Nursing is the backbone of healthcare; those professionals you count on when you or a family member are admitted, when you need emergency care, or when you’re recovering at home.
Yet in the Lone Star State, that backbone is under significant strain.
The nursing shortage in Texas is real, complex, and only growing.
Fortunately, there are thoughtful, practical pathways forward.
Let’s unpack the problem and explore how Texas might tackle it.
The Shortage Explained
Texas faces a sizable gap between how many nurses are needed and how many are available.
For example, projections from the Texas Center for Nursing Workforce Studies (TCNWS), which falls under the Texas Department of State Health Services (DSHS), show that by 2036, the shortage of registered nurses (RNs) alone could exceed 56,000.
Another report states that in 2023, more than 13,700 qualified nursing school applicants in Texas were turned away because there wasn’t enough faculty or clinical training space.
Ultimately, demand is climbing (thanks to population growth, aging, and chronic illnesses), and supply is falling behind.
Beyond just raw numbers, the issue hits hardest in certain settings and regions, such as inpatient hospital care, long-term care facilities, and rural or underserved counties, which are facing acute pressure.
What’s Driving the Shortage?
We can’t fix something until we understand the mechanics behind it.
Several major factors converge in Texas:
Rapid Population Growth
Texas remains one of the fastest‐growing states.
A larger, more diverse population means more demand for healthcare services, including nursing care.
Aging Population & Increased Complexity
The state’s healthcare needs are shifting.
More people are living with chronic conditions, and more require long-term care services.
That increases how many of nurses are needed, and the skill level required.
Education and Training
Nursing programs report constraints including: lack of qualified faculty, insufficient clinical sites, and limited labs.
This places limits on how many new nurses can be trained.
Geographic and Setting Imbalances
Urban centers might attract more nurses; rural areas tend to attract fewer.
The caregiving settings (like nursing homes or home health) often struggle with staffing in ways hospitals might not.
Workplace Stress
While this isn’t unique to Texas, nurses face longer hours, higher acuity, burnout, and competing demands.
If we lose experienced nurses faster than we can train new ones, the gap widens.
How This Affects You
Patient Outcomes
More nurses per patient typically means fewer complications, shorter stays, and better recovery.
When units are understaffed, risks go up.
Access to Care
In underserved or rural areas, especially, a lack of nursing staff can mean fewer services available locally, longer drives to care, and worse health disparities.
Cost and Sustainability
When a region cannot staff its units, it may shut services or rely on expensive agency/travel nurses, which are not so effective as a long-term solution.
Workforce Morale & Retention
If nurses are chronically overworked, it’s harder to retain them.
That creates a vicious cycle of fewer nurses, which means higher workload, leading to increased pressure and resulting in even fewer nurses.
What Can Be Done?
Expand and Support Nursing Education Capacity
Texas already has programs aimed at this.
For instance, the Texas Higher Education Coordinating Board (THECB) administers the Nursing Shortage Reduction Program (NSRP) and other grants to encourage enrollment, retention, and graduation of more nurses.
Incorporating more of these types of programs into ABSN programs in Texas (and any similar education) can result in:
- Boosting faculty numbers
- Creating more clinical training sites
- Diversifying training models (e.g., online/hybrid for nursing education)
- Reducing tuition or debt for nursing students.
Create Pathways and Incentives for Retention and Advancement
It’s not just about more new nurses; it’s also about keeping the nurses we have, and helping them become more skilled.
That means offering better career ladders, strong mentorship for new grads, and competitive compensation.
Targeted incentives can also help, such as:
- tuition forgiveness for nurses who commit to staying in underserved regions
- sign-on/retention bonuses
- loan repayment tied to service
- rural practice stipends
Strengthen Rural and Underserved Area Staffing
Since many of the shortages are geographic, Texas can tailor solutions for rural/remote settings, such as:
- Utilizing telehealth support
- Creating “grow your own” programs that recruit local students (more likely to stay local)
- Partnering with community colleges and regional hospitals to provide training closer to home
- Providing service-obligation scholarships tied to these areas
Improve Working Conditions and Support for Nurses
Addressing workload, burnout, and safety (emotional and physical) is vital.
Nurses are less likely to leave if they have manageable patient loads, support from leadership, continuing education, and a workplace culture that values them.
Healthcare organizations and state policy can both play a role by:
- setting staffing standards
- offering flexible scheduling
- ensuring access to mental health and wellbeing resources
- implementing team‐based care models
- reducing administrative burdens
Foster Innovation in Care Delivery Models
The role of nurses is ever-evolving. Texas can encourage models that make full use of nurses’ skills, like nurse-led clinics, expanded use of advanced practice registered nurses (APRNs) in primary care, and interprofessional teams that enhance efficiency.
This helps alleviate pressure on acute-care settings and distributes nurse expertise more broadly.
Enhance Data, Monitoring, and Strategic Planning
Good policy requires good data.
The TCNWS exists for this reason: collecting and analyzing supply/demand, demographics, migration of nurses, etc.
Texas must ensure these workforce reports are up-to-date, transparent, and used to guide funding, program design, and regulation.
Tracking results over time is as important as identifying problems.
Let’s Close the Nursing Gap
The shortage of nurses in Texas is serious, but it is not insurmountable.
With the right mix of education investment, retention strategies, rural focus, improved work conditions, and smart delivery innovations, Texas can move from reacting to the shortage to proactively solving it.
For every hospital bed, every home-care patient, and every family in need, it’s the nurse who makes the difference.
We owe it to them (and to all Texans) to ensure there are enough nurses who are well-trained and supported.
After all, this isn’t just a nurse staffing issue.
It’s a community-health issue.
It’s an access-to-care issue.
When Texas invests in its nursing workforce, it’s investing in the health and well-being of its people.
With sound strategy, collaboration, and sustained effort, Texas can close the nursing gap and build a system that’s resilient, equitable, and prepared for the future.
