Best states for nurses
After dividing May 2025 RN state medians by BEA 2024 all-items regional price parities, California has the highest real-pay equivalent at $126,712 (raw median $140,270 ÷ RPP 110.7). Hospital staffing laws are listed where a statute or regulation publishes them; this page does not rank states by working conditions.
Updated August 2026 · Verified August 13, 2026 · Next review November 13, 2026 · 50 states + D.C. · OEWS ÷ RPP · NLC · staffing laws
Real-pay rank is not a job offer.
Use the RPP-adjusted table as a geography screen, then browse RN openings in compact and non-compact states.
Unique ranking table
RN median ÷ BEA 2024 RPP
state OEWS median ÷ (BEA 2024 all-items RPP / 100). Compact status is from nursecompact.com / NCSBN. The staffing-law column is a statute flag, not extra pay. States without a cited hospital staffing law show an em dash. Metro COL weights and STATE_TAX_RATES are not used.
| Rank | State | RN median | RPP (2024) | Real-pay equivalent | Compact | Staffing law |
|---|---|---|---|---|---|---|
| 1 | California | $140,270 | 110.7 | $126,712 | Not a compact member | Statewide hospital ratios |
| 2 | Oregon | $129,010 | 103.4 | $124,768 | Not a compact member | Statewide hospital ratios |
| 3 | Hawaii | $136,320 | 110.0 | $123,927 | Not a compact member | — |
| 4 | Washington | $124,200 | 107.0 | $116,075 | Compact implemented | Staffing committee |
| 5 | Alaska | $109,480 | 102.4 | $106,914 | Not a compact member | — |
| 6 | Nevada | $103,670 | 100.0 | $103,670 | Not a compact member | — |
| 7 | Minnesota | $101,510 | 98.6 | $102,951 | Not a compact member | — |
| 8 | New Mexico | $94,340 | 92.2 | $102,321 | Compact implemented | — |
| 9 | Wisconsin | $95,530 | 94.1 | $101,520 | Compact implemented | — |
| 10 | New York | $109,440 | 107.9 | $101,427 | Not a compact member | Staffing committee |
| 11 | Delaware | $99,520 | 99.8 | $99,719 | Compact implemented | — |
| 12 | Vermont | $97,460 | 98.0 | $99,449 | Compact implemented | — |
| 13 | Connecticut | $102,740 | 103.6 | $99,170 | Compact implemented | — |
| 14 | Texas | $95,970 | 97.1 | $98,836 | Compact implemented | — |
| 15 | Massachusetts | $104,550 | 105.8 | $98,819 | Enacted, not implemented | ICU ratios only |
| 16 | Arizona | $99,500 | 100.7 | $98,808 | Compact implemented | — |
| 17 | Pennsylvania | $96,430 | 97.6 | $98,801 | Compact implemented | — |
| 18 | Rhode Island | $100,640 | 102.3 | $98,377 | Compact implemented | — |
| 19 | Michigan | $94,300 | 96.2 | $98,025 | Not a compact member | — |
| 20 | New Jersey | $106,500 | 108.8 | $97,886 | Compact implemented | — |
| 21 | Colorado | $100,260 | 103.1 | $97,245 | Compact implemented | — |
| 22 | Georgia | $93,550 | 96.3 | $97,144 | Compact implemented | — |
| 23 | Idaho | $92,460 | 95.5 | $96,817 | Compact implemented | — |
| 24 | Illinois | $95,990 | 100.0 | $95,990 | Not a compact member | — |
| 25 | New Hampshire | $99,700 | 104.2 | $95,681 | Compact implemented | — |
| 26 | Maryland | $99,790 | 105.0 | $95,038 | Compact implemented | — |
| 27 | Oklahoma | $82,920 | 87.8 | $94,442 | Compact implemented | — |
| 28 | Nebraska | $84,730 | 90.1 | $94,040 | Compact implemented | — |
| 29 | District of Columbia | $102,540 | 109.9 | $93,303 | Not a compact member | — |
| 30 | Virginia | $93,600 | 101.1 | $92,582 | Compact implemented | — |
| 31 | Louisiana | $80,230 | 88.2 | $90,964 | Compact implemented | — |
| 32 | Arkansas | $78,940 | 86.9 | $90,840 | Compact implemented | — |
