What Are the Best States for Nurses?

sheila mickool

Written and reported by:

Sheila Mickool

Contributing writer

A nurse checks a little girl's mouth as she sits on her mother's lap
A nurse checks a little girl's mouth as she sits on her mother's lap

For anyone who’s thought about becoming a nurse, now could be the time to jump into this versatile career. Nurses are in demand virtually everywhere. The U.S. Bureau of Labor Statistics (BLS) expects the number of nursing jobs to grow by 9% from 2020 to 2030. That translates into more than 190,000 job openings each year over the decade.

With so many opportunities in the field, we’ve ranked all 50 states for nurses, based on salary, affordability, and other metrics.

Top 10 States for Registered Nurses

Many states—especially those on our top 10 list—share a strong commitment to advancing nursing practice, innovation, leadership, education, standards, and care initiatives. If you are considering becoming a registered nurse or taking your current nursing career to the next level, there will be opportunities across the country. And if you have the flexibility to relocate to another state, this may be a good time to consider it.

The information included here will help you evaluate your best options. Which states pay the most? That’s the first question most people ask. But it’s just as important to consider which states are most affordable—and which have a significant number of jobs.

At first glance, Alaska, with a median salary of $99,110, looks attractive. But there are only 6,060 registered nurses employed in the state and the cost of living is high compared to many other states. Illinois’ median salary is $77,589, but there are more than 129,000 RNs employed in the state, and the cost of living is much lower.

Either state—or both—may be a good choice for you, depending on your flexibility and priorities.

#1 Illinois

Median salary: $77,580

Cost of living index: 90.5

Number of nurses employed: 129,260

Location quotient (density of jobs in a given area): 1.06

Forecast for growth (2018-2028): 12.4%

State highlights: Illinois takes the top spot with solid overall rankings. Broken down, the state is seventh in employment and ninth in affordability. Plus, it ranks among the top 25 states in salary, location, and projected job growth. All of this means that registered nurses in the state are paid well, jobs are plentiful, and it’s an affordable place to live. In addition, job density is above the national average, and solid growth is projected through 2028. Historically, Illinois has been a leader in nursing practice and education. The Illinois Training School for Nurses, the first nursing school in the state as well as the Midwest, was founded in 1880.

#2 Michigan

Median salary: $76,710

Cost of living index: 91.4

Number of nurses employed: 102,480

Location quotient (density of jobs in a given area): 1.17

Forecast for growth (2018-2028): 9.8%  

State highlights: Michigan is a very close second to Illinois. Like Illinois, Michigan ended up with rankings in the top half of states for all categories and two top 10 rankings—for employment and location quotient. Just a few years after Illinois opened its first nursing school, Michigan did the same. In 1891, Michigan’s first nursing training program was established and the first six students were enrolled.

#3 Pennsylvania

Median salary: $76,940

Cost of living index: 100.5

Number of nurses employed: 149,270

Location quotient (density of jobs in a given area): 1.24

Forecast for growth (2018-2028): 12.5%

State highlights: Strong rankings for both the employment of RNs and job density cement Pennsylvania’s high ranking, and solid projected job growth makes the state attractive for registered nurses. Pennsylvania made nursing history as the home to nurse, educator, and Brig. Gen. Hazel Johnson-Brown, the first female African-American general and chief of the U.S. Army Nurse Corps.

#4 Minnesota

Median salary: $79,100

Cost of living index: 99.6

Number of nurses employed: 69,000

Location quotient (density of jobs in a given area): 1.17

Forecast for growth (2018-2028): 12.4%

State highlights: Minnesota has solid rankings in all categories and is respected for its history of contributions to the advancement of nursing and medicine. Diane Carlson Evans, a renowned U.S. Army nurse who served during the Vietnam war, was born and raised in the state. She later founded the Vietnam Women’s Memorial on the grounds of the Vietnam Memorial in Washington, D.C., in honor of the 11,000 women who served in that war, many of whom were nurses.

#5 Ohio

Median salary: $74,080

Cost of living index: 92.9

Number of nurses employed: 129,720

Location quotient (density of jobs in a given area):1.15

Forecast for growth (2018-2028): 9.6%

State highlights: Out of the 50 states, Ohio is 34th in size, but it’s a powerhouse for nursing. It ranks sixth overall in employment and boasts a cost-of-living index of 92.9, notably lower than the national average of 100. In 1904, the Ohio State Association of Graduate Nurses was incorporated, with Mary Hamer Greenwood serving as president. The organization worked to secure legislation for the advancement of the nursing profession and to improve education standards for nurses. Today, the organization is known as the Ohio Nurses Association.

