North Carolina
The North Carolina nursing shortage, in numbers
By Flor for Nurses ·
Is there a nursing shortage in North Carolina? Yes: 12,459 RNs and 5,044 LPNs short by 2033, per NC Nursecast (Nov 2021 model).
By role
12,459 RNs short in North Carolina by 2033, 11% of the projected RN workforce (NC Nursecast, Nov 2021 model).
5,044 LPNs short in North Carolina by 2033, a 26.8% shortfall in projected LPN supply (NC Nursecast, Nov 2021 model).
NC Nursecast projects RNs and LPNs only, so there is no matching projection for nursing assistants.
By setting
The gap is not spread evenly. Long-term care is short the largest share of the nurses it needs, and hospitals are short the largest number of RNs.
nearly 31% projected RN shortage in nursing homes, extended care and assisted living by 2033 (NC Institute of Medicine, Nov 2021).
nearly 50% projected LPN shortage in nursing homes, extended care and assisted living by 2033 (NC Nursecast key findings, Nov 2021 model).
nearly 10,000 RN positions North Carolina hospitals could be short by 2033 (WUNC, May 2024).
Baseline projection. (NC Nursecast, settings brief, Tables 1 and 2, Nov 2021 model, 2033 projection)
Show the numbers as a table
| Setting | Role | Nurses | % |
|---|---|---|---|
| Nursing homes, extended care, assisted living | RN | -1,888 | -30.8% |
| Home health and hospice | RN | -1,535 | -17.9% |
| Hospital | RN | -9,927 | -16.7% |
| Correctional facility | RN | -128 | -15.7% |
| Nursing education | RN | -132 | -8.9% |
| Mental health hospital or facility | RN | -26 | -0.9% |
| Community and population health | RN | 86 | 1.4% |
| Ambulatory care | RN | 363 | 2.3% |
| Nursing homes, extended care, assisted living | LPN | -3,510 | -49% |
| Hospital | LPN | -314 | -31.7% |
| Home health and hospice | LPN | -504 | -14% |
| Mental health hospital or facility | LPN | -58 | -9.4% |
| Ambulatory care | LPN | -148 | -6.7% |
| Correctional facility | LPN | -9 | -2.2% |
One caution: the Nursecast model was built before the pandemic, and later reporting notes that supply may be smaller than it forecast (WUNC, May 2024).
By region
Wake AHEC (including Raleigh-Durham) and Northwest AHEC (including Winston-Salem) face the largest projected RN shortages, and large metro areas face significantly higher RN shortages than non-metro areas (NC Nursecast key findings, Nov 2021 model).
Mountain AHEC (western NC) and Wake AHEC face the largest projected LPN shortages, and metro and non-metro areas face similar LPN shortages (NC Nursecast key findings, Nov 2021 model).
What it means for pay
A projected shortage has not closed the pay gap with the rest of the country.
$84,350 median annual pay for RNs in North Carolina ($40.56 an hour), 14% below the US median of $97,550 (BLS OEWS, May 2025).
$90,620 median annual pay for RNs in the Charlotte metro ($43.57 an hour) (BLS OEWS, May 2025).
$63,270 median annual pay for LPNs in North Carolina ($30.42 an hour) (BLS OEWS, May 2025).
$38,460 median annual pay for nursing assistants in North Carolina ($18.49 an hour) (BLS OEWS, May 2025).
94% of nurses we surveyed have encountered hidden pay during a job search (n=16, RI and surrounding states) (Flor nurse survey, 2026).
Every job on Flor shows its pay when the employer has given it to us, and says so when it hasn't.
If you work at a smaller facility
Nursing homes, assisted living, home health and hospice carry some of the steepest projected shortfalls in the charts above. If you work in one of them, you work where the state is shortest on nurses. Why nurses pick smaller facilities in North Carolina.
Questions
Is there a nursing shortage in North Carolina?
Yes. NC Nursecast projects North Carolina will be short 12,459 RNs (11% of the projected RN workforce) and 5,044 LPNs (a 26.8% shortfall) by 2033.
Which care settings in North Carolina are shortest on nurses?
Nursing homes, extended care and assisted living: a projected RN shortfall of nearly 31% and an LPN shortfall of nearly 50% by 2033. In raw numbers, hospitals face the largest RN gap, nearly 10,000 positions.
Where in North Carolina is the nursing shortage worst?
Wake AHEC (including Raleigh-Durham) and Northwest AHEC (including Winston-Salem) face the largest projected RN shortages, and large metro areas face significantly higher RN shortages than non-metro areas. Mountain AHEC (western NC) and Wake AHEC face the largest projected LPN shortages, and metro and non-metro areas face similar LPN shortages.
Does the shortage mean higher pay for nurses in North Carolina?
The projections don't forecast pay. Today: $84,350, the median annual pay for RNs in North Carolina ($40.56 an hour), 14% below the US median of $97,550 (BLS OEWS, May 2025).
Do the projections include CNAs?
No. NC Nursecast projects supply and demand for RNs and LPNs only.