Why Hospitals Are Building Their Own Nursing Pipelines

Hospitals and health systems have long faced a tough staffing question: buy or build?

For years, many bought their way through the nurse shortage by relying on traveling or agency nurses — a quick but costly fix. Now, as labor expenses remain high and vacancy rates persist, some organizations are choosing a third way: a “built-for-you” workforce model that develops home-grown nurses from within.

A new AHA Trailblazers report, “Buy or Build? Solving the Nursing Shortage,” explores how hospitals partnering with workforce education companies are creating reliable, sustainable nursing pipelines and cutting their dependency on contract labor.

The Numbers Behind the Shortage

The Bureau of Labor Statistics projects more than 189,000 open RN positions every year through 2034. Yet, despite rising demand, traditional nursing schools can’t keep pace.

In 2024-2025 alone, 65,398 qualified applicants were turned away due to limited faculty and clinical placement capacity, according to the American Association of Colleges of Nursing.

At the same time, hospitals are spending heavily to fill gaps. The AHA’s “Cost of Caring” report found that labor costs reached $890 billion in 2024 — 56% of total hospital expenses.

3 Takeaways for Hospital Leaders

Cultivate talent from within. Hospitals increasingly are looking to their own workforce to fill nursing gaps — helping administrative and support staff advance into clinical roles through targeted education and training opportunities.
Collaborate to accelerate workforce development. Partnerships between hospitals and academic or education providers can expand nursing pipelines more efficiently, combining clinical training environments with existing instructional expertise.
Track outcomes and retention over time. Some organizations that invest in internal talent pathways and partnerships are seeing such benefits as improved staff engagement, lower turnover and greater workforce stability.

A Case Study in Action

Community Medical Centers (CMC) in Fresno, California, launched its Nursing Education Pathway in 2024 with Unitek College. More than 175 employees enrolled across seven cohorts, combining online coursework with hands-on clinical training at CMC facilities. “The response has surpassed our expectations,” says Danny Davis, R.N., CMC division president. “Our culture is changing for the better as team members become peers with the nurses they’ve long supported.”

Hospitals can’t rely solely on the external labor market to fill critical roles. By partnering to train and license nurses from within, they’re building something more powerful than a quick fix — a permanent, patient-ready workforce pipeline. Download the report.

Sponsored by UniTek Learning