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 U.S., comprising about 2% of the workforce. Hospitalizations in some states are down, but until recently hospitals were scrounging for health care professionals, including nurses, to come and help patients with COVID-19. Many retired nurses had 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 most (and fewest) nurses per capita in the United States.

More nurses were needed as COVID-19 began spreading in the United States. Those who were already taking care of the sick faced a much higher risk of contracting the virus and becoming quarantined. There was 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 had opened all over the country. Some of the biggest spikes in demand were in Massachusetts, Washington, California, New York, and New Jersey, which were — and still are — among the states with the most confirmed COVID-19 cases — these are the states where the coronavirus is spreading the fastest right now.

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 workload. Some cities, with considerably larger health care workforces, seem to have been better prepared to fight the outbreak.

Nationwide, there are about nine registered nurses per 1,000 people. In the 25 metro areas with the fewest nurses per capita, there are no more than 5.4 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 25 cities with the most nurses per capita, there are more than 15 nurses per 1,000 people. Seven metro areas have a ratio greater than 20 registered nurses per 1,000 residents. 

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