California is facing one of the most severe nursing shortages in the country, and front-line workers say the crisis is not due to a lack of people willing to serve — but to worsening management practices that drive nurses away and compromise patient safety.
A new report by KFF Health News reveals that nearly 60% of California counties are now short on registered nurses, with shortages projected to surge over the next decade. As demand grows with an aging population and increasing complexity of care, the state is not producing, retaining, or supporting enough bedside nurses to meet basic needs.
Despite state investments and reforms, the gap between what patients require and what the healthcare workforce can deliver continues to widen — particularly in hospitals, emergency rooms, and long-term care facilities.
According to projections from the California Health Care Foundation, the state’s registered nurse shortage is expected to grow from a 3.7% deficit in 2024 to over 16% by 2033 — a gap of more than 61,000 nurses.
Areas hardest hit include:
Researchers say inadequate career pathways and high turnover contribute to the crisis. But nurses themselves overwhelmingly point to something else:
Poor management practices that overload staff, increase patient ratios, and push RNs out of the profession altogether.
Lorena Burkett, a registered nurse of 12 years in Turlock, described being so overwhelmed that she briefly failed to document an opioid dose — a mistake she says never would have happened under safe staffing.
“We are under pressure to get patients out and free up beds,” Burkett said. “It’s about profit, not patient care.”
Nurses statewide report:
Unions argue that staffing shortages are manufactured by hospitals prioritizing profit margins. Industry groups deny that claim, blaming rising labor and equipment costs.
Even though many hospitals say they’re losing money on daily operations, state data shows the industry reported $11.5 billion in net income in 2024, returning to pre-pandemic profit levels.
At the same time:
And looming federal health-care cuts may exacerbate financial pressure, especially for hospitals serving low-income and uninsured populations.
Nurses say COVID-era trauma was never fully resolved. Many left or retired early, and hospitals turned to traveling nurses — creating unstable care teams and increasing costs.
At Hazel Hawkins Memorial Hospital, for example:
California requires strict nurse-to-patient ratios. Still, since 2020 the state has issued 32 citations totaling $840,000 for violating minimum staffing laws.
California lawmakers have taken steps to support the workforce, including:
Still, nurses say these efforts are not enough when management pressures and unsafe workloads continue to push staff away.
State Sen. Caroline Menjivar — a former emergency medical technician — is pushing new legislation to enforce staffing laws more aggressively.
“Hospitals have been getting a pass,” she said. “If we don’t support nurses, patients pay the price.”
The nursing shortage directly impacts the safety of vulnerable residents in long-term care.
Fewer nurses means:
For families, this translates to more risk — and fewer safeguards — in nursing homes and rehabilitation facilities.
When touring or checking on a facility, ask:
If the facility can’t answer these questions clearly — or avoids them — it’s a red flag.
If your loved one has suffered falls, bedsores, medication errors, or neglect linked to short staffing, our nationwide team can help investigate what went wrong.
Bedsore.Law holds facilities — and corporate owners — accountable when unsafe staffing puts residents at risk.
Source: KFF Health News / California Healthline (via Healthbeat)