#6 Massachusetts

Median salary: $94,960

Cost of living index: 132.5

Number of nurses employed: 88,270

Location quotient (density of jobs in a given area): 1.20

Forecast for growth (2018-2028): 8.2%

State highlights: Massachusetts has a long history of supporting the advancement of nursing. Clara Barton—known as the Angel of the Battlefield for her work in the Civil War and founder of the American Red Cross—was born here. Massachusetts ranks in the top 10 in salary, jobs, and location quotient. With a median salary of $94,960, the state pays its nurses well and ranks highest in salary among the top 10. The state does have a downside, however: Massachusetts ranks 47th overall in affordability, with a cost-of-living index of 132.5, far above the national average of 100.

#7 Missouri

Median salary: $61,920

Cost of living index: 91.2

Number of nurses employed: 69,240

Location quotient (density of jobs in a given area): 1.17

Forecast for growth (2018-2028): 16.2%

State highlights: Missouri has the lowest median salary in the top 10 and ranks 44th in this category nationally. Despite this, the state ranks in the top 15 overall in the other categories. It’s also the birthplace of Virginia Henderson, known as the “first lady of nursing” for her work in defining the role of nurses in healthcare.

#8 Wisconsin

Median salary: $76,560

Cost of living index: 95.5

Number of nurses employed: 62,860

Location quotient (density of jobs in a given area):1.05

Forecast for growth (2018-2028): 7.8%

State highlights: Wisconsin is firmly in the middle of the pack in the overall rankings, pushing the Midwestern state into the eighth spot in the top 10. Child welfare and public health is a recurring theme in the state’s nursing history. In 1911, recent nursing graduate Cornelia Van Kooy became the first child welfare nurse for the Milwaukee Health Department. Van Kooy, considered the mother of public health nursing in Wisconsin, went on to make Wisconsin’s public health service a model for other states.

#9 Texas

Median salary: $77,320

Cost of living index: 92.6

Number of nurses employed: 217,630

Location quotient (density of jobs in a given area): .82

Forecast for growth (2018-2028): 16.8%

State highlights: Among the top 10 states, Texas employs the largest number of nurses by a wide margin, and it’s second among all 50 states. Although Texas is 49th in location quotient, the state does rank in the top half overall for both salary and affordability, and that helped Texas secure its place in the top 10. In 1890, Texas established its first nursing school at the John Sealy Hospital in Galveston, with 18 students admitted to the first class.

#10 North Carolina

Median salary: $72,220

Cost of living index: 96.4

Number of nurses employed: 104,810

Location quotient (density of jobs in a given area): 1.10

Forecast for growth (2018-2028): 10.8%

State highlights: Although the state only ranks 36th for salary, North Carolina landed the final spot in the top 10 by ranking in the top half of all states in affordability and job density and eighth overall in employment. In 1903, the North Carolina Legislature passed the nation’s first law permitting (but not requiring) nurses to become licensed, which reinforced the professional stature of nurses.

Honorable Mention: First in Category

The following states each ranked first overall for nurses in the ranking categories. While none of them made the top 10 list, a state ranking first in any category may be worth checking out.

  • Median Salary: California $125,340
  • Employment: California 324,400
  • Location Quotient: South Dakota 1.55
  • Cost of Living Index: Mississippi 85.1
  • Job Growth Forecast for 2018-2028: Arizona 35%

States Ranked 11-50

Rank and StateMedian SalaryEmployment
#11 New York$96,170188,300
#12 Alabama$60,51049,780
#13 Mississippi$60,79029,140
#14 West Virginia$62,39019,800
#15 New Mexico$78,34017,030
#16 Indiana$62,40066,800
#17 Florida$75,000187,920
#18 Georgia$75,04078,290
#19 California$125,340324,400
#20 Louisiana$64,45042,870
#21 Tennessee$62,39062,250
#22 New Jersey$94,69077,980
#23 Kentucky$62,48043,540
#24 South Carolina$72,65046,160
#25 Washington$96,98062,470
#26 Iowa$61,79032,650
#27 Connecticut$83,86034,320
#28 North Dakota$73,25011,810
#29 Oregon$99,41037,780
#30 Kansas$61,79028,980
#31 Delaware$75,38011,760
#32 Virginia$76,90066,980
#33 Arizona$78,26057,260
#34 Oklahoma$62,17031,510
#35 Colorado$78,07051,680
#36 Maryland$78,35051,550
#37 South Dakota$60,55014,140
#38 Rhode Island$78,90010,860
#39 Arkansas$61,53026,320
#40 Maine$75,04014,380
#41 Nebraska$64,00020,660
#42 Nevada$79,36024,590
#43 Vermont$75,3807,210
#44 Alaska$99,1106,060
#45 Idaho$75,56014,400
#46 Hawaii$111,07011,110
#47 New Hampshire$77,23012,890
#48 Montana$75,0009,640
#49 Wyoming$75,0004,890
#50 Utah$75,00023,760

More About Nursing

Healthcare has struggled with a shortage of nurses for several years, and the problem only intensified with COVID-19. An aging baby-boom population with more complicated health conditions means highly trained nurses are needed more than ever before. To make matters worse, there’s also a shortage of faculty to train new nurses.

The result has been greater shortages and increased nursing burnout. The situation is so serious that the American Nurses Association has asked the Department of Health and Human Services to declare the ongoing shortages a national crisis.

The BLS says the national median salary for registered nurses is $77,600 annually, with the lowest 10% earning $59,450 and the top 10% earning $120,250.

Working with physicians and other healthcare providers, registered nurses provide and coordinate patient care. Common tasks include:

  • Assessing patient conditions
  • Administering medicine and treatments
  • Advising patients and their families about care
  • Operating medical equipment
  • Perform diagnostic testing

RNs work in a variety of places:

  • Hospitals
  • Outpatient surgical centers
  • Doctors’ offices
  • Long-term care facilities
  • Home health care settings
  • Public health departments
  • Government

They often specialize by patient or condition.

To become a registered nurse requires formal education and training, as well as licensing in all states. At a minimum, a diploma from an approved nursing program is required. A two-year Associate Degree in Nursing (ADN) is another option. A Bachelor of Science in Nursing (BSN) is highly recommended as many hospitals and larger medical groups now either prefer or require RNs with a four-year degree.

How Advancing Your Career May Boost Your Salary

As a registered nurse, you’ll have many options to advance your career. In general, the more education and experience you have, the more your salary may increase and the more advancement opportunities you may have.

Gain experience: Even while earning your nursing degree, you can gain experience through required clinical training, volunteering, or working in a medical lab or hospital in an administrative role. This can set you apart from other job candidates once you graduate.

Education: If you have an RN diploma or an ADN, take the next step. Many nurses do this while they work, taking advantage of online programs geared to working professionals and fast-track programs such as ADN-to-BSN degrees. If you have a BSN and want to move into supervisory or managerial roles, a Master’s will up your game, and many hospitals prefer or require that level of education for certain roles.

Registered nurses who want to work at the highest levels with patients can pursue a Master of Science in Nursing (MSN) and become advanced practice registered nurses (APRNs). These highly trained nurses have broad authority to assess and treat patients and provide many of the same preventive care services as physicians. APRNs must have at least an MSN. Some, including nurse anesthetists, soon will be required to earn a Doctor of Nursing Practice (DNP).

Specialize: Many registered nurses find a passion and specialize as travel nurses, trauma nurses, operating room nurses, and more. You may need general experience before jumping into a specialty, and some may require certification.

Certification: RNs who specialize must often be certified. This may require a combination of experience in the specialty, coursework such as continuing education, and testing. Certification is also helpful or required for nurses as they advance into roles such as nurse educators and nurse managers.

Ranking Methodology for the Top States

There are four key questions you are likely to ask yourself when thinking about which states might be best to consider as you enter the field of nursing or seek to further your nursing career:

  • Which states have the most jobs?
  • How much can I earn in those states?
  • Can I afford to live in those states?
  • What is the long-term job outlook in each state?

To answer these questions, we pulled RN data for each state from several sources, including:

Employment, salary, and location quotient: Nursing data from the BLS Occupational Outlook Handbook

Cost of living index: Cost of Living Data Series from the Missouri Economic Research and Information Center

Ten-year job growth projections by state: U.S. Department of Labor’s Projections Central site

To determine the rank of each state, we:

  1. Gathered employment, salary, location quotient, and cost of living index data for each state.
  2. Ranked each data point in relation to all states.
  3. Totaled the rankings for each state.

In the event of a tie, we used the 10-year projected job growth rate as a tie-breaker.


Employment: The current number RNs employed in each state

Annual median wage: The midpoint for annual earnings for all RNs; half earn below the midpoint, and half earn above it.

Location quotient: The ratio of nurses employed in a state compared to the national average concentration. A location quotient greater than one indicates that registered nurses in a state have a higher share of state employment than the national average for nurses. A location quotient of less than one indicates RNs have a lower share of employment than they do nationally.

Cost of living index: This is a measure of the affordability of each state. It’s derived by averaging costs in each state for living expenses, including housing, groceries, transportation, and health. That national average is 100. States with an index below 100 are more affordable compared to the national average and states with an index above 100.

Ten-year job growth projection: This is the projected percentage of growth for registered nurses over a 10-year period. This data point is used in the rankings and as a tiebreaker.

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