How Millennials Could Ward Off a Skilled Nursing Staffing Crisis

An influx of millennials is energizing the nursing workforce during a crucial period of demand growth—but that may be offset by a wave of baby boomers retiring en masse.

An average millennial is now 186% more likely to become a registered nurse (RN) than an average baby boomer, according to a new study published in the October edition of Health Affairs. The study is based on data from the U.S. Census Bureau’s Current Population Survey for 1979 to 2000 and the American Community Survey for 2001 to 2015.

Millennials are the group born between 1982 and 2000, and make up more than a quarter of the nation’s population. The age group could represent a key recruiting target for skilled nursing providers, especially as the industry grapples with attracting and retaining new workers.


“A decade ago, we expected by this time that we’d be in the midst of a severe nursing shortage,” David Auerbach, an external adjunct faculty member at Montana State University’s College of Nursing and study author, told Skilled Nursing News. “What we didn’t expect was this huge influx of millennials into the nursing workforce.”

Baby boomers previously represented the largest segment of the RN workforce from 1981 to 2012. The number of baby boomer RNs hit a high-water mark of 1.26 million in 2008, the study’s authors noted in a May 3 Health Affairs blog post.

Growing Workforce


The nursing workforce saw 2.5% annual per capita growth between 2000 and 2015, which was likely enough to prevent widespread shortages and rapid increases in RN wages, the researchers noted. By 2030, the workforce is expected to grow another 36%, or 1.3% annually, to just more than four million registered nurses (RNs), despite more older nurses retiring over that time period.

However, the growth may not meed demand, which is predicted to increase roughly 1.5% per year through 2025, according to the U.S. Health Resources and Services Administration. Additionally, while more millennials are entering the field, the growth rate for the number of RNs taking the required licensure exam plateaued from 2013 to 2016.

But maintaining that plateau could be enough to avoid a large shortage of nurses in the future, Auerbach said.

“I don’t think we’re looking at a crisis,” he added. “It doesn’t look like there are shortages looming, at least on a national level.”

Still, some parts of the U.S. could see a lack of nurses more than others in the coming years, Auerbach said. States such as Arizona, North Carolina, Colorado, and Maryland are already seeing looming RN shortages.

Health care providers will also need to find a way to adequately replace the veteran nurses they’re losing to retirement.

About 60,000 boomer RNs have exited the workforce each year since 2012, a number that will grow to more than 70,000 by the end of the decade, the study’s authors explained in the blog post. Provided that rate holds true, there will be just 660,000 working baby boomer RNs by 2020.

“The amount of nursing experience that’s going out the door as the baby boomers retire is tremendous,” Auerbach said. “Any way they can retain that experience before it goes away would really be valuable.”

Home health care and long-term care are increasingly popular career paths for millennial nurses, partially due to the sheer number of those jobs, Auerbach said.

“When you look at the top projected demand for jobs, you always see home health care and other aspects of long-term care as such a need,” he said. “There’s just so many jobs available.”

‘Pig in the Python’

Though the number of younger RNs dipped to a low of 440,000 in 2000, that number nearly doubled to 834,000 in 2015. By the 2020s, the nursing workforce “will be dominated by millennials,” according to the study.

Some previous generations haven’t rushed into the nursing workforce like baby boomers or millennials have. By the time the first millennials turned 33 years old, 760,000 of them were full-time equivalent RNs. But when the previous generation, Generation X, reached the same age, only 400,000 were full-time equivalent RNs.

Those alternating periods of high and low statistical bulges are sometimes referred to as the “pig in the python” phenomenon.

“The baby boomers were the first pig, and they’re on their way out,” Auerbach said. “Generation X was kind of the diet…and millennials are the second course.”

Though it’s not entirely clear why millennials are rushing into the field of nursing more than members of other generations, it could have something to do with their attitude toward jobs in general. The generational group is also known anecdotally for its tendency to switch jobs, which could increase turnover for some care providers.

“Baby boomers…came of age in an era where a lot of career-oriented women were still going into nursing and teaching,” Auerbach explained. “Millennials seem to be going into it for perhaps a different set of reasons…it’s an area where you’re making a difference in people’s lives day to day. I think that is a motivator.”

Economic uncertainty and earnings instability could also be driving more millennials toward the career, the study noted. RNs have more stable lifetime earnings and lower rates of unemployment than other careers. They also have more chances to change positions and move to new geographic locations.

Written by Tim Regan

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