A Profession Built on Trust Faces a Workforce Turning Point | Opinion

This is an opinion piece, contributed by Carol Timmings, MEd, RN, Interim Editor-in-Chief, NCSBN Journal of Nursing Regulation

For the 24th consecutive year, nurses have been ranked as the most trusted professionals in Gallup’s annual Most Honest and Ethical Professions Poll. That trust reflects nurses’ central role in safeguarding public health across hospitals, long-term care facilities, and community settings. As both caregivers and frontline stewards of safety and quality, nurses are essential at every level of care.

However, that trust faces serious threats. Persistent shortages, burnout, workplace violence, and the inability of health care facilities to recruit and retain nurses undermine the foundation of trusted care.

NCSBN’s New Environmental Scan Identifies Issues Facing Nurses Today

NCSBN’s 2026  environmental scan, “Evidence in Action,” published in the Journal of Nursing Regulation, looks closely at the key issues, challenges, risks, and opportunities affecting today’s nursing workforce. NCSBN has produced this scan for more than a decade to help nursing regulators, educators, employers, researchers, and policymakers understand trends shaping the profession. The report draws on many sources, including NCSBN data and reports, reviews of online research, and input from nursing leaders. NCSBN experts then combined and analyzed this information to identify the most important trends. Nursing regulators use these findings to guide planning and decision-making, strengthen policies, and better respond to new challenges and opportunities in health care.

The report found that the nursing pipeline is in trouble. Problems affecting the pipeline now could hurt the quality of care in the future.

Staffing and Faculty Shortages Affect the Nursing Pipeline

NCSBN’s 2024 National Nursing Workforce Study found that about 40% of RNs and LPN/VNs said they plan to leave the workforce or retire within the next five years. The study also found that more than 138,000 nurses have left their jobs since 2022. They gave the same reasons as nurses who were surveyed in 2022 - stress, burnout, and retirement.

Also, because of a serious shortage of nursing faculty, many nursing programs have had to turn away qualified students. The scan found that fewer students are enrolling in graduate-level nursing programs, especially PhD programs. Instead, nurses are choosing clinical degrees, such as a doctorate in nursing practice. Previous NCSBN research shows that nursing programs with more faculty and deans who hold doctoral degrees have higher graduation rates and better NCLEX^® pass rates. Additionally, a recent administration proposal to remove nursing as one of the professional degrees that would qualify for graduate-level loans could make the faculty shortage even worse.

Nurse Licensure Compact (NLC) Provides More Nurse Mobility and Career Opportunities

Interstate barriers can limit where nurses are allowed to practice, but the Nurse Licensure Compact (NLC) helps reduce those roadblocks. The NLC allows qualified nurses who live in an NLC member state or jurisdiction to provide telehealth care to patients in other NLC states without having to get additional licenses. A multistate license also makes it easier for nurses, such as primary care nurses, case managers, transport nurses, school and hospice nurses, and others to work across state lines. 

There is some good news for the nursing pipeline. The Centers for Medicare & Medicaid Services recently highlighted the NLC in a funding opportunity aimed at improving rural health care. Starting in 2026, $50 billion in funding will be given to states that qualify. Whether a state has joined the NLC can affect its chances of receiving the funding, which may encourage more states to join the NLC.

Nurse Regulators Carefully Monitor the Nursing Landscape

The public trust in nurses remains exceptionally high, but it can’t be taken for granted.

Nurse regulators work to keep patients safe and respond to changes in health care. They set clear rules for licensure and discipline, make sure nurses stay competent throughout their careers, and on the rare occasions when it’s necessary, remove unsafe nurses from practice.

Regulators use data from NCSBN research, the environmental scan, and other expert sources to identify risks early. They focus on:

• Monitoring education programs, faculty staffing, and readiness for practice; 
• Protecting the trust in nursing by supporting solutions to workforce shortages without lowering safety standards; and
• Evaluating the increasing use of AI and telehealth. 

Their goal is to maintain a strong and durable nursing workforce that meets the country’s changing health care needs.

Protecting Trust in the Nursing Profession

Nurses earn trust the same way they deliver care—one patient, one moment, one shift at a time.

Keeping the trust in nursing strong for the next generation takes more than dedication at the bedside. It requires stronger pathways that bring new nurses into the profession.

Every time a nurse precepts a student, welcomes a new grad, advocates for stronger clinical partnerships, or simply shows what compassionate, evidence-based practice looks like, they are building the pipeline, upholding the trust in nursing, and shaping the future of nursing.

To read more about issues facing nurses today, check out NCSBN’s environmental scan.

🤔Nurses, do the findings in the NCBSN’s environmental scan reflect your experiences? Share your stories in the comments below!