New Data Show Enrollment Declines in Schools of Nursing, Raising Concerns About the Nation’s Nursing Workforce

Newswise — WASHINGTON, D.C., May 2, 2023 – According to new data released today by the American Association of Colleges of Nursing (AACN), the number of students in entry-level baccalaureate nursing programs decreased by 1.4% last year, ending a 20-year period of enrollment growth in programs designed to prepare new registered nurses (RNs). With declines also recorded in master’s and PhD programs, collective action must be taken to strengthen pathways into nursing to ensure the nation’s healthcare needs are met. Despite the decrease in enrolled students, nursing schools turned away thousands of qualified applicants last year due largely to a shortage of faculty and clinical training sites.

“Consistent with declines across higher education, nursing programs are enrolling fewer students, which raises serious concerns about how this will impact the nation’s nursing supply,” said Dr. Deborah Trautman, AACN President and Chief Executive Officer. “With enrollments trending downward, academic and practice leaders should work together to ensure that schools are able to accommodate all qualified applicants to meet the growing demand for nurses to provide care and serve as faculty, researchers, and leaders.”

Each year, AACN initiates a national survey of nursing schools with baccalaureate and higher degrees to compile data on student enrollment and graduations, faculty and dean demographics, applications received, and qualified applications turned away, among many other key benchmarks. Conducted in Fall 2022, AACN’s latest annual survey, titled 2022-2023 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, contains data reported by 974 schools of nursing, which represents a 90.6% response rate.

Enrollment Declines by Program Level

Most individuals pursuing a career as a registered nurse in the U.S. enter the profession with a Bachelor of Science in Nursing (BSN) degree offered at 844 colleges and universities. Data from AACN’s Fall 2022 survey show that enrollment in BSN programs declined by 1.4% or 3,518 students from 2021 to 2022. This was the first time since the year 2000 that enrollments decreased in these programs (see trend chart here). From 2001 through 2021, enrollment in entry-level BSN programs climbed from 77,958 to 256,578 students. Though a one-year decline may not signal a trend, any decrease in these critical programs raises concerns and deserves further investigation. 

Also at the baccalaureate level, the number of students in RN to BSN degree-completion programs decreased significantly for the fourth consecutive year. These bridge programs for nurses entering the nursing profession in associate degree or diploma programs provide an important pathway for nurses looking to advance their education to better meet patient care needs and employer expectations. Last year, enrollment in RN to BSN programs decreased by 16.9% or 19,871 students. This downward trend follows an enrollment surge in RN to BSN programs, which saw a rapid increase from 30,684 students in 2002 to 139,587 enrolled students in 2018. Today, fewer than 100,000 students (98,734) are enrolled in these programs. AACN is exploring the causes that may be contributing to this trend, including declines by program type and any variations by region. AACN is also looking at any correlation between the increase in the number of nurses entering the profession with a baccalaureate and the number of nurses needing to complete a post-licensure BSN program.    

At the graduate level, students in master’s programs decreased by 9.4% (13,965 fewer students) since 2021, marking the second year of enrollment decline. Master’s nursing programs prepare individuals for a variety of roles in administration, teaching, research, informatics, and direct patient care. Currently, 658 schools of nursing nationwide offer master’s degree programs with a population of 131,524 students. AACN continues to monitor master’s program enrollments to identify any factors that may be influencing student demand, including the steady increase in enrollment in the practice doctorate. 

Enrollment in PhD nursing programs continued to decline, with a 4.1% decrease (183 students) from 2021 to 2022. Since PhD program enrollment began to dip in 2013, enrollments has decreased by 14.8%, from 5,145 students in 2013 to 4,381 students in 2022. This downward trend over the last 9 years has created great concern among academic nursing leaders responsible for preparing future nurse scientists, educators, and leaders. In its report on the Future of Nursing: 2020-2030, the National Academy of Medicine, Science, and Engineering called the lack of robust enrollment in the PhD in nursing “a major concern for the profession and for the nation.” AACN’s research and data team are examining survey findings to determine factors that may impact enrollment declines, including program characteristics and applications received.

