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Why nearly 200,000 of these good-paying jobs will go unfilled

America, we need more nurses.

By 2020, the U.S. economy will create an estimated 1.6 million jobs in nursing. But hospitals and care facilities will be short 193,000 nurses to fill those positions. That’s according to a report from Georgetown University’s Center for Education and the Workforce.

It’s a demanding job—often 12-hour shifts, constantly on-the-go, caring for others. But it pays well. The average annual salary for a licensed practical nurse -- a certification usually tied to an associate degree-- is nearly $43,000. For a registered nurse, someone who typically holds a Bachelor of Science in Nursing, it’s $68,910 a year. For those with more advanced degrees in the field, salaries are even higher. A nurse practitioner makes about $95,070 a year on average.

It's a steady job with good pay, so why the coming nurse shortage? Reasons include an aging U.S. population -- we'll need more nurses to care for the elderly -- as well as an aging profession. Lots of demand, weakening supply. “Many of the nurses who are registered nurses right now in this country are in fact aging,” says Nicole Smith, Senior Economist at the Georgetown University Center of Education and the Workforce who was one of the leads on the study. “Over 50% of the nurses are over 50 years old. We have many nurses we expect to retire you know in the next 10 to 15 years,” she says.

And, thanks to the Affordable Care Act, in addition to those openings, there will be many newly-created jobs as well. And not just the traditional type of nursing positions.

Bobby Matthews, who handles talent acquisition and retention for the Mount Sinai Health System in New York, says the Affordable Care Act has put emphasis back on preventive care. “As care moves from less of an in-patient focus to more of an out-patient focus,” he says, “we’re going to have a higher need for things like clinical coordinators, patient navigators, nurses that are educated in the community so they are never admitted to the hospital to begin with.”

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The job opportunities are there, but many can't get the credentials needed to take advantage. That's because nursing schools can’t keep up with demand. According to the Georgetown study, 37% of applicants with the necessary test scores and qualifications were rejected from nursing schools. That’s largely because these schools simply don’t have the space or faculty to keep up with demand. Another report from the American Association of Nursing Schools found more than 78,000 applicants in total were rejected from undergraduate and graduate nursing schools in the 2013-2014 academic school year.

Matthews says there are challenges already in finding top talent for nursing positions specifically in certain niche fields like neurosurgery and oncology. Finding experienced nurses in these fields can be difficult he says. "We have to start looking ahead and figure out how we are going to train talent that we already can we can we give them the skills and education to help them transition into those roles?"

For those with the education and qualifications, it’s a demanding job with solid pay and room for growth. Zhanna Khandros, a registered nurse at the cardiac care unit at Mount Sinai Heart Hospital in New York, started her career as a Licensed Nurse Practitioner, but once on the job, went back to school to get her Bachelor’s of Science. The hospital she was working for at the time, reimbursed her for tuition. She became an RN and eventually moved to a better-paying job at Mount Sinai Heart.

But for Khandros, it’s not the pay and career mobility, that drew her to the profession, she says. “At the end of the day, no matter how hard your day is no matter how much you’re running, no matter how much you’re on your feet and you’re exhausted,” she says, “when that patient thanks you for everything you’ve done, you say okay maybe it’s all worth it. It’s all worth it.”

Tips for those considering the nursing field? Get as much education as possible. “It’s an opportunity to attach yourself to a job that pays a pretty decent starting wage,” says the Georgetown economist Smith. Smith says her research has found many of the most competitive and top-paying hospitals are now requiring a bachelor of science degree in nursing for many staff jobs.

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