NC Nurse Graduates Still Trail Statewide RN Demand
Employers hiring nurses in North Carolina should plan for a graduate pool that remains short of annual replacement and growth needs.
Updated on Nov. 2, 2026 in Nursing Jobs
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The N.C. Health Talent Alliance released a report on North Carolina's nursing pipeline and vacancies, showing state programs produced 4,670 newly licensed registered nurses in 2025 while the state still carries more than 7,000 RN vacancies. For nurse-staffing employers and health systems across the state, the gap between graduates and open positions is the central hiring constraint.
Why it matters
North Carolina needs about 6,930 new registered nurses each year to replace departing workers and fill new jobs, a figure that graduate output has not yet closed. Health systems are competing for the same pool, so retention and local pipeline partnerships are becoming as important as external recruiting.
State programs produced 4,670 new registered nurses in 2025, nearly 3% more than the prior year, while licensed practical nurse graduates rose 18%. Against roughly 6,930 RNs needed annually and more than 7,000 open RN positions, graduate output still falls short of demand, with more than 2,700 certified nursing assistant and over 1,000 medical assistant vacancies also reported statewide.
The players
N.C. Health Talent Alliance
A North Carolina workforce coalition that tracks health-care staffing pipelines and vacancies across the state.
Novant Health
A large multi-hospital health system operating across North Carolina, which competes for nursing talent and is expanding, including a planned hospital in Leland.
UNC Wilmington
A public university in southeastern North Carolina whose nursing graduates are a recruiting source for regional health employers.
Cape Fear Community College
A community college in Wilmington whose nursing programs supply licensed nurses to local employers.
Health Resources and Services Administration
A federal agency that projects health-workforce supply and shortages, including its 2038 full-time RN shortfall estimate for North Carolina.
The details
Nursing programs at UNC Wilmington and Cape Fear Community College are recruiting students and connecting graduates with local employers, and the New Hanover Healthcare Career Partnership funded southeastern North Carolina programs with a grant last year. Novant Health attributes its growing hiring from UNCW, up 103% between 2023 and 2025, to expanded enrollment and recruitment efforts. Its reported retention of 95.5% of regional RNs in Q1 2026 and 98.1% in Q2 2026 shows how much of the pipeline effort depends on keeping nurses once they are hired.
Timeline
2023 to 2025: Novant Health hires 103% more nurses from UNCW.
2025: State nursing programs produce 4,670 newly licensed registered nurses.
Last year (2025): New Hanover Healthcare Career Partnership awards a grant to southeastern nursing programs.
Q1 2026: Novant Health retains 95.5% of regional registered nurses.
Q2 2026: Novant Health retains 98.1% of regional registered nurses.
Market Landscape
The Health Resources and Services Administration projects a 20% shortfall of full-time registered nurses in North Carolina by 2038, which frames the state's current graduate growth as necessary but not yet sufficient. Competition among health systems and community colleges for the same regional graduates is intensifying as employers expand facilities.
Employers hiring RNs, LPNs, and certified nursing assistants in North Carolina should expect continued competition for a limited graduate pool and plan retention alongside recruitment. Staffing and HR teams may find that partnerships with nearby university and community-college nursing programs are a practical hiring channel to evaluate.
The takeaway
Operators hiring clinical staff should treat the 2038 projected shortfall as a planning horizon and budget for retention alongside recruitment. Track the next N.C. Health Talent Alliance pipeline update and compare new RN graduate counts against the roughly 6,930 annual replacement and growth need before committing to long-term staffing plans.
Further reading
For the broader hiring picture, browse current Nursing Jobs openings and employer trends across the state.
Source note: This article includes information reported by Wect.
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