with a combined excess of 7,500.
But these surpluses won’t make up for the deficits.
By 2026, the national shortage of registered nurses is looking to reach 10 percent, equivalent to 350,540 unoccupied positions.
And the shortage of licensed practical nurses is estimated at 7 percent, or 46,920 vacancies.
Students, Instructors, Openings, and Challenges
When Alexa Patel entered Greenville Technical College in 2020, she did so knowing that her first two years would determine her last two: since she eventually wanted to become a nurse, she began preparing in ways that even she had not expected.“It was necessary to get very good grades in the prerequisite classes to get the most points on the application,” Patel told The Epoch Times via email.
“The nursing program required changes such as not being able to work as much, studying much more, and not having as much of a social life as before starting the program. It was hard to balance school with having a life because it took a lot of effort to study and try not to fall behind.”
But even with her focus and determination, Patel knew at some point that she could be battling a situation beyond her control: low availability of slots and instructors to fill them.
“The shortage of faculty in nursing schools is placing limitations on student enrollment capacity, while the need for highly skilled registered nurses continues to escalate.”
And schools cited the need to create an additional 103 faculty positions to accommodate student demand.
“The abrupt shift from in-person clinical duties to alternative learning experiences due to clinical instructor unavailability has disrupted the typical learning environment for nursing students,” Antig said.
“Student nurses in the Philippines are often met with substantial workload to achieve the learning objectives of the nursing curriculum, struggling with a rigorous nursing program that sets them apart from other college programs.”
Hudgins echoed similar observations, adding that while she often sees students with the kind of mindset displayed by both McKeown and Patel, the ambition of almost half of GTC’s nursing applicants is routinely cut short by aptitude, time, and money.
“We enroll 36–40 students every seven weeks—or 180-200 annually—and the five-year average of admissions is 57 percent,” she said.
“Currently, students have not been admitted due to limited academic success, which results in a lower weighted admission score (low entrance test scores, course failures, low GPA, etc.).”
She noted that just getting accepted into the nursing program carries many rigorous prerequisites, such as anatomy and biology, which not only require substantial study but, like McKeown’s experience, too often means an imbalanced life.
“Our students commonly work at least part-time, with many working full-time,” Hudgins said.
Solutions
As much as Hudgins and other colleagues would love to be able to just enroll all qualified students, hire more instructors to teach them, and add them into the hospital system after graduation, she said major financial insecurities such as housing, transportation, food, and access to health care too often get in the way.Nursing schools across the United States are forming strategic partnerships and seeking private support to help expand student capacity.
The question is whether they will be enough to head off the crisis.
Patel, for one, intends to keep her sleeves rolled up as far as they can go.
“I began to receive interest from hospitals for full-time work in my second to last semester,” she said. “I have always wanted to be in the medical field, and nursing is a way to improve the patients’ lives.
