The contradiction between tremendous interest and a failure to meet that need from both institutions and the labor market reveals something important: California’s nursing shortage is not simply an enrollment problem. It is a systems problem.
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The contradiction between tremendous interest and a failure to meet that need from both institutions and the labor market reveals something important: California’s nursing shortage is not simply an enrollment problem. It is a systems problem.
In Los Angeles County, nearly 5,000 registered nurse positions were open in 2023 while the region’s nursing programs graduated just under 4,400 nurses. Those numbers cannot be matched one to one. Many openings require experienced nurses that new graduates cannot immediately fill, and when experienced nurses retire, the nurses who move up to replace them leave entry-level openings behind.
Over the next decade, Los Angeles County is projected to see more than 5,600 RN openings every year. California already ranks 39th nationally in nurses per capita, and four in ten Californians say their community does not have enough nurses or doctors.
As our population ages and experienced nurses retire, the consequences will become increasingly visible: longer waits for care, greater pressure on hospitals, and fewer healthcare professionals available when communities need them most.
But the most important question is whether our education, healthcare, and workforce systems are designed to move enough people efficiently from interest, to education, to clinical training, to employment, and ultimately to career advancement.
You guessed it. Right now, they are not.
Consider clinical training. Private institutions take 71% of local clinical training slots, even though California’s public colleges and universities provide nursing education at a fraction of the cost. Meanwhile, public institutions turn away qualified applicants because they lack sufficient instructional and clinical capacity.
At the other end of the pipeline, new graduates can struggle to secure their first nursing position while hospitals simultaneously report shortages of experienced nurses.
These are different breaks in the same pipeline.
California has repeatedly approached the nursing shortage through individual policies, individual programs, and individual investments. Yet no single college, university, hospital, or workforce agency controls the entire pathway from student entry to licensed practice and career advancement.
Regional coordination is not an administrative add-on; it is essential infrastructure. The LARC serves as the connective tissue that aligns priorities, leverages collective resources, and transforms individual institutional efforts into regional impact. Here in Los Angeles County, we are already demonstrating what is possible when we move from silos to systems. The challenge now is not whether this model works, but whether we have the commitment and investment to take it to scale
California already supports a statewide system designed to connect nursing students with clinical training sites. Yet technology alone cannot solve a coordination problem. A platform only works when colleges, universities, and hospitals across a region agree to use it together, share information, and align their practices around a common goal.
That requires sustained regional capacity.
As California enters a new legislative session and prepares for a new governor, policymakers should keep rethinking how the state approaches this workforce crisis. Not one more isolated solution. Not one more short-term pilot that disappears just as partnerships begin to take hold.
Instead, California should invest in the regional infrastructure required to make the entire nursing pipeline work. That means sustained funding for regional coordination. It means strengthening shared clinical-placement infrastructure and creating incentives for hospitals and public colleges to expand clinical capacity together. It means building seamless ADN-to-BSN pathways and stronger transitions from graduation into practice. And it means giving employers, colleges, universities, and workforce partners shared accountability for outcomes.
If a coordinated model can connect 19 community colleges, college and university partners, healthcare employers and workforce organizations across one of the nation’s largest and most complex labor markets, it can offer a blueprint for other regions confronting similar shortages.
In California, we did not create its nursing challenge overnight, and one bill will not solve it. However, every student who is ready to become a nurse, every hospital searching for qualified talent, and every Californian who will one day need a nurse at their bedside is counting on us to build a system that works from beginning to end.
Dr. Keith Curry is the president and CEO of Compton College in California, and Dr. Narineh Makijan is the chair and Assistant Vice President of the Los Angeles Regional Consortium (LARC).
This story originally ran in The EDU Ledger's November 5, 2026 edition. Subscribe here for full access.
