Top States for Nurses

Nurses are in demand almost everywhere. The Bureau of Labor Statistics projects registered nursing jobs to grow about 5% through 2034, which works out to roughly 189,100 openings a year over the decade. If you're considering the field or thinking about relocating, the state you work in shapes your pay, your cost of living, and how many jobs are actually available.

We ranked all 50 states using salary, affordability, job density, and projected growth. The numbers below come from the BLS and Projections Central releases cited in the methodology, so read them as the ranking's vintage rather than this week's figures.

How to read the rankings

Salary alone won't tell you where you'll do best. Alaska's median is high at $104,910, but only 6,590 RNs are employed there and the cost of living runs steep. Illinois sits lower at $82,470, but it employs more than 139,000 RNs and costs far less to live in. Either could be right depending on your flexibility and priorities. The list below balances all four factors.

Top 10 states for registered nurses

1. Illinois

Median salary: $82,470 Cost of living index: 90.5 Nurses employed: 139,910 Location quotient: 1.11 Projected growth (2018-2028): 12.4%

Illinois takes the top spot on strong all-around rankings: seventh in employment, ninth in affordability, and inside the top 25 for salary, density, and growth. Nurses are paid well, jobs are plentiful, and it's affordable to live there. The state has a long nursing legacy too, with the Illinois Training School for Nurses, the first in the state and the Midwest, founded in 1880.

2. Michigan

Median salary: $81,710 Cost of living index: 91.4 Nurses employed: 102,240 Location quotient: 1.12 Projected growth (2018-2028): 9.8%

Michigan finishes a close second, landing in the top half of every category and the top 10 for employment and location quotient. Its first nursing training program opened in 1891 with six students.

3. Pennsylvania

Median salary: $82,780 Cost of living index: 100.5 Nurses employed: 144,100 Location quotient: 1.16 Projected growth (2018-2028): 12.5%

Strong employment, high job density, and solid projected growth carry Pennsylvania up the list. It's also the home state of Brig. Gen. Hazel Johnson-Brown, the first Black female general and chief of the U.S. Army Nurse Corps.

4. Minnesota

Median salary: $97,300 Cost of living index: 99.6 Nurses employed: 66,700 Location quotient: 1.11 Projected growth (2018-2028): 12.4%

Minnesota ranks solidly across the board and carries a deep history in nursing and medicine. Army nurse Diane Carlson Evans, who served in Vietnam, founded the Vietnam Women's Memorial in Washington, D.C., honoring the 11,000 women who served in that war, many of them nurses.

5. Ohio

Median salary: $79,940 Cost of living index: 92.9 Nurses employed: 133,300 Location quotient: 1.17 Projected growth (2018-2028): 9.6%

Ohio is 34th in size but a heavyweight in nursing, ranking sixth in employment with a cost-of-living index well below the national average of 100. The Ohio State Association of Graduate Nurses, now the Ohio Nurses Association, incorporated in 1904 to advance the profession and raise education standards.

6. Massachusetts

Median salary: $99,730 Cost of living index: 132.5 Nurses employed: 87,320 Location quotient: 1.15 Projected growth (2018-2028): 8.2%

Massachusetts pays the highest salary in the top 10 and ranks inside the top 10 for jobs and density. The catch is cost: it ranks 47th in affordability, with a cost-of-living index of 132.5, far above the national average. Clara Barton, the Civil War nurse who founded the American Red Cross, was born here.

7. Missouri

Median salary: $77,190 Cost of living index: 91.2 Nurses employed: 73,190 Location quotient: 1.22 Projected growth (2018-2028): 16.2%

Missouri has the lowest median salary in the top 10, ranking 44th nationally there, but it lands in the top 15 for everything else. It's also the birthplace of Virginia Henderson, often called the first lady of nursing for defining the nurse's role in healthcare.

8. Wisconsin

Median salary: $83,300 Cost of living index: 95.5 Nurses employed: 61,870 Location quotient: 1.03 Projected growth (2018-2028): 7.8%

Wisconsin sits in the middle of the pack overall, which is enough for eighth. Public health runs through its nursing history. In 1911, recent graduate Cornelia Van Kooy became Milwaukee's first child welfare nurse and went on to make the state's public health service a model for others.