Last year, Doctor of Nursing Practice (DNP) programs showed virtually no growth with a less than one percent increase (0.6% or 242 students) in enrollment. DNP programs are designed to prepare nurses for practice at the highest level, including Advanced Practice Registered Nurses (nurse practitioners, certified registered nurse anesthetists, clinical nurse specialists, and nurse midwives). Enrollment in DNP programs has grown steadily over the last two decades from 70 students in 2003 to 41,021 students last year. DNP programs are now offered at 426 schools of nursing.

Applications to Schools of Nursing

In addition to enrollment and graduations, AACN tracks applications to schools of nursing in order to better assess interest in nursing education and careers among prospective students. Last year, the total number of applications to baccalaureate and higher degree programs decreased by 5.3%, with programs receiving 721,182 applications in 2021 and 683,002 in 2022. Applications were down in entry-level BSN (-2.4%), RN to BSN (-14.5%), and master’s (-7.3%) programs. In more promising news, applications increased to both DNP (+1.4%) and PhD (+3.7%) programs, which may signal that efforts to promote careers in nursing science are having an impact. 

AACN also tracks qualified applications not offered admission to nursing programs. Even though enrollments were down across program levels last year, thousands of qualified students were turned away from four-year colleges and universities. In 2022, a total of 78,191 qualified applications (not applicants, students may apply to more than one program) were not accepted at schools of nursing nationwide. Within this total, applications turned away included 66,261 from entry-level baccalaureate, 1,239 from RN-to-BSN, 5,907 from master's, 4,583 from DNP, and 201 from PhD nursing programs. Given the persistent shortage of nurse faculty, AACN remains concerned that more than 10,000 applications were turned away from graduate programs, which may further limit the pool of potential nurse educators.  

The primary barriers to accepting all qualified students at nursing schools continue to be insufficient clinical placement sites, faculty, preceptors, and classroom space, as well as budget cuts. For a graphic showing the number of qualified applications turned away from entry-level baccalaureate nursing programs over the last 20 years, click here.

“Maintaining optimal nurse staffing levels is a top concern raised by health system leaders and hospital administrators across settings,” said Dr. Trautman.  “To meet this objective, pathways into nursing must be protected and supported by all stakeholders with an interest in ensuring access to quality health care.”  

AACN is leading the charge to advocate for more federal support for nursing education, including funding for students interested in a nursing career and for schools of nursing to support faculty development and the infrastructure needed to accommodate more students. AACN is also calling for full participation among nursing schools in NursingCAS, the profession’s centralized application service for students seeking to enter nursing school to begin or advance their education. Through NursingCAS, students are alerted to open enrollment slots at schools of nursing, which will help to ensure that all available seats are filled, and fewer qualified applicants are turned away.

About the AACN Survey

Now in its 42nd year, AACN’s annual survey of baccalaureate and higher degree nursing programs is conducted by the association’s Department of Research and Data Services. Information from the survey forms the basis for the nation's premier database on trends in enrollments and graduations, student and faculty demographics, and faculty and deans' salaries. These data are essential for policymaking at the local, state, and federal levels as well as for benchmarking by participating institutions. 

The annual AACN survey is a collaborative effort, with data on nurse practitioner programs collected jointly with the National Organization of Nurse Practitioner Faculties and data on clinical nurse specialist programs collected with the National Association of Clinical Nurse Specialists. Complete survey results are compiled in three separate reports, including:

• 2022-2023 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing
• 2022-2023 Salaries of Instructional and Administrative Nursing Faculty in Baccalaureate and Graduate Programs in Nursing 
• 2022-2023 Salaries of Deans in Baccalaureate and Graduate Programs in Nursing 

To obtain copies, visit AACN's website.

View Highlights from AACN's 2022 Annual Survey

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About the American Association of Colleges of Nursing
The American Association of Colleges of Nursing (AACN) is the national voice for academic nursing representing more than 865 schools of nursing nationwide. AACN establishes quality standards for nursing education, influences the nursing profession to improve health care, and promotes public support of baccalaureate and graduate nursing education, research, and practice.