Nursing is one of the most demanding professions in America. Nurses are often required to work long shifts (spending much of the time on their feet), provide round-the-clock care, and interact with patients, some of them difficult. This profession became much more challenging in 2020, when nurses had to put themselves at risk to care for COVID-19 patients.
While nursing may be a difficult job anywhere, it may be more challenging in some major metro areas. In these metro areas, nurses are likely to make little money and face taxing working environments as budget constraints may limit the staff and resources at the hospital or office where they work.
To determine the worst cities for nurses, 24/7 Wall St. developed an index consisting of several measures related to nurse wage and employment.
Of the 25 worst cities for nurses, 16 are in the South. The Midwest has seven of the worst cities, while the West has two. None of the cities on this list are in the Northeastern part of the U.S.
One key factor in all the worst cities for nurses is compensation. Nationwide