Demand for nurses surged during the COVID-19 pandemic, and for those willing to travel, the field became more lucrative: traveling nurses earn roughly two to three times more per hour than those in traditional hospital-staffing positions. Yet as healthcare across the country begins to stabilize, the demand for traveling nurses has waned dramatically, with a 60% decrease in the number of open positions between January and April of 2022. And as those dynamics might lead to a drop in income, it’s increasingly important for nurses to consider stability and affordability, too, when seeking employment in a new city to get a true conception of their earning potential.
To uncover the best-paying places for nurses, we compared 50 of the largest metro areas across topics such as current pay, change in pay over time and affordability. For more information on our data and how we ranked metro areas, read the Data and Methodology section below.
This is SmartAsset’s second annual study on the best-paying places for nurses. Check out the previous version here.
Nurse pay is not keeping pace with other occupations. Nationally, average pay for all occupations has increased by 8.92% between 2019 and 2021. However, registered nurse income falls more than two percentage points behind this national average over the same time period, increasing by only 6.83%.
The top five best-paying places for nurses are in California. In the Sacramento, San Francisco, Riverside, Los Angeles and San Jose metro areas, registered nurses earn upwards of $111,000 on average. Despite higher housing costs than other areas across the country, the typical nurse pays less than 20% of their income on housing in all five places.
Housing costs relative to income vary across the 50 largest metro areas. The Washington, D.C. metro area is where registered nurses pay the most in housing costs relative to average income (25.37%). By contrast, housing costs make up just 13.24% of average pay for nurses in Buffalo, New York – which ranks best for this metric.
1. Sacramento–Roseville–Arden-Arcade, CA
Registered nurses in the Sacramento, California metro area earn just over $135,400 on average (third-highest of all metro areas in this study). When compared to the average salary of all workers, nurse earnings are more than two times higher (taking the No. 1 spot for this metric). Finally, typical housing costs make up just 13.34% of a nurse’s pay (second-best).
2. San Francisco-Oakland-Hayward, CA
San Francisco-Oakland-Hayward, California has the second-highest salary for registered nurses ($151,640), and the average registered nurse salary here is 1.75 times higher than the average pay for all workers (the metro area ranks fifth-highest for this metric). Between 2019 and 2021, annual pay for a registered nurse increased by nearly 10% (sixth-highest).
3. Riverside-San Bernardino-Ontario, CA
On average, registered nurses in the Riverside, California metro area earn more than two times the average salary for all workers - the second-highest ratio for this metric. Registered nurses earn nearly $112,000 in this metro area on average (sixth-highest) and can expect to pay roughly 16% of their income on housing costs (eighth-best).
4. Los-Angeles-Long Beach-Anaheim, CA
The Los-Angeles, California metro area ranks No. 4 for two metrics - the average salary for registered nurses ($116,110) and the ratio compared to the average salary for all workers (1.76). Registered nurses in the area have seen a 9.34% increase in pay between 2019 and 2021 (ninth-highest of all 50 metro areas in the study).
5. San Jose-Sunnyvale-Santa Clara, CA
Across the 50 largest metro areas, registered nurses earn the most in the San Jose, California metro area (roughly $155,200 annually). This metro area is one of five where nurses have experienced income growth greater than 10% between 2019 and 2021, and when compared to the average earnings across all workers, nurses here take home 1.56 times more income.
6. San Antonio-New Braunfels, TX
Registered nurses in San Antonio-New Braunfels, Texas earn just under $79,000 annually (23rd-highest). Compared to all workers, nurses here earn 52% more on average. Finally, nurses in the area have experienced a nearly 9% pay bump annually over two years (since 2019).
7. Portland-Vancouver-Hillsboro, OR-WA
The Portland, Oregon metro area ranks seventh-best for both the average salary for registered nurses ($101,710) and the ratio when comparing this figure to the average earnings of all workers (1.58 times higher). In terms of housing, related costs in this metro area will take up only about 17% of a nurse’s pay (22nd-best).
8. San Diego-Carlsbad, CA
The San Diego, California metro area offers the fifth-highest average salary for registered nurses ($113,150), which is 1.68 times higher than the average salary for all workers in the area. Between 2019 and 2021, pay for registered nurses in the area increased by 7.91% (14th-highest).
9. Buffalo-Cheektowaga-Niagara Falls, NY
Registered nurses looking for the lowest housing costs relative to income across the 50 largest metro areas should seek out the Buffalo, New York metro area. We found that median annual housing costs make up just 13.24% of average pay for nurses. Moreover, registered nurses here typically earn about $80,700, which is about 1.44 times higher than the average salary of all workers in the area.
10. Rochester, NY
Rochester, New York has experienced the largest income growth for registered nurses across the largest 50 metro areas. Here, nurses earn roughly $76,100, which is up 13.72% since 2019. This pay increase has helped make housing costs more affordable in the area: nurses here typically spend less than 16% of their income on this expense.
Data and Methodology
To find the best-paying places for nurses, we looked at data on 50 of the largest U.S. metro areas. We compared those metro areas across four metrics:
Average pay for registered nurses. Data comes from the Bureau of Labor Statistics’ (BLS) May 2021 Occupational Employment Statistics release.
Two-year change in average pay for nurses. This is the percentage change in average earnings for registered nurses from 2019 to 2021. Data comes from the BLS’ May 2019 and May 2021 Occupational Employment Statistics releases.
Nurse pay relative to average pay. This is the ratio of average registered nurse earnings to average earnings for all workers in the metro area. Data comes from the BLS’ May 2021 Occupational Employment Statistics release.
Housing costs as a percentage of nurse pay. This is median annual housing costs divided by average earnings for registered nurses. Data comes from the Census Bureau’s 2020 5-year American Community Survey and the BLS’ May 2021 Occupational Employment Statistics release.
We ranked each metro area in every metric, giving an equal weighting to all four metrics. We then found each metro area’s average ranking. The metro area with the best average ranking places first in our study while the area with the lowest average ranking places last.
Tips for Nurses to Maximize Income
Consider a new nursing opportunity. “Organizations [employing nurses] are having to really consider retention benefits like sign on bonuses, increasing hourly pay, bonus pay for overtime - all in the name of safe patient care because ratios of nurse-to-patient [are] increasing, as is acuity of care,” says Laura J. Fero, PhD, MSN, RN, who is dean of nursing at St. Catherine School of Nursing in St. Paul, Minnesota. Beyond upfront incentives, be sure to take a new job's retirement benefits into consideration. Many nurses have access to a 401(k) or 403(b), but this may not be the case at all jobs.
Consider your future expenses before moving. “As someone who has relocated close to 16 times to all parts of the United States, I tell nurses to look at the cost of living and the quality of life," Fero added. "Nurses need work/life balance.” Use SmartAsset’s cost of living calculator to determine how much your income will stretch in different places and our budget calculator to help organize your spending.
Speak with a financial advisor. You’re the expert in your field; now talk to an expert in personal finance. Whether you supported your local area or took on the burden of the pandemic in another city, a financial advisor can help you choose the right retirement options for you and support you through your financial journey. SmartAsset’s free tool matches you with up to three financial advisors who serve your area, and you can interview your advisor matches at no cost to decide which one is right for you.
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