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May 6, 2020

The best (and worst) states for nurses in 2020, according to WalletHub

Daily Briefing

    Oregon is once again the best state in the country for nurses, according to a WalletHub report released Tuesday.

    Resource page: How to celebrate National Nurses Month—even amid the epidemic

    Report details

    For the report, WalletHub researchers assessed all 50 states on 22 weighted metrics.

    Researchers based 70% of a state's score on 11 metrics related to opportunity and competition, including:

    • Overall nursing school quality;
    • The monthly average starting salary for nurses in a state, which was adjusted for cost of living;
    • The number of nursing-job openings per capita in a state; and
    • The number of nurses per 1,000 residents in a state.

    The researchers based the remaining 30% of the score on 10 metrics related to work environment, including:

    • Any mandatory overtime restrictions in a state;
    • The quality of a state's public hospital system;
    • The ratio of nurses to hospital beds in a state; and
    • Whether a state has a nursing licensure compact law.

    State rankings

    WalletHub gave every state an overall ranking as well as a ranking based only on opportunity and competition factors and a ranking based only on work environment factors.

    According to the report, the overall five best states for nurses in 2020 are:

    1. Oregon;
    2. Washington;
    3. New Mexico;
    4. Minnesota; and
    5. Nevada.

    Oregon also ranked as the top state for nurses in WalletHub's 2019 rankings.

    Meanwhile, the five worst states for nurses in 2020, according to the report, are:

    1. New York;
    2. Louisiana;
    3. Hawaii;
    4. Alabama; and
    5. Oklahoma.

    According to the report, when looking only at opportunity and competition metrics, Nevada ranked as the best state for nurses, while New York ranked as the worst. Meanwhile, when assessing just work environment metrics, Minnesota ranked as the best state, while Louisiana ranked last, the report showed.

    According to the report, some states fared better in one of the two individual ranking categories than they did in the other. For example, while Florida ranked No. 5 in the opportunity and competition category, it ranked No. 47 in the work environment category. Conversely, while New Hampshire ranked No. 2 in the work environment category, it ranked No. 44 in the opportunity and competition category.

    Experts discuss Covid-19's effect on nursing—and the profession's outlook

    WalletHub spoke with Deborah Hopla, an associate professor at Francis Marion University; Allison Findlay, an assistant professor at the University of Colorado Colorado Springs; and Esmeralda Clark, a lecturer at the University of Nevada, Las Vegas' school of nursing, about how local authorities and governments can support nurses and other frontline health care workers in the midst of the country's new coronavirus epidemic, and about the long-term outlook for the nursing field.

    Overall, all three experts said local authorities can best support nurses and other frontline health care workers during the epidemic by ensuring there are sufficient amounts of personal protective equipment available for employees.

    Clark added that it's important for officials to ensure the public receives appropriate education about the epidemic.

    In addition, Findlay said authorities should work as a "conduit between the megacorporation hospital silos" and "make hospitals accountable to ensure" there is an adequate supply of mechanical ventilators and other equipment needed to adequately address the epidemic and treat patients with Covid-19, the disease caused by the new coronavirus.

    As for the nursing profession's future outlook, Findlay said the profession "often function[s] at the hub of the wheel of the health care team" and "fits well in disaster preparedness."

    Hopla said the future of nursing is "bright," adding that patients "are hospitalized most often to receive nursing care" and there are a growing number of opportunities for nurses to serve patients in many different capacities, such as through telehealth.

    Clark said nursing is "an essential profession," and "as long as there are humans [who] need care there will always be a need for nurses."

    However, Clark noted that, despite significant increases in enrollment in nursing school over the past 15 years, the United States continues to face a nursing shortage because of the amount of nurses leaving the workforce.

    Clark added that the nursing working force also is "in dire need of" more diversity. "As [the U.S. coronavirus epidemic] has shown there are huge health disparities amongst racial and ethnic minorities in [the] country, and it is well documented that a health care workforce that mirrors the racial and ethnic makeup of the population helps to reduce health disparities," she said (Kiernan, "2020's Best & Worst States for Nurses," WalletHub, 5/4).

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