The Best and Worst States to be an RN: 2015 Edition

This article was republished with permission from SCRUBS Magazine.

If you’re an RN or thinking of becoming one, we have good news: The registered nurse is expected to be among the fastest growing professions in the United States in the coming years.

The latest numbers from the U.S. Bureau of Labor Statistics (BLS) predict that employment of registered nurses will grow 19 percent between 2012 and 2022. This is compared to 11 percent growth expected across all occupations during the same time period.

As we’ve discussed in recent articles on nursing salary and the highest paying nurse specialties, RN salaries vary widely across the U.S., from state to state and city to city. Of course, the cost of living varies just as widely.

With this in mind, check out the following data exploring what the nursing industry is like in different areas across the country, including states with the highest (and lowest) nurse salaries, cost of living and more.

We know that each nurse has his or her own definition of “best” and “worst” places to work; does this data impact your perceptions? Do the numbers reinforce that you are happy where you are working or make you want to explore possibilities in new areas? Let us know in the comments below!

Top Five RN Mean Hourly Wage by State

As it has for many years, California has the highest RN pay rate of any state, with an annual mean salary of $98,400, according to the BLS. The state also has the highest number of registered nurses in the U.S., with 253,310 RNs currently working.

California: $47.31
Hawaii: $42.42
Massachusetts: $41.23
Alaska: $41.22
Oregon: $39.87

Five States with Highest Cost of Living

Seeing the high salaries in the list above, it probably comes as no surprise that many of these states have among the highest costs of living in the country. USA Today released an informative list of the top seven most expensive states to live in, drawing data from a variety of sources.

Two states—Alaska and Hawaii—that are among the top five states for nursing salaries are also among the top five most expensive states to live in. California barely missed the cutoff, coming in at number six on the Cost of Living Index* list.

Hawaii: 162.9
Washington, D.C.: 139.6
New York: 132.2
Alaska: 131.8
New Jersey: 127.6

*Note: Cost of Living Index measures the cost of services and consumer goods in an area relative to the rest of the country. The average for the entire U.S. is 100 and the Cost of Living Index is read as a percentage of that average.

Five States with Highest Nursing Employment (Rate of RNs per 1,000 Jobs)

While looking at nursing employment as a whole, the number of nurses working in each state is of course significantly affected by the total population in that state. To get a better idea of how common RN jobs are in a state’s workforce, here’s a look at the states with the highest quotient of registered nurses, measured in RN employment per 1,000 jobs.

South Dakota: 28.41
West Virginia: 27.01
Mississippi: 25.66
Rhode Island: 25.43
Missouri: 25.15

Lowest Five RN Mean Hourly Wage by State

Of course, it’s also important to see what states offer the lowest RN pay. Though these wages are relatively low, many of these states offer a very low cost of living.

South Dakota: $25.95
Iowa: $25.97
West Virginia: $27.11
Alabama: $27.15
Arkansas: $27.15

Five States with the Lowest Cost of Living

Two of the states with the lowest hourly wages also appear in the top five least expensive places to live. Two more—Alabama and Arkansas—appear in the top 10. Here’s a look at the five states with the lowest Cost of Living Index, according to USA Today.

Mississippi: 87.8
Tennessee: 89.7
Kentucky: 90.0
Oklahoma: 90.4
Indiana: 90.7

Five States with Lowest Nursing Employment (Rate of RNs per 1,000 Jobs)

Even though California has the most RNs currently working, it also has among the lowest number of RNs relative to its overall workforce. Here are the five states with the lowest number of RNs in relation to the total number of jobs.

Utah: 15.26
Nevada: 15.49
Oklahoma: 16.73
California: 16.75
Texas: 16.94


Urban vs. Rural

The U.S. Department of Health and Human Services released a report with additional information on the current nurse workforce, including stats on the number of RNs who work in urban areas versus those who work in rural areas.

The report finds that 15.7 percent of RNs work in rural areas of the U.S. This is compared with 17 percent of the workforce as a whole that works in rural areas.

However, the report also finds that there are more RNs per capita in urban areas than in rural ones. There are 934.8 RNs per 100,000 residents in urban areas compared to 852.7 RNs per 100,000 people in rural areas.

Five Non-Metro Areas with Highest Nursing Employment (Rate of RNs per 1,000 Jobs)

Speaking of urban versus rural, it’s also interesting to see where the nursing jobs are in non-metro areas. The following are the five non-metro areas (designated by the BLS) that have the highest rate of RNs per 1,000 jobs.

Western New Hampshire non-metropolitan area: 36.03
Hammond (LA) non-metropolitan area: 30.08
East Kentucky non-metropolitan area: 30.02
Southeast Mississippi non-metropolitan area:
Southern Ohio non-metropolitan area:


Nurse Legislation by State (in Brief)

Finally, many states have passed legislation affecting the careers of RNs and other nurses. Some of the more common and/or controversial are listed below.

  • 33: Number of states that have a legislative mandatory education requirement for license renewal/re-registration. See the entire list at the ANA website.
  • 3: Number of states (New York, New Jersey and Rhode Island) that have introduced legislation to require RNs to obtain a BSN within 10 years of initial licensure. To date, none of these measures have passed.
  • 14: Number of states that have addressed nurse staffing ratios through legislation.
  • 1: Number of states with minimum nurse-patient ratio requirement (California). Massachusetts has a law requiring a 1:1 or 1:2 nurse-patient ratio in the ICU, depending on the stability of the patient.

This article was republished with permission from SCRUBS Magazine.


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