For healthcare organizations, the latest nursing workforce data offers both encouragement and a warning.
A recent study published in the Journal of Nursing Regulation found that nurses under age 35 are no longer the most burned-out group in the profession a notable shift from 2022, when younger nurses reported the highest levels of stress, emotional exhaustion, and intent to leave nursing.
That is welcome news for hospitals, long-term care facilities, rehabilitation centers, behavioral health providers, and other healthcare employers that have invested heavily in nurse retention. However, the same study also revealed a major concern: the number of young registered nurses in the U.S. workforce declined sharply between 2022 and 2024.
For healthcare leaders already struggling with nurse shortages, recruitment delays, rising labor costs, and workforce instability, the findings highlight a critical reality: domestic nurse retention alone may not be enough. Many organizations are now looking more seriously at international nurse recruitment, nurse immigration solutions, and employment-based visa strategies to build a more reliable long-term staffing pipeline.
The Under-35 Nursing Workforce Has Shrunk Significantly
According to the study, nurses under age 35 represented only 18% of the registered nurse workforce in 2024, down from 24.3% in 2022. That change reflects an estimated net loss of approximately 200,000 young RNs in just two years.
The decline was not limited to registered nurses. The supply of young licensed practical nurses and licensed vocational nurses also dropped, falling from 20.7% of the LPN/LVN workforce in 2022 to 15.9% in 2024 a net loss of more than 44,000 workers.
At the same time, the share of nurses aged 50 and older increased by 24%.
This trend should concern healthcare employers because older nurses are closer to retirement, while younger nurses typically represent the future of the profession. If fewer young nurses remain in the workforce, hospitals and healthcare systems may face deeper staffing gaps in the years ahead.
Although researchers noted that 2022 numbers may have been elevated by pandemic-era nursing school enrollment surges, the overall pattern still raises important questions about the strength of the U.S. nursing workforce pipeline.
Younger Nurses Are Reporting Less Burnout Than Before
One of the more positive findings is that burnout among younger nurses appears to have improved.
In 2022, nurses under 35 reported significantly higher emotional exhaustion than nurses between ages 35 and 49. They scored worse across multiple burnout indicators and were more likely to say they intended to leave the profession.
By 2024, that gap had largely closed. In fact, young registered nurses were less likely than nurses ages 35 to 49 to report feeling emotionally drained.
This shift may reflect several factors, including:
- Improved working conditions in units or facilities where younger nurses are concentrated
- Better onboarding, mentoring, and early-career support programs
- Reduced pandemic-related pressure compared with 202-2022
- The departure of some of the most burned-out young nurses from the profession
For healthcare organizations, this suggests that retention strategies can work. Investments in nurse mentorship, scheduling flexibility, clinical support, professional development, and workplace culture may be helping early-career nurses stay engaged.
However, lower burnout does not automatically mean the staffing crisis is over.
Many Young Nurses Still Plan to Leave the Profession
The study found that young nurses are less likely than they were in 2022 to report plans to leave nursing, but exit intent remains a serious problem.
In 2022, young RNs were 44% more likely than middle-aged nurses to say they planned to leave the profession within five years. By 2024, that gap had narrowed to 10%.
That improvement is meaningful but the underlying number remains concerning. Roughly 15% of young nurses still say they intend to leave the nursing profession within five years.
For employers, even a modest percentage of nurse exits can create major operational challenges. Nurse turnover affects patient care, staff morale, overtime costs, agency spending, and continuity of care. In high-need settings such as hospitals, skilled nursing facilities, home health agencies, and rural healthcare systems, losing nurses can quickly worsen already strained staffing models.
This is where long-term workforce planning becomes essential. Healthcare organizations need strategies that go beyond short-term hiring. They need sustainable nurse recruitment pipelines, including domestic hiring, retention programs, and, where appropriate, international nurse sponsorship.
Pay Remains a Major Factor for Younger Nurses
The study also found that salary is a stronger driver of exit intent among younger nurses than older nurses.
Among young RNs who said they planned to leave nursing, 60% cited inadequate salary. By comparison, 49% of nurses ages 35 to 49 cited pay as a reason for wanting to exit.
The same pattern appeared among LPNs and LVNs. Approximately 56% of young LPNs/LVNs who planned to leave cited salary, compared with 48% of middle-aged peers.
