High-paying locations are often highlighted for travel nurses who move around frequently, but what about top-paying spots for staff nurses? Registered nurses (RNs) working in permanent positions may consider a move to pursue promotions, better benefits, lucrative sign-on incentives or significantly higher salaries. For those seeking higher pay, this post is for you. While nurses make up the largest group of healthcare professionals, with nearly 4.2 million RNs nationwide, there are never enough of them to go around. The demand for skilled nursing professionals means you have numerous staff RN job options, but this guide tells you where to find the highest-paying locations.
The Top 5 States by Salary
According to the Bureau of Labor Statistics (BLS), the top 5 highest-paying states for registered nurses in May 2021 were California, Hawaii, Oregon, the District of Columbia and Alaska. While California and Oregon appear in the same positions as they did in May 2020, Hawaii took the place of Massachusetts, and the District of Columbia edged Alaska out of the number four slot to number five, pushing Texas off the BLS list.
However, salary data from Vivian shows a slightly different line-up as of January 24, 2023. While California and Hawaii remained in the top two slots, the District of Columbia moved up to third place instead of fourth, while Oregon fell to fifth instead of third place. One major difference is that Massachusetts made a comeback, landing in fourth place and knocking Alaska out of the top five.
The following breakdown shows the top 5 highest-paying states based on Vivian’s most recent data, including the top-paying specialties and cities in each of those states. We also briefly cover background information that impacts each state’s livability, including the overall cost of living per Sperling’s Best Places, to allow a more in-depth comparison.
California historically has the highest wages nationwide year after year, and 2023 isn’t any different. The average staff RN salary in California was $54.44 per hour in January 2023, about 32% higher than the national average. However, staff RN jobs in California were paying an average of $59 per hour based on the average salaries of jobs posted over the last 7 days of January 24, 2023. Some positions had an hourly rate of as much as $104. Although certain RN specialties pay more than others, even entry-level positions tend to pay more in California compared to other states.
RELATED: Top 10 Highest Paying RN Specialties
Top Paying Specialties in California:
- $98 to $101 for RN Managers
- $69 to $73 for Home Health Directors of Nursing
- $54 to $65 for Interventional Radiology RNs
- $46 to $60 for Labor and Delivery, ICU and Emergency Department RNs
Top Paying California Cities:
- San Jose
- San Dimas
- Mt. Shasta
- San Diego
Unfortunately, California’s overall cost of living can put a big dent in even the heftiest paychecks. Currently, it’s about 50% higher than the national average, and housing is the largest expense. Average housing costs in the state are more than double the average nationwide.
Despite inflated costs, living in California offers numerous perks that continually draw people, including nurses, to the Golden State. Sunny skies and mild winters in much of the state are among the biggest attractions. Although places up north and mountain areas have their share of winter weather, large portions of the state don’t ever see snow or ice.
California boasts some of the most beautiful places to call home, with nine National Parks, acres of vineyards, 33 million acres of forest land and 3,400 miles of scenic coastline to enjoy. It’s also home to the “Happiest Place on Earth,” where Mickey Mouse and his pals live, a spectacular bonus for nurses with children.
The state also has numerous other fun places for kids, from tots to teens, to enjoy, making it the ultimate family-fun zone. However, California also has a vibrant food and drink culture, shopping galore and a thriving entertainment scene, with tons of chic places for young couples and singles of all ages to hang out.
Who wouldn’t want to live in paradise? Hawaii is so popular that staff RN jobs are sometimes difficult to snag. The average RN salary in Hawaii was $50.03 per hour in January 2023, about 26% higher than the national average. But salaries ranged between $46 and $64 in many top-paying cities. No staff RN jobs were posted in Hawaii during the third week of January 2023 to compare the most current average.
Top Paying Specialties in Hawaii:
- $35 to $53 for Nursing Home RNs
Top Paying Hawaii Cities:
- Ewa Beach
The drawback of living in paradise is that it comes with a hefty price. The overall living costs in Hawaii are even higher than in California, at nearly 66% more than the national average. Once again, housing is the greatest expense at 1.5 times more than the average nationwide.
Although Hawaii’s housing costs tend to be high, each island that makes up this phenomenal state has a variety of diverse neighborhoods that offer an array of housing options and price ranges. Thrifty nurses can shop around to find affordable choices that meet their budgets. If you have your heart set on moving to Hawaii but can’t secure a staff position immediately, Vivian has 100s of posts for travel nursing jobs in Hawaii on many of the popular islands. A temporary gig could offer an excellent way to discover your favorite island and potentially help you get your foot in the door for a permanent role.
Hawaii’s overall quality of life reflects the state’s nearly ideal year-round climate and numerous recreational opportunities that encourage outdoor activities. The state has a well-developed public parks system and more than 1,600 recognized surfing sites with some of the world’s best surf conditions. Its stunning natural scenery, low violent crime rates, quality of education and varied cultural opportunities are just a few reasons Hawaii consistently ranks as the best place to live, despite its high cost of living.
3. District of Columbia
The average staff nursing salary in the District of Columbia was $45.59 in January 2023, about 18% higher than the national average. However, staff nursing jobs in the District of Columbia averaged $51 per hour during the third week of January, with some positions paying up to $60. The District of Columbia, or D.C. as it’s often called, has only one city, Washington, so perm nursing jobs are all located there. But the D.C. metro area includes several cities in surrounding states that provide other employment and entertainment opportunities.
