State with Most Employed Nurses

The need for registered nurses is expected to grow by 9% from 2020 to 2030, as fast as the average growth across all occupations, according to the Bureau of Labor Statistics. Similarly, the need for licensed practical nurses (LPNs) is projected to grow by 9% and nursing assistants by 8% over the same period. With an aging baby boomer population, climbing rates of chronic issues like obesity and diabetes, and a growing emphasis on preventative care, will the healthcare industry be able to keep up with the demand for registered nurses?

As of May 2021, The U.S. employs to 3,047,530 registered nurses (RNs) earning average annual salaries of just over $80,000. While employment prospects for healthcare workers remain promising across the country, some states offer nursing professionals greater job opportunities, more favourable work environments, and a better quality of life.

Employed Nurses in California

Top on the list is California with over 324,400 Registered Nurses. In terms of hourly mean wage and annual mean wage, California tops the list once again with a $48.92 hourly mean wage and a $124,000 annual mean wage.

Despite California having the most number of employed Registered Nurse, they are still experiencing a shortage of Nurses.

California leading the nursing shortage. The widespread need for nurses affects the quality of care, access to care, and patient outcomes. The word “shortage” creates more demands, work, and stress. However, with planning, a shortage can also be positive, providing more overtime pay, better salaries, and more employment opportunities, especially for foreign-educated Nurses

California is home to 40 million residents and counting, as well as a growing elderly population with more healthcare needs. Compared to Medicaid programs in other states, California’s version (Medi-Cal) is a “public health insurance program that provides free or low-cost medical services for children and adults with limited income and resources.”

California employs one of the highest numbers of nurses. The California Board of Registered Nursing (CBRN) reported almost 360,000 registered nurses (RNs) with an active license and a California address in 2019. Yet, this number keeps changing based on nurses who are graduating, retiring, migrating in or out of state, deciding not to work, or reducing their hours.

One concern is that the percentage of licensed nurses over 65 years old is outpacing the number of nurses younger than 30. This age shift could make the nursing shortage worse than projections, leaving the next generation without enough healthcare.

The same with other states, RNs must pass the standard National Council Licensure Examination (NCLEX), and the CBRN handles all regulatory issues. If you hold a valid license in another state, then you can often apply to practice or process licensed endorsement or (reciprocity) process.

Be sure to allow plenty of time for reciprocity, as it may take anywhere between 12 weeks and six months. Consider using Live Scan to speed up the fingerprinting procedure. With a temporary RN license, you can practice while your permanent licensure is processing.

California is not a Compact State, but recent California legislation may make it a compact license state. The Enhanced Nursing Licensure Compact (eNLC) agreement streamlines the licensure process to enable nurses to practice through a multi-state compact license. eNLC is critical in times of natural disasters, outbreaks, shortages, strikes, telehealth, and practice in border areas. You can sign up to Nursys for real-time notifications about the status of California.

California’s nurse supply is not meeting the current demand. California tops the list as the state needing the most nurses by 2030. Approximately 44,500 nurses are required — nearly three times as many as the state with the next-highest demand, Texas. Overall, almost 800,000 new RNs will be needed in the next decade, with California adding over 110,000 new RN positions. Even with these numbers, the demand will not be easily met.

California nurses are among the highest-paid in the country, mostly due to the high cost of living and unionization, mandatory staffing ratios, and a robust state Medicaid program. The California Nurses Association/National Nurses Organizing Committee/ALF-CIO (CNA/NNOC) is one of the country’s largest, most powerful nursing unions. It provides nurses with a collective voice for higher pay, safer working conditions, better benefits, and healthcare accessibility and quality.

Since the Golden State’s geography and population density vary across the state, so does the salary range for RNs. The annual RN salary ranges from $90,490 to $140,684, with a median annual wage of $120,000 or $48.92 hourly. Nurses working in metroplex areas like San Francisco often command better pay, some as high as $170,000 per year.

Employed Nurses in Texas

The state closest to California in terms of wages is Texas with a $38.04 hourly mean wage and a $79,120 annual mean wage.

In 2021, nearly 400,000 nurses were working in Texas, representing different levels of the profession: certified nursing assistants (CNAs), who are unlicensed however ancillary to the nursing profession; licensed vocational nurses (LVNs); registered nurses (RNs); and advanced practice registered nurses (APRNs) such as nurse midwives, nurse practitioners, and nurse anesthetists. Each category requires a progressively higher level of education and training.

Fifty-eight percent of nurses in Texas are RNs, followed by LVNs at 16.7 percent and CNAs at 20.1 percent. APRNs are a comparatively small group, comprising just 5.2 percent of Texas nursing employment, but they command much higher wages. The annual wages of RNs in Texas typically start at $57,300 and increase to $86,500, depending on their level of experience. On average, nurse anesthetists are paid the most, with some earning more than $200,000 per year.

According to the Texas Board of Nursing’s 2021 Annual Report (PDF), new licenses are growing the fastest for advanced practice registered nurses in Texas — a 12 percent increase from fiscal 2020 to fiscal 2021. New RNs increased by 3.5 percent during the same time, but the number of vocational nurses declined by 1.7 percent.

Though 41.1 percent of Texas nurses work in hospitals, nurses also fill a variety of positions in other healthcare settings such as long-term care facilities, doctors’ offices, schools, and businesses

Texas is a compact state, under the legislation of Enhance Nursing Licensure Compact (eNLC) allows the RNs to practice their License from another Compact State, however, some of the facilities in Texas only allow their employed nurses to travel not more than 70miles, as they are experiencing Nursing Shortage.

The quality of health care and Texans’ access to it could be at risk due to a nationwide nursing shortage. As the population ages and the demand for health care continues to grow, the number of nursing school graduates simply is not keeping pace with demand. In a 2019 survey by jobs site CareerCast, RNs were the fifth most in-demand profession in the United States.

According to a March 2022 NurseJournal analysis of U.S. Bureau of Health Workforce data, Texas had the fourth-lowest nurse-to-population ratio among all states, with only 9.25 nurses per 1,000 residents.

The Texas Center for Nursing Workforce Studies (TCNWS), part of the Center for Health Statistics at the Texas Department of State Health Services, conducted a March 2021 study of the projected demand for nurses in Texas (PDF). The Updated Nurse Supply and Demand Projection, which used 2018 as its baseline year and projected nursing demand through 2032, concluded that Texas faces an increased shortage in every nursing category if, as expected, demand continues to outpace the supply.

The supply of vocational nurses, for example, is expected to grow 13.8 percent by 2032, but the demand will grow by 45.5 percent. The outlook for RNs also is dire: The study estimates that 16.3 percent of the projected demand for registered nurses in 2032 will not be met.

Although the demand for nurses is expected to increase in all settings, the largest shortage of RNs is expected primarily in inpatient hospital settings. Shortages of vocational nurses are expected to fall on inpatient hospital settings and nursing homes almost equally (see “Elder Care in Texas”). Shortages are expected to be worse in rural areas of the state.

The state’s aging population — which comes with a higher degree of chronic medical conditions such as diabetes, obesity, and dementia — puts pressure on Texas’ already overburdened nursing workforce, and the COVID-19 pandemic hasn’t helped. Because of the pandemic, nurses have been working longer hours, seeing more difficult cases, and dealing with the constant threat of exposure to a deadly disease — with a dramatic impact on the nursing workforce.

“COVID-19 has really increased the shortage,” says the Texas Board of Nursing’s executive director, Kathy Thomas. “Nurses are walking out. They’re worn out, burned out, and stepping away from their jobs.

Employed Nurses in New York

While New York State comes in second in terms of the highest wages for RNs, its largest city — New York City — leads the way in terms of the highest number of employed RNs in metropolitan areas throughout the U.S. New York City is home to 123,640 RNs.

The need for registered nurses is expected to grow by 15% from 2016 to 2026, according to the Bureau of Labor Statistics. Similarly, the need for licensed practical nurses (LPNs) is projected to grow by 12% and nursing assistants by 11% over the same period.

With an aging baby boomer population and growing emphasis on preventative care, the health care industry is struggling to keep up with the demand for nursing while nurses’ unions throughout the country have been pressing for rules setting minimum staffing levels, arguing that too few nurses leave patients at risk.

In addition, several states are taking steps to help close the staffing gap in nursing. For example, Texas is allowing more community colleges to offer bachelor’s degrees in nursing. Other programs include federal student loan repayment programs and employer-based loans to encourage individuals to choose nursing as an occupation.

One of the easiest and fastest ways to become a USRN is to apply for NCLEX in the State of New York, as they require fewer requirements and processes. However, The State of New York is a Single State and has no pending legislation on Enhance Nursing Licensure Compact (eNLC) meaning if you pass NCLEX and become a USRN, you can only practice in the state of New York, unless you process Licensed Endorsement or reciprocity. Source: U.S. Bureau of Labor Statistics

Nasya can help you achieve your USRN goal, from the assessment on what state to choose for your NCLEX Exam application, processing, checking all the documentation, and scheduling of the examination. Nasya prioritizes convenience so that an applicant can accomplish their exam application in the comfort of their homes and focus on exam preparation and review.

Be licensed and recognized internationally as you aim for competitive opportunities around the world.

Send us a message here for the FREE assessment and evaluation: support@nasya.ph

Share this article