The nursing industry is in a significant state of transition. According to the U.S. Bureau of Labor Statistics (BLS), the nursing industry is expected to grow far faster than the average occupation through 2022. Compounded by an aging population, implementation of the Affordable Care Act, and the fluctuation of the economy, it’s easy to see why. Nursing has always been a critical part of the medical industry, and demand for nurses is expected to continue to rise in the coming decades.
Interestingly, these factors are driving a critical shortage for nurses all over the country, thus creating an influx of job opportunities. The BLS projects that the U.S. nursing workforce will grow from 2.71 million in 2012 to 3.24 million by 2022, putting additional strain on an already tight job market. But for recent nursing graduates looking for a new job, some states may be more appealing than others.
Best and Worst States for Nurses
WalletHub, a personal finance social network, recently decided to take stock of the nursing industry in order to help registered nurses “lay down roots in areas that are conducive to both personal and professional success.” Their 2015 report compared the 50 U.S. states and the District of Columbia across 15 key metrics that collectively speak to the nursing job opportunities existing in each market and looked at factors such as the number of nurses per capita, number of job openings, average annual salary, average number of hours worked, and number of health care facilities in the area.
According to WalletHub, Washington State ranked number one overall for nurses, followed by Colorado, Minnesota, Wisconsin, and Texas. In terms of highest salary (when adjusted for cost of living), Texas offers the highest annual salary followed by Michigan, Nevada, Idaho, and New Mexico.
Job opportunities are booming in the District of Columbia, which had the most nursing job openings per capita, along with New Hampshire, New Mexico, North Dakota, and Maine, rounding out the top five. The nation’s capital is projected to have three times as many nurses per capita as Nevada by 2022, though competition will be high. Nevada, on the other hand, has the lowest competition when it comes to jobs with Alaska, California, Hawaii, and Utah trailing.
Louisiana was ranked the worst state for nurses overall with Hawaii, Kentucky, West Virginia, and New Jersey rounding out the bottom. Hawaii has the lowest annual salaries (when adjusted for cost of living) with the District of Columbia, Connecticut, and New York close behind. Alabama ranked dead last with the fewest nursing job opportunities per capita, just below Mississippi and Utah.
The report also revealed a few surprising facts. For example, the entire southeast region of the United States ranked poorly. Conversely, the mountain states fared much better in terms of overall rankings. There were also some extremes revealed in the report between the highest and lowest ranking states. By 2030, the percentage of people age 65 and older will be twice as high in Florida as in Utah and the number of health care facilities per capita is five times higher in Oregon than in Delaware.
Analyzing the Rankings
So, how should nurses use these rankings when deciding their next career move, if at all? Koreyan Crain, RN, a regional nursing director for Epic Health Services, says the nursing field will always strive and blossom. “The fluctuation of the economy has people starving for stability. What better field to find it in?” she says. “Personally, I considered relocating due to the opportunity to grow professionally. If the relocation is going to be beneficial to your professional desires, I say go for it.”
Odysseas Papadimitriou, CEO of WalletHub, says the 2015 state rankings were designed to promote awareness among new entrants into the nursing profession about the most pressing issues facing the field and how the policies used in different states and by different employers can affect the tenor of their day-to-day activities.
“This may lead both recent graduates and currently employed nurses in low ranking states to look across borders for their next job, or it may force them to be more discerning about which hospital or health care facility they sign with locally,” says Papadimitriou.
Should I Relocate?
Relocation may be necessary for recent nursing graduates or anyone looking for a change of scenery if the job demand in their specific geographic region is low. While there is technically a shortage and great demand, that demand is highly variable by state, region, and city.
Jan Jones-Schenk, DHSc, RN, NE-BC, national director of the College of Health Professions at Western Governors University, believes there are many reasons, both personal and professional, why a nurse may consider relocation.
“On the professional side, relocation to gain experience in a specific area of specialization is a common reason,” says Jones-Schenk. “So a new graduate in Northern California, for example, may decide to relocate to Texas where the selection of jobs for new graduates is much more open.”
For mid-career nurses, relocation is a consideration for promotions, significant leadership or teaching opportunities, and other more advanced and specialized roles.
“If you are planning to become a nurse anesthetist, you need to have a number of years in the ICU or Emergency Room in order to apply,” explains Elena Roth, RN, owner of Abcor Home Health, a small home care and home health agency in Chicago. “If you cannot find an opportunity like that locally, you might relocate to a place where you can find it.”
What to Consider
For recent graduates and currently employed nurses considering relocating, Jones-Schenk says there are many factors to consider and suggests doing a little homework first. Consider the following:
- What are the licensing requirements in the state where you are considering moving?
- What does the Board of Nursing of that state require?
- Is the state a compact state? Compact states provide a more seamless state-to-state practice and additional state licensing may not be required.
- What is the practice environment like in the state you are considering?
“For example, if you are considering moving to a state with lots of Magnet hospitals, you will find a greater emphasis on professional development and probably more opportunities for professional growth,” she says.
In addition to considering the constants of the state, such as its crime rate and inclement weather, the cost of living and average salary for nurses should be factored into any decision. WalletHub’s report revealed a glaring difference in terms of salaries from state to state. For example, registered nurses in Nevada earn twice as much as those in Connecticut, when average annual wages are adjusted for cost of living.
Roth says to ask yourself: Are the taxes substantially more than what you are accustomed to? Is the cost of living within your means?
“Of course, you have to consider the monies that you will be making, how far away you have to relocate, [and] the geographical location in which you are moving. Is the company going to assist with the relocation?” she says. “Cost of living is only one factor that you should consider when weighing job and salary offers, but it is an important one.”
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