9. Texas

Median salary: $85,110 Cost of living index: 92.6 Nurses employed: 251,840 Location quotient: 0.89 Projected growth (2018-2028): 16.8%

Texas employs more nurses than any state in the top 10 by a wide margin and ranks second nationally in raw numbers. Its location quotient is low (49th), but top-half rankings in salary and affordability secure its spot. The state's first nursing school opened at John Sealy Hospital in Galveston in 1890 with 18 students.

10. North Carolina

Median salary: $79,580 Cost of living index: 96.4 Nurses employed: 104,380 Location quotient: 1.04 Projected growth (2018-2028): 10.8%

North Carolina ranks 36th in salary but takes the final spot on strong affordability, job density, and eighth-place employment. In 1903, its legislature passed the nation's first law permitting nurses to become licensed, an early step in professionalizing the field.

Honorable mention: first in category

These states topped a single ranking category. None made the top 10, but a category leader can still be worth a look.

• Highest salary: California, where RN wages average about $148,330 (BLS, May 2024), still the highest in the country
• Most employment: California, 332,560
• Highest location quotient: South Dakota, 1.19
• Lowest cost of living: Mississippi, 85.1
• Highest projected growth (2018-2028): Arizona, 35%

More about nursing

The nursing shortage has run for years, and COVID-19 made it worse. An aging population with more complex conditions needs skilled nurses more than ever, and a shortage of nursing faculty makes it harder to train replacements. The result has been deeper staffing gaps and rising burnout. The American Nurses Association has asked the Department of Health and Human Services to declare the ongoing shortages a national crisis.

Nationally, the BLS puts the RN median wage at $93,600, with the lowest 10% earning $66,030 and the top 10% earning $135,320.

Registered nurses coordinate and deliver patient care alongside physicians. Common tasks include assessing patient conditions, administering medications and treatments, advising patients and families, operating medical equipment, and running diagnostic tests. They work in hospitals, outpatient surgical centers, physicians' offices, long-term care facilities, home health, public health departments, and government. Many specialize, in pediatrics, neonatal care, oncology, cardiovascular care, or critical care.

Becoming an RN requires formal education and a state license. The minimum is a diploma from an approved program, though a two-year ADN is a common path. A BSN is increasingly preferred or required, since many hospitals and larger groups now want a four-year degree.

How advancing your career can raise your pay

More education and experience generally means more money and more options. A few ways to move up:

Gain experience. Even during school, clinical training, volunteering, or working in a lab or hospital role sets you apart once you graduate.

Add education. If you hold a diploma or ADN, take the next step, often while working through an online or fast-track ADN-to-BSN program. A BSN holder eyeing management can move into a master's, which many hospitals prefer or require for certain roles.

Specialize. Travel, trauma, OR, and other specialties open up with experience, and some require certification.

Get certified. Specialty roles, plus positions like nurse educator and nurse manager, often require certification built from experience, coursework, and testing.

To work at the top of the field with patients, pursue an MSN and become an advanced practice registered nurse. APRNs have broad authority to assess and treat patients and deliver many of the same preventive services as physicians. They need at least an MSN, and nurse anesthetists are now required to earn a Doctor of Nursing Practice.

Methodology and sources

We answered four questions for each state: which have the most jobs, how much you can earn, whether you can afford to live there, and what the long-term outlook is. Data came from the BLS Occupational Outlook Handbook (employment, salary, location quotient), the Missouri Economic Research and Information Center (cost-of-living index), and the U.S. Department of Labor's Projections Central (10-year job growth).

To rank the states, we gathered each data point, ranked every state against the others on each point, and totaled the rankings. Ties were broken using the 10-year projected growth rate.

Glossary: Employment is the current number of RNs in each state. Annual median wage is the midpoint of earnings, with half of RNs above and half below. Location quotient is the ratio of nurses in a state to the national average concentration; above 1.0 means a higher share than average, below 1.0 means lower. The cost-of-living index averages housing, groceries, transportation, and health costs, with 100 as the national average; below 100 is more affordable, above 100 less so. The 10-year job growth projection is the projected percentage growth for RNs over a decade, used in the rankings and as the tiebreaker.