Narrative Review of the US Specialty Palliative Nursing Workforce 2025: Measurement for Now and the Future.

Abstract

A robust, expertly trained nursing workforce is needed to care for over 13 million people living with serious illness in the United States (US). However, palliative nursing workforce needs remain poorly characterized. To describe the current state and future demands for palliative nursing in the US. We conducted a narrative review of the palliative nursing workforce in the US. Literature was identified through PubMed and CINAHL (1981-2025) using terms related to palliative care, nursing, workforce, training, and certification. Articles were selected based on relevance, with additional sources identified through snowball sampling. Findings were synthesized qualitatively. We identified 39 sources, grouped into three categories: education, certification, and workforce. Palliative nursing education was not formally integrated into US nursing curricula until 2021 with the AACN publication of The Essentials, and only 12 healthcare organizations offer specialty nurse residency or fellowship programs. The National Board for Certification of Hospice Nurses was established in 1992 in the US and awarded the first certification to registered nurses in 1994; in 2025 nearly 12,000 nurses are certified. Workforce data remain limited due to the diversity of nursing roles in hospice and palliative care. No comprehensive estimate exists for the broader palliative nursing workforce; however, a 2024 national survey estimated 56,619 registered nurses working in hospice. Limited targeted measurement of the specialty palliative nursing workforce constrains the ability to quantify supply and gaps. Research linking education, training, and certification to patient outcomes could inform planning for the future US palliative nurse workforce.