How to Cite

To cite, please include the following: The Program on Health Workforce Research and Policy at the Cecil G Sheps Center. “NC Nursecast: A Supply and Demand Model for Nurses in North Carolina.” November 1, 2021.


By 2033, North Carolina faces an estimated shortage of nearly 12,500 registered nurses and slightly more than 5,000 LPNs.

Employment Setting Projections


  • The largest numeric shortfalls for RNs is projected to occur in hospitals where demand could exceed supply by nearly 10,000 positions by 2033.

  • The second largest projected shortage of RNs in absolute numbers and the largest shortage as the percent of the workforce is projected to occur in nursing home, extended care, and assisted living facilities.


  • Nursing home, extended care, and assisted living facilities employ the greatest number of LPNs and these settings face a nearly 50% forecasted shortage of LPNs by 2033.

  • Hospitals also face a large percentage shortfall (31.7%) of LPNs by 2033.

Also see our brief about employment settings.

Regional Projections

  • Most regions of the state are projected to face RN shortages except for the Southeast region; all regions will face LPN shortages.

  • Large metropolitan areas face significantly higher RN shortages than non-metro areas; both metro and non-metro areas face similar levels of LPN shortages.

  • Wake AHEC (including Raleigh-Durham) and Northwest AHEC (including Winston-Salem) face the largest RN shortages.

  • The Mountain AHEC (western NC) and Wake AHEC face the largest LPN shortages

Also see our brief about regional projections.

NC Nursecast models alternative, “what if” scenarios and how they change the baseline model predictions

Scenarios Likely to Increase Nurse Shortage

  • What if nurses exit the workforce 2 years early?

    • The shortage worsens to 16,700 RNs by 2033

    • The shortage worsens to 5,500 LPNs by 2033

  • What if nurses exit the workforce 5 years early? 

    • The shortage worsens to more than 21,000 RNs by 2033

    • The shortage increases to 6,000 LPNs by 2033

  • What if the supply of out of state nurses decreases by 2.5%?

    • The shortage of worsens to 14,400 RNs by 2033

    • The shortage worsens to 5,250 LPNs by 2033

Scenarios Likely to Improve or Decrease Nurse Shortage

  • What if nurses remain in the workforce two years longer than expected?

    • The RN shortage improves from 12,500 to 11,500 by 2033

    • The LPN shortage remains similar, going from 5,000 to 4,900 by 2033

  • What if the number of nurse graduates increases by 10%?

    • The RN shortage improves slightly from 12,500 to 10,000 by 2033

    • The LPN shortage remains similar, going from 5,000 to 4,500 by 2033

Takeaway: It will require a combination of increasing graduate supply, retaining current nurses, and possibly recruiting nurses that have left the workforce to address projected shortages.

Also see our brief about forecast scenarios.

What about COVID? We do not know the effect that COVID will have on the supply and demand of nurses in NC. Reports of burnout, nurses shifting to travel positions for higher pay, nurses returning to work, students wanting to become nurses, and other factors will affect future nursing supply and demand.

In one possible scenario, if we combine early exits from the nurse workforce and increased competition from other states with increased enrollment in nursing programs:

  • The RN shortage worsens from 12,500 to 18,600 by 2033
  • The LPN shortage worsens from 5,000 to 5,800 by 2033

For more key findings, check out our briefs.



Supply & Demand

Want to learn about the future supply and demand of our state's licensed practical nurses and registered nurses across settings and geographic regions?

See projections

Graduate Diffusion

Want to see how different North Carolina nursing programs impact the distribution of health professionals in their area and across the state?

Examine graduate diffusion

Key Findings

What are the main takeaways from the nursecast projections? In what regions and settings will nurses be in shortage?

Read key findings

Who are we?

This project is brought to you by The Cecil G. Sheps Center For Health Services Research at the University of North Carolina in partnership with the North Carolina Board of Nursing.