| 33 | North Dakota | $80,730 | 89.0 | $90,708 | Compact implemented | — |
| 34 | Wyoming | $83,760 | 92.7 | $90,356 | Compact implemented | — |
| 35 | Montana | $85,280 | 94.6 | $90,148 | Compact implemented | — |
| 36 | Missouri | $81,780 | 90.8 | $90,066 | Compact implemented | — |
| 37 | Kentucky | $81,040 | 90.2 | $89,845 | Compact implemented | — |
| 38 | Maine | $86,990 | 97.0 | $89,680 | Compact implemented | — |
| 39 | Iowa | $78,630 | 87.8 | $89,556 | Compact implemented | — |
| 40 | West Virginia | $80,130 | 89.5 | $89,531 | Compact implemented | — |
| 41 | Indiana | $83,500 | 93.3 | $89,496 | Compact implemented | — |
| 42 | North Carolina | $84,350 | 94.3 | $89,449 | Compact implemented | — |
| 43 | Ohio | $82,510 | 92.8 | $88,912 | Compact implemented | — |
| 44 | Tennessee | $81,500 | 91.9 | $88,683 | Compact implemented | — |
| 45 | Mississippi | $77,090 | 87.0 | $88,609 | Compact implemented | — |
| 46 | South Dakota | $78,060 | 88.6 | $88,104 | Compact implemented | — |
| 47 | Kansas | $79,320 | 90.1 | $88,036 | Compact implemented | — |
| 48 | South Carolina | $82,360 | 93.7 | $87,898 | Compact implemented | — |
| 49 | Alabama | $77,080 | 88.8 | $86,802 | Compact implemented | — |
| 50 | Utah | $84,600 | 98.9 | $85,541 | Compact implemented | — |
| 51 | Florida | $84,190 | 103.4 | $81,422 | Compact implemented | — |
Unadjusted comparison
Highest raw RN medians
Same May 2025 OEWS state medians, not divided by RPP. California's raw median is $140,270.
| State | Median annual | 10th | 90th |
|---|---|---|---|
| California | $140,270 | $101,260 | $213,320 |
| Hawaii | $136,320 | $82,500 | $147,830 |
| Oregon | $129,010 | $95,280 | $155,010 |
| Washington | $124,200 | $89,630 | $161,910 |
| Alaska | $109,480 | $85,030 | $149,070 |
| New York | $109,440 | $79,760 | $157,090 |
| New Jersey | $106,500 | $83,060 | $135,170 |
| Massachusetts | $104,550 | $80,310 | $174,510 |
| Nevada | $103,670 | $79,500 | $133,270 |
| Connecticut | $102,740 | $80,350 | $134,870 |
Unique working-conditions tables
Hospital staffing laws from primary sources
BLS notes that registered nurses who work in hospitals and nursing care facilities usually work in shifts to provide round-the-clock coverage and may work nights, weekends, and holidays. That national schedule note is not a state rank. Numeric ratios appear only for states whose cited law publishes them.
| State | Law type | What the cited law says |
|---|---|---|
| California | Statewide hospital ratios | Title 22 § 70217 sets licensed nurse-to-patient ratios by hospital unit, including ICU 1:2 and medical-surgical 1:5. These are minimums, not recommended staffing. |
| Oregon | Statewide hospital ratios | ORS 441.765 sets unit-specific direct-care RN assignment limits. The medical-surgical limit in the text operative on and after July 1, 2026 is 1:4. ICU is 1:2. The statute allows limited committee-approved deviations. |
| Massachusetts | ICU ratios only | M.G.L. c. 111, § 231 limits ICU registered-nurse assignments to 1:1 or 1:2 based on patient stability and a certified acuity tool. It is not a statewide med-surg ratio law. |
| New York | Staffing committee | Public Health Law § 2805-t requires each general hospital to maintain a clinical staffing committee and a staffing plan. It does not publish one statewide numeric ratio for every unit. |
| Washington | Staffing committee | RCW 70.41.420 requires a hospital staffing committee and an annual unit-and-shift staffing plan. It is a committee-and-plan law, not a California-style statewide ratio matrix. |
California Title 22 licensed-nurse ratios
22 CCR § 70217. These are licensed nurse-to-patient minimums, not a recommended staffing model and not extra pay.
| Setting | Licensed nurse-to-patient ratio |
|---|---|
| Critical care / ICU | 1:2 |
| Intensive care newborn nursery | 1:2 |
| Emergency department | 1:4 |
| Step-down / intermediate care | 1:3 |
| Telemetry | 1:4 |
| Medical-surgical | 1:5 |
| Pediatrics | 1:4 |
| Psychiatric | 1:6 |
| Active labor | 1:2 |
| Antepartum, not in active labor | 1:4 |
| Postpartum mother-baby | 1:4 |
Oregon ORS 441.765 direct-care RN limits
Ratios below are from the text operative on and after July 1, 2026. The statute allows limited committee-approved innovative-care deviations.
| Setting | Direct-care RN assignment |
|---|---|
| Intensive care unit | 1:2 |
| Emergency department (12-hour average) | 1:4 (max 5; trauma 1:1) |
| Medical-surgical | 1:4 |
| Cardiac telemetry | 1:4 |
| Intermediate care | 1:3 |
| Pediatric unit | 1:4 |
| Oncology | 1:4 |
| Operating room | 1:1 |
| Post-anesthesia care | 1:2 |
| Labor (active or with complications) | 1:1 |
| Labor (not active, no complications) | 1:2 |
| Postpartum, antepartum, and well-baby nursery | 1:6 (mother and baby counted separately) |
| Mother-baby unit | 1:8 (mother and baby counted separately) |
Massachusetts ICU assignments
M.G.L. c. 111, § 231 is an ICU-only limit. It is not a statewide medical-surgical ratio.
| Setting | RN assignment |
|---|---|
| Intensive care unit | 1:1 or 1:2Assignment depends on patient stability as assessed by a certified acuity tool and unit staff nurses. |
Primary sources
BLS OEWS, BEA RPP, NCSBN compact map, and staffing statutes
Verified August 13, 2026. Next review November 13, 2026.
- O*NET RN local wages 29-1141.00 — May 2025 state medians, retrieved 2026-08-13
- BEA regional price parities — 2024 all-items RPP
- FRED republish of BEA SARPP — State all-items index values used for rounding checks
- Nurse Licensure Compact — Verified August 17, 2026
- BLS OOH registered nurses, work environment — BLS OOH registered nurses, Work Environment, retrieved 2026-08-13
- 22 CCR § 70217 — California licensed nurse-to-patient ratios
- ORS chapter 441 (441.765) — ORS 441.765 (text operative on and after July 1, 2026)
- M.G.L. c. 111, § 231 — Massachusetts ICU registered-nurse assignment limit
- N.Y. Public Health Law § 2805-t — New York clinical staffing committee requirement
- RCW 70.41.420 — Washington hospital staffing committee requirement
Common questions
Best states for nurses FAQ
What is the best state for nurses by real pay?
In this table, California ranks first after dividing the May 2025 RN median ($140,270) by the BEA 2024 all-items RPP (110.7). The real-pay equivalent is $126,712.
How is real pay calculated?
state OEWS median ÷ (BEA 2024 all-items RPP / 100). RPP values are rounded to one decimal place to match BEA highlights. This is not a metro cost-of-living index and does not use this site’s real-pay comparator COL weights.
Does this include state income tax?
No. Tax rates are not used as facts on this page. Compact status comes from the NCSBN compact map already maintained on this site.
Which states have hospital nurse staffing ratio laws?
California, Oregon, Massachusetts publish numeric hospital assignment limits in a cited statute or regulation. New York and Washington require hospital staffing committees and plans, not one statewide numeric ratio for every unit. Other states are marked “—” because this page does not invent a ratio.
Do you rank states by working conditions?
No. Pay rank is OEWS median divided by BEA RPP. Staffing laws are a separate sourced layer. A committee law is not treated as a California-style ratio matrix, and this page does not publish a working-conditions score.
Is the national RN median in this ranking?
The national May 2025 RN median is $97,550. State rows are OEWS state medians via O*NET, not that national number divided by RPP.
How do I check compact travel between two states?
Use the compact nursing states checker for a route-level NLC lookup.
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