Stress, workload, and understaffing remained the most common reasons nurses across all age groups planned to leave, with approximately 65% to 81% of nurses identifying these issues. Still, the salary gap is important because it shows that younger nurses may be especially sensitive to compensation pressures.
This creates a difficult balancing act for healthcare employers. Facilities must compete for domestic nurses in a tight labor market while also managing reimbursement challenges, rising operating costs, and increased demand for care.
For many organizations, relying exclusively on local hiring may not be enough to meet patient care needs.
The New Nursing Workforce Is More Diverse and Not Always Young
Another important finding is that the newest group of nurses entering the profession is becoming more racially diverse and older.
In 2024, only 54% of RNs licensed for fewer than two years identified as white/Caucasian, compared with 71% in 2022. Among newly licensed LPNs/LVNs, Black nurses represented nearly one-third of the group, increasing from 20% in 2022 to 32% in 2024.
Researchers also noted that Black and Hispanic nurses often enter nursing at older ages. For example, the median age of first licensure for Black RNs was 30, compared with 25 for white/Caucasian RNs.
This distinction matters for employers. A “new nurse” is not always a “young nurse.” Some newly licensed nurses may be balancing family responsibilities, second-career transitions, financial obligations, or relocation needs. Retention strategies must be tailored accordingly.
For healthcare organizations hiring international nurses, this is especially relevant. Internationally educated nurses may bring years of clinical experience, diverse cultural backgrounds, multilingual skills, and strong motivation to build long-term careers in the United States. However, they also require structured onboarding, immigration support, credentialing guidance, and workplace integration.
What This Means for Healthcare Employers
The latest nursing workforce data sends a clear message: while burnout among younger nurses may be improving, the overall nurse staffing pipeline remains fragile.
Healthcare employers should be asking:
- Will our current domestic recruitment strategy meet future staffing needs?
- Are we prepared for retirements among older nurses?
- Do we have a plan to reduce turnover among early-career nurses?
- Are we using every available legal pathway to recruit qualified nurses?
- Could international nurse hiring help stabilize our workforce?
For many healthcare organizations, international nurse recruitment is becoming an essential part of workforce planning. Employment-based immigration options can help hospitals, nursing homes, rehabilitation centers, and healthcare systems fill critical nursing roles with qualified professionals from abroad.
International Nurse Hiring Can Support Long-Term Staffing Stability
The U.S. continues to face persistent nurse shortages across many regions and care settings. While international hiring is not a replacement for improving workplace conditions, it can be a powerful complement to domestic recruitment and retention efforts.
Hiring foreign-trained nurses may help healthcare employers:
- Reduce chronic nurse vacancies
- Lower dependence on temporary staffing agencies
- Improve continuity of patient care
- Build a more stable full-time workforce
- Expand diversity and cultural competency within care teams
- Address staffing shortages in rural and underserved communities
- Strengthen long-term workforce planning
Common immigration pathways for international nurses may include employment-based immigrant visas, Schedule A nurse green card sponsorship, consular processing, adjustment of status, and related visa strategies depending on the employer, nurse qualifications, country of birth, licensing status, and immigration timing.
Because nurse immigration involves multiple legal, regulatory, and credentialing steps, healthcare organizations benefit from working with an immigration law firm that understands both healthcare staffing and employment-based immigration.
Why Healthcare Organizations Need an Immigration Strategy Now
The decline in younger nurses should serve as a wake-up call. Even as burnout improves, the domestic nursing workforce may not be growing fast enough to meet future demand.
Waiting until vacancies become urgent can leave employers facing long delays. International nurse hiring often involves credential evaluation, English proficiency requirements, NCLEX passage, state licensing, VisaScreen certification, immigrant visa processing, and coordination with government agencies.
The earlier a healthcare organization begins building an international nurse recruitment and immigration plan, the better positioned it will be to meet staffing needs over the next several years.
A strong immigration strategy can help employers identify:
- Which nursing roles are eligible for sponsorship
- Whether candidates qualify for nurse green card processing
- What documents are needed from the employer and nurse
- How long the immigration process may take
- Which risks could delay approval
- How to structure compliant recruitment and onboarding systems
For healthcare employers, international nurse sponsorship is not just a hiring tactic. It is a long-term workforce investment.
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Nurse staffing challenges are changing and healthcare organizations need solutions that look beyond today’s vacancies.
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