RENTON, Wash. -- It's a sign of a statewide nursing shortage -- dozens of nurses stood outside overnight at Renton Technical College to try to get into a registered nursing course.

There were 40 slots open and 45 LPNs in line.

"This one is first come first serve and doesn't go strictly on grades," said Patricia Beers.

Hospitals are suffering a critical shortage of registered nurses -- there are 100,000 job openings nationwide. By 2020, it's predicted the nursing shortage could lead to 500,000 open positions.

"They'll probably increase their salaries by $20,000 to $30,000 a year by going from LPN to RN," said Dean Heather Stephen-Selby.

It's a difficult program to get in. Classes are competitive and there aren't enough teachers because nursing instructors can make more money working in hospitals and clinics than in classrooms.

"To become an instructor (I) took a 60 percent cut in salary," said Brian Halpern. And he works four jobs.

And he's not just overloaded. So are working RN's. The nursing shortage means more double shifts, more patients, and more burnout.

If hospitals don't have enough nurses, they have to shut down beds and RN's say that happens a lot in Washington, putting patients at risk.

"The risk goes up, patients are at greater risk of facing mistakes while in facility," said one nurse.

It's a vicious health cycle in need of healing. They're overworked and understaffed, but still attracting people willing to camp out in the cold.