The report, commissioned by the Maryland Hospital Association, presents a detailed analysis of the current and projected nursing workforce shortages in Maryland through 2035. Nurses, who form the largest occupation within the healthcare sector, are vital to patient outcomes and the overall quality of care.
Download the original report. (PDF)
Nurses Are Central to Maryland’s Healthcare System
Despite over 86,500 registered nurses (RNs) and 11,100 licensed practical nurses (LPNs) holding active licenses in Maryland as of March 2022, labor statistics suggest far fewer are actively practicing in the state.
The COVID-19 pandemic intensified a pre-existing shortage, with nurse vacancy rates sharply increasing in 2021 and many licensed nurses considering leaving the field due to burnout, early retirements, and reduced opportunities for training and mentorship.
Growing Shortages Forecast Through 2035
The study projects significant and growing shortages of both RNs and LPNs if current trends continue:
- In 2021, Maryland lacked approximately 5,000 RNs and 4,000 LPNs to meet demand at the national average standard of care.
- These shortages are expected to worsen, reaching 13,800 RNs and 9,200 LPNs by 2035.
- The RN workforce would then meet only 80% of demand, while LPNs would meet just 44%.
Even with efforts to expand the nursing pipeline—such as increasing graduation rates by 10% or delaying retirement by two years—the state would still face substantial shortfalls, particularly among LPNs due to their smaller pipeline and greater initial deficit.
Status Quo and Alternative Scenarios
Projections are based on a “Status Quo” scenario, which assumes healthcare use and delivery patterns will remain stable, with demand shaped primarily by population growth, aging, and chronic disease prevalence.
Alternative scenarios model factors such as increased access to care and workforce changes like early retirement. A “Reduced Barriers” scenario, which assumes underserved populations gain access to care at the same rate as insured, urban, non-Hispanic Whites, significantly increases projected demand for nurses, requiring 18,400 additional RNs and 10,100 LPNs by 2035.
These findings underscore how expanding health equity can further strain an already stressed workforce.
Factors That Influence Supply Adequacy
The report also highlights key nuances in interpreting nursing workforce projections. Regional disparities may hide behind state-level estimates, with urban and rural areas experiencing different levels of supply and demand.
Additionally, substitution between nursing roles, such as RNs taking on LPN duties or vice versa, can shift the workforce burden. New graduates generally have lower productivity than experienced nurses, further complicating assumptions about supply adequacy.
The study emphasizes that projected shortages could worsen if burnout and early retirement outpace retention and recruitment efforts.
A Call to Strengthen the Workforce Pipeline
Overall, Maryland faces a growing nurse shortage that threatens care quality and access. While the modeling accounts for various scenarios, the trends suggest that without strategic investment in training, retention, and equitable access to care, the state will be increasingly unable to meet healthcare demands. Addressing this challenge will require coordinated efforts across education, healthcare systems, and public policy to build and sustain a nursing workforce that can meet Maryland’s future healthcare needs.
Thinking About Becoming a Nurse in Maryland?
Maryland needs more nurses—and fast. One of the quickest ways to enter the profession is through an Accelerated Bachelor of Science in Nursing (ABSN) program. If you already have a non-nursing bachelor’s degree, ABSN programs let you become a registered nurse in as little as 12 to 18 months. Find an accelerated nursing school in Maryland.