The best and worst states for nurses

Oregon ranks as the best state for nurses, according to research conducted by the finance site WalletHub. Mississippi is the worst. 

Researchers used census data to compare states and the District of Columbia's performances in 15 measures, divided into the categories of competition, work environment and opportunity. Measures included average annual salary for nurses, adjusted for cost of living, nursing job openings per capita, mandatory overtime restrictions, unemployment rate and average number of hours worked.

The five top-ranked states overall, according to the research, were:

  1. Oregon, which ranked second in opportunity, fifth in competition and first in work environment

  2. Washington, which ranked fourth in opportunity, sixth in competition and 12th in work environment

  3. South Dakota, which ranked first in opportunity, 17th in competition and 15th in work environment

  4. Arizona, which ranked ninth in opportunity, fourth in competition and 22nd in work environment

  5. New Mexico, which ranked 20th in opportunity, third in competition and 28th in work environment.

The overall lowest-ranked states (in descending order) were:

  1. West Virginia, which ranked 27th in opportunity, 50th in competition and 47th in work environment

  2. Tennessee, which ranked 40th in opportunity, 43rd in competition and 46th in work environment

  3. Alabama, which ranked 46th in opportunity, 49th in competition and 37th in work environment

  4. Louisiana, which ranked 41st in opportunity, 45th in competition and 50th in work environment

  5. Mississippi, which ranked 47th in opportunity, 42nd in competition and 49th in work environment

Major problems facing the profession include poor work environments that undermine nurse effectiveness and efficiency; lack of evidence-based decision-making by healthcare executives that often leads to dangerous reductions in nurse staffing that adversely affect care quality and safety; and restrictive state practice act and reimbursement barriers to full scope of nursing practice for nurse practitioners, Linda H. Aiken of the University of Pennsylvania told WalletHub.

To create a more attractive environment for nurses, states should "expand and protect the scope of practice for advanced practice nurses," said Pegge Bell of the University of Arkansas, a strategy that several states continue to debate.

To learn more:
- read the rankings

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