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This report summarizes the findings from a survey of general acute care hospital employers of registered nurses (RNs) in California conducted in fall 2017. This is the eighth annual survey of hospital RN employers; these surveys provide an opportunity to evaluate overall demand for RNs in the state and changes that have occurred over time. The survey also collects information specific to the hiring of newly-graduated nurses because they are at particular risk for unemployment during a weak labor market. The data obtained in this survey reveal very strong overall demand for RNs across California, a preference for hiring experienced nurses, and an ongoing lack of positions available for newly graduated RNs. 

Key Findings:

• The vast majority of hospitals reported 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. 
• Demand for experienced RNs was greatest in the Central California region and lowest in the San Francisco Bay Area. Demand for new RN graduates was strongest in the Sacramento and Northern Counties region and the San Francisco Bay Area, and weakest in the Southern Border region. 
• Rural and non-rural hospitals reported similar perceptions of RN demand, which is a change from prior years when rural hospitals consistently perceived greater demand than did urban hospitals. 

As California’s population grows larger and older, and more nurses reach retirement age, the demand for RNs – including new graduates – will continue to rise. It is essential that nursing education programs maintain the size of their programs and continue to foster opportunities for new graduates to use and develop their knowledge and skills. 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. Such efforts are needed to ensure an adequate supply of high-skilled RNs in the future and without them, California’s strong investment in nursing education may be lost.