The Nursing Shortage is a Solvable Problem — If We Rethink the Pipeline

At first glance, the nursing shortage looks like it may be dropping. According to Indeed, nursing job postings have declined 10% over the past year. After years of pandemic-driven turmoil, it is tempting for health systems to believe the deficiency is in the rear-view mirror.

But that viewpoint is risky. Beneath the surface, the shortage is still growing. Double-digit vacancies and consistent turnover remain the pattern across hospitals. Nearly one million nurses are over the age of 50, 60% are over the age of 40, and by 2030, almost one million will retire. Another 28,000 RNs a year are leaving bedside care for nurse practitioner roles. Even with roughly 218,000 U.S.-educated nurses passing the RN-NCLEX in 2024, the number has only grown by about 14,000 in the past decade—so the math still doesn’t add up and education isn’t keeping up.

Here is the kicker: health systems don’t have to accept vacancies and turnover as the norm. The way to change it is to challenge it—and thinking differently can drive gains in retention, workforce stability, and reduced spending on recruitment and onboarding. However, that will only happen if hospitals consider taking an alternative path.

A New Approach: Develop, Don’t Buy

We all know that traditional nursing schools cannot produce enough nurses to meet demand. Not enough faculty, limits on how many can enroll, and outdated models keep the supply low. Hospitals end up competing for the same small group of nurses, moving them around instead of fixing the shortage. What is also clear is that recruitment alone cannot solve the problem either. The path forward is a new, radical way of thinking: systems need to start looking inward and building their own workforce pipelines. Hear me out.

If hospitals turn their attention towards developing from within and creating clear paths for current staff to become nurses, and training them where they will work, they can secure their own pipeline of job-ready talent. This is not about another degree program—it is about creating a homegrown talent pipeline that is designed for operational efficiency and operational excellence.

The model works because it aligns with what health systems need:

Pipeline creation, not competition. Secure 100% of the graduates trained inside your system instead of fighting over external hires.
Predictable costs. Reduce ups and downs in hiring and the costs of employees leaving with a steady flow of job-ready talent.
Retention and cultural alignment. Employees who train inside your hospital already know your culture, operations, and teams—and they are more likely to stay.

The Talent is Already There

Every hospital already has many employees in various roles who can become great nurses if given the chance. These employees already know your systems, patients, and community. They do not need recruitment, but they need new skills.

By creating clear career paths, hospitals can grow their own workforce, improve retention, and build loyalty in ways traditional hiring cannot. Instead of spending money on external recruitment, you are investing in people who are already dedicated to your organization.

Time to Rethink the Pipeline

The nursing shortage isn’t unsolvable; it is just unsolvable under the old playbook. The future lies in hospital-driven workforce solutions that align education directly with operational needs.

If health systems, educators, and policymakers change their focus from hiring to growing their own workforce, the shortage won’t be a crisis anymore. It will be something we can fix.

Patients, health care workers, and communities rely on having enough nurses. With innovative ideas and hospital-led solutions, we can make sure nursing stays a key part of American health care for years to come.

Caitlin Masterson, SVP, Workforce Development, Unitek Learning - Texas Hospital Association

About the Author
Caitlin Masterson is Senior Vice President of Workforce Development at Unitek Learning, a health care education partner helping hospitals build embedded, sustainable workforce pipelines.

This article is sponsored by Unitek Learning.