HRSA’s new workforce report: more RNs and NPs, fewer LPNs, and a rural gap.
HRSA’s December 2025 report counts a growing RN and NP workforce and a shrinking LPN workforce, and projects a wider RN shortage outside metro areas by 2038.
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Nursing Mastery Editorial
Source published Dec 1, 2025 · 5 min read
HRSA’s new workforce report: more RNs and NPs, fewer LPNs, and a rural gap.
“Nursing shortage” is usually said as if it were one national number. HRSA’s State of the U.S. Health Care Workforce report, dated December 2025, is more specific than that.
The workforce is growing, unevenly
As of 2024 there are more than four million RNs, LPNs, and APRNs in the U.S. workforce.
See the data
Nursing MasteryData
Workforce · 2020–2024
The workforce is growing — unevenly.
HRSA's December 2025 report: the profession is redistributing toward RN and NP roles and away from LPN roles, with the projected gap concentrated outside metro areas.
Workforce change by role, 2020–2024
Nurse practitioners
+38.5%
Registered nurses
+9.4%
LPNs
−6.0%
Where the projected 2038 gap lands
HRSA / NCHWA projections:
3%national RN shortage projected in 2038
11%RN shortage projected in nonmetro areas
30%projected LPN shortage (245,950 FTEs)
The LPN bar reads at the chart floor on purpose — that workforce moved the other way, shrinking 6.0% while RNs and NPs grew.
Infographic: nurse practitioners up 38.5% and RNs up 9.4% from 2020 to 2024 while LPNs declined 6.0%, with the projected 2038 shortage concentrated outside metro areas
Between 2020 and 2024, the RN workforce grew 9.4% and nurse practitioners grew 38.5%. The LPN workforce shrank 6.0%. Newly licensed RNs increased 27.5% over the same period.
The profession is not shrinking. It is redistributing toward RN and NP roles and away from LPN roles.
The shortage is a location story
HRSA projects a 3% national shortage of RNs in 2038, and an 11% shortage in nonmetro areas.
For LPNs the projection is larger: a shortage of 245,950 full-time equivalents, or 30%, by 2038.
For RNs, the projected nonmetro gap (11%) is larger than the national one (3%). If geography is negotiable for you, that is worth checking first.
The strain is real too
Citing a 2024 NCSBN survey, the same report says 35% of RNs and 38% of LPNs experience feelings of burnout at least a few times a week.
Headcount growth and floor-level strain coexist. One does not cancel the other.
What to do with this
Treat the shortage as a map. Ask where demand outruns supply by region and by role before assuming any market is easy or hard.
If you are an LPN, weigh the 30% projected gap against the 6.0% decline in LPN headcount. An LPN-to-RN bridge is worth pricing now.
If you are weighing NP school, note that NPs grew 38.5% between 2020 and 2024, the fastest of the three nursing roles above. Check current postings in the specific markets you would work in.
Ask rural employers directly what loan repayment or differentials they offer. The projection does not tell you that.
The practical takeaway
The national numbers say growth. The local numbers decide your leverage.
Primary source: HRSA National Center for Health Workforce Analysis, State of the U.S. Health Care Workforce, 2025 (dated December 2025); checked July 20, 2026.
