Special Report

Cities With the Fewest and Most Nurses

In a time of true crisis, like the coronavirus pandemic, we find out who are the real heroes and absolute essential workers among us. And no, they’re not CEOs, lawyers, or Wall Street brokers. Rather, they are drivers, food retail workers, and first and foremost, health care workers — many of whom are nurses.

There are 2.98 million registered nurses in the US, comprising about 2% of the workforce. Currently, that may not be enough. Hospitals are scrounging for health care professionals, especially nurses, to come and help treat the mushrooming numbers of people with COVID-19. Many retired nurses have answered the call.

24/7 Tempo reviewed data from the Bureau of Labor Statistics’ Occupational Employment Statistics program to identify the metropolitan areas with the fewest nurses per capita in the United States.

More nurses are needed as the number of COVID-19 patients is expected to grow and those who already take care of the sick face a much higher risk of contracting the virus and becoming quarantined. There is an unprecedented demand for “travel nurses,” or nurses from other states, according to NurseFly, a temporary health care staffing platform.

Positions in intensive care units and emergency rooms have opened all over the country. The biggest spikes in demand are in Massachusetts, Washington, California, New York, and New Jersey, which are among the states with the most confirmed COVID-19 cases. Some of the cities with the most nurses per capita are in those states.

The adequate nurse-to-patient ratio has always been a much debated topic – some states have a legally defined minimum nurse-to-patient ratio — and now more than ever, it is clear why. Due to staffing shortage, nurses in some hospitals’ intensive care units are caring for five patients at a time — more than twice the normal work load. more than twice the number of COVID-19 patients than the standard of care. Some cities, with considerably larger health care workforces, seem better prepared to fight the outbreak.

Nationwide, there are about nine registered nurses per 1,000 people. In the 50 cities with the fewest nurses per capita, there are no more than 6.4 nurses per 1,000 people. In cities at the bottom of the list, the ratio is just two or three nurses per 1,000 people.

In the 50 cities with the most nurses per capita, there are more than 13 nurses per 1,000 people. Seven cities have a ratio greater than 20 registered nurses per 1,000 residents. 

Along with nurses, there is a shortage of health care professionals with less familiar roles. They include those who help the sick breathe –– respiratory therapists. These therapists operate the ventilators that are crucial for COVID-19 patients. There are about 134,000 respiratory therapists nationwide, compared to nearly  3 million registered nurses.

Click here to see the cities with the fewest nurses
Click here to see the cities with the most nurses
Click here for our methodology