New Survey Finds that California Needs More Highly Skilled and Experienced Nurses


Lela Chu, Joanne Spetz and Timothy Bates

April 9, 2018

As the registered nurse (RN) baby boomers retire, there is a need for more highly skilled and experienced nurses in California, according to a new survey published by Healthforce Center at UCSF and the UCSF Institute for Health Policy Studies. 

This report summarizes the findings from the eighth annual survey of general acute care hospital employers of RNs in California. Conducted in fall 2017, this survey provided an opportunity to evaluate overall demand for RNs in the state and changes that have occurred over time. The survey also collected information specific to the hiring of newly graduated nurses because they are at particular risk for unemployment during a weak labor market. 

This report found that there is:

  • A strong overall demand for RNs across California
  • A preference for hiring experienced nurses

While the fall 2017 survey results indicate a stabilization of labor market conditions faced by California’s RNs, with the vast majority of hospitals reporting that there was greater demand for RNs than supply, the perceived shortage was primarily for nurses with clinical experience, particularly for the clinical areas of peri-operative (OR) care, critical care, labor & delivery and the emergency department. On average, hospitals indicated that there is a slight surplus of new RN graduates, although the demand for new RN graduates has slowly improved between 2013 and 2017. 

There is notable regional variation in RN demand. Demand for experienced RNs was greatest in the Central California region and lower in the San Francisco Bay Area. Demand for new RN graduates appeared greater in the Sacramento and Northern Counties region and the San Francisco Bay Area, and weakest in the Southern Border region. 

Policy Implications

It is essential that nursing education programs maintain their size and that new programs be established and expanded. This will allow new graduates to use and develop their knowledge and skills, which will ensure an adequate supply of highly skilled RNs in the future. This may include expanded efforts by employers to develop the skills of new graduates and to fill positions that are normally reserved for experienced nurses. Without these efforts, California’s strong investment in nursing education may be in trouble.