The Oklahoma Bar Journal October 2025

Approximately 1 million U.S. nurses are at least 50 years old, and nearly 60% are over age 40. 22 In a survey taken in December 2023, more than one in five in the U.S. stated that they planned on retiring before the end of 2028. 23 A fourth reason for the short age is related to a declining inter est in nursing school enrollment by qualified students. According to the American Association of Colleges of Nursing, enrollment in bachelor’s degree programs fell in 2022, marking the end of a 20-year period of growth in those pro grams. 24 Enrollment is also down for nursing students seeking mas ter’s degrees and for those pursu ing doctoral programs. 25 To make matters worse, because of budget constraints, salary inequality and aging faculty members, many nursing schools have not had enough educators in classrooms to teach courses for incoming nursing students – a problem that led U.S. nursing schools to turn away tens of thousands of would-be students in 2019. 26 Another reason that can be attributed to the current short age is an overall dissatisfaction with the profession itself among those in the workforce. Nursing workplaces across the country suffer from high rates of turnover and low rates of retention. One study found that more than half of nurses leave their jobs within the first two years of starting work in the field. 27 According to a 2022 survey of registered nurses, those specifically working in a hospital setting had the lowest level of job satisfaction among others in the nursing profession. 28 If the shortage maintains its present course and trajectory, more and more patients will have

to wait longer in medical facil ities that do not have adequate staff, and the overworked staff may feel rushed to get patients seen quickly. This could lead to errors in medication dosage and other care delivery tasks by a burned-out staff, which, in turn, could mean a higher number of fatalities. 29 Because of the shortage, some communities are facing hos pital closures, and many medical centers around the country have had to close medical departments or end services. 30 In June 2023, as many as 293 rural hospitals were at risk of immediate closure. 31 It is expected that 42 out of the 50 states will experience nursing staff shortages by 2030, the year that ADDRESSING THE SHORTAGE WITH FOREIGN NATIONAL NURSES One solution that could almost immediately increase the number of nurses in the U.S. is bringing in more foreign national nurses for lawful employment. Qualified nurses from countries around the world can help ease current U.S. shortages while bringing their professional, linguistic and cul tural skills to the workplace. 33 The U.S. has welcomed many foreign national nurses through various immigration programs over the years, and America is still the preferred destination for inter national nurses around the world looking for employment. 34 The number of foreign national nurses in the U.S. has grown substan tially since the 1970s, when there were about 50,000 nurses, com pared to 2022, which saw about 500,000 foreign nurses working in the United States. 35, 36 Currently, all baby boomers will have reached retirement age. 32

variety of reasons. First, a large segment of the U.S. population is getting older and will require more medical care as they age. America currently has more people over the age of 65 than at any time in history, and their health care needs continue to grow. 12 Baby boomers represent a “silver tsunami” 13 of about 21% of American adults. 14, 15 Estimates show that by 2029, there will be 71 million Americans over the age of 64. 16 Further, according to the U.S. Census Bureau, by 2050, there will be approximately 82 million Americans over 64, which will represent almost one fourth of the U.S. population. 17 Second, the current shortages can be directly attributed to the COVID-19 pandemic. Between 2020 and 2021, there was a drop in the nursing workforce of around 100,000 registered nurses, which marked the largest decline of nurses in the U.S. in 40 years. 18 Some of the documented reasons for this decline were related to the adequacy of staffing at hospitals, physical exhaustion and burnout and the sufficiency of personal pro tective equipment (PPE). 19 Nurses were universally overworked during the peak of the pandemic, and many faced concerns about their own exposure to the disease. This increased pressure and stress took a physical and mental toll on the nurses working with COVID-19 patients, leading to a general sense of burnout. 20 Most of the regis tered nurses who left the nursing profession during the pandemic were under the age of 35, and most worked in a hospital setting. 21 A third reason for the nurs ing shortage is that a large per centage of nurses currently in the workforce are aging and nearing the end of their careers.

Statements or opinions expressed in the Oklahoma Bar Journal are those of the authors and do not necessarily reflect those of the Oklahoma Bar Association, its officers, Board of Governors, Board of Editors or staff.

16 | OCTOBER 2025

THE OKLAHOMA BAR JOURNAL