Top Paying Specialties in D.C.:
- $50 to $60 for House Supervisors, Operating Room Leads and Endoscopy Leads
- $53 for Float RNs, especially those specializing in PACU, ICU, med/surg/telemetry and women’s services
- $50 to $59 for Case Management RNs
- $35 to $52 for Wound Care, Infection Control and Skilled Nursing Facility RNs
The nation’s capital can be an exciting location to live and work, as well as being lucrative for nurses. However, the cost of living is on the high side at 51% more than the national average. Housing costs are a primary reason, with the average cost about 130% more than averages across the nation.
Nestled between southern Maryland and northern Virginia, Washington, D.C., sits along the Potomac River and offers an active lifestyle that appeals to many nursing professionals. It boasts renowned museums and historical attractions that bring millions of annual visitors to the city and provide many interesting things for residents to see on their days off.
The city’s unique boutiques, cafes and other shopping and dining venues offer a diversity that some find surprising in such a compact city. It also has a thriving nightlife and a fantastic array of cultural, music, art and food festivals annually and throughout the year. Should you tire of Washington’s plentiful attractions, visiting Virginia or Maryland offers even more things to do and see just over the border.
Massachusetts’s average salary for staff RNs was $44.79 in January 2023, about 17% higher than the national average. This average rose considerably to $57 for Massachusetts staff RN jobs posted during the third week of the new year. However, there was a broad pay range between $36 and $75 for various RN specialties and rates of up to $82 for certain managerial roles.
Top Paying Specialties in Massachusetts:
- $67 to $82 for Emergency Department Directors
- $64 to $80 for Med Surg/Telemetry RN Managers
- $36 to $75 for Cardiac Cath Lab, Labor and Delivery, Med Surg/Telemetry, Emergency Department and Operating Room RNs
- $57 to $70 for Psychiatric RNs
- $60 to $66 for Intensive Care Unit RNs
Top Paying Massachusetts Cities:
The overall cost of living in Massachusetts is nearly 28% higher than the national average but compared to the other states in the top 5, it’s the second lowest after Oregon. Housing costs are still on the high side but also lower than all states but Oregon, at 75% above the average nationwide.
Residents of the Bay State enjoy exceptional summers, colorful autumns and world-famous seafood. Massachusetts has an eclectic mix of geological features, including Cape Cod’s glorious beaches, bluffs, dunes, lighthouses and sunsets, as well as the mountainous Berkshires region, where ski resorts and mountain sports reign supreme. Living in Boston offers an exquisitely diverse, historically significant atmosphere that appeals to nurses looking for a vibrant community in one of the nation’s oldest cities.
Massachusetts is also home to several of the world’s top universities and colleges, offering top-notch educational opportunities. The state is rich in history, with remarkable cultural and historic sites, such as Plymouth Rock, the Mayflower’s landing spot. From its six metropolitan areas, one micropolitan and tons of quintessential small towns and cozy coastal villages, you have a wealth of varied environments to consider for your new home.
Average wages for staff RNs in Oregon were $44.69 per hour in January 2023, about 17% higher than the national average. However, this average jumped to $51 per hour based on the posted RN jobs in Oregon during week three of the month. Some staff positions paid as much as $65 during this period based on the specialty and location.
Top Paying Specialties in Oregon:
- $36 to $65 for Med Surg/Telemetry, Labor and Delivery, ICU and Emergency Department RNs
- $39 to $59 for Operating Room RNs
- $30 to $47 for Home Health RNs specializing in case management, behavioral health, infusion and palliative care
Top Paying Oregon Cities:
- Grants Pass
- Klamath Falls
Although Oregon’s cost of living is lower than all the other highest-paying staff RN locations on our list, it’s still about 14% more than the national average. Average housing costs are about 50% higher than those across the country, but utilities are 19% lower, and it’s one of only five states that doesn’t charge sales tax on a state or local level.
Like California, Oregon sits on the West Coast but has a slightly different climate than its southern neighbor. Winters are a tad colder and feature snow but with below-average amounts. Cooler summers, with an average high of only 81 degrees in the hottest summer month, make getting outdoors more comfortable, especially with the state’s lower humidity.
Oregon is known for having lots of rain, but it helps the amazing scenery throughout the state thrive. The state has an unusually diverse geography, from its picturesque Pacific Ocean coastline on one side to the desert and mountains on the other. Oregon also boasts the deepest lake in the nation inside Crater Lake National Park and a docile but not dormant volcano called Mount Hood. The state’s stunning tree lines are another example of its beautiful landscape and provide fantastic treetop adventures the whole family might love.
Tips for Choosing the Best Location
Whether you’re looking for a higher-paying staff nursing job or simply a change of scenery, you should make sure your move is a good one and not just for the money. As you can see from our list, states with higher-paying RN jobs also generally have higher costs of living. These inflated costs typically have something to do with the state’s higher salaries. Be sure to compare states with lower wages and living costs to see how much difference it makes.
It’s essential to consider whether a job’s salary is high enough to provide a livable wage compared to a specific location’s living costs. Just because a state has a higher-than-average cost of living doesn’t mean there aren’t cities within the state offering more affordable lifestyles. Rural areas tend to have lower housing costs than urban areas but may have higher prices for groceries and other essentials if there aren’t any major chain stores nearby.
Personal preferences should also factor into determining whether a position is in a desirable location. If you’re not a fan of winter, a state known for above-average snow and cold temperatures probably wouldn’t be an ideal fit. Since you’re taking a permanent position and not a temporary travel gig, you’ll likely be living in this location for some time. If you’re extremely uncomfortable and unhappy, no amount of money will make the location worthwhile.