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

CONTEXT: A robust, expertly trained nursing workforce is needed to care for over 13 million people living with serious illness in the United States (U.S.). However, palliative nursing workforce needs remain poorly characterized.

OBJECTIVE

To describe the current state and future demands for palliative nursing in the U.S.

METHODS

We conducted a narrative review of the palliative nursing workforce in the U.S. 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.

RESULTS

We identified 39 sources, grouped into three categories: education, certification, and workforce. Palliative nursing education was not formally integrated into U.S. nursing curricula until 2021 with the American Association of Colleges of Nursing 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 U.S. 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.

CONCLUSION

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 U.S. palliative nurse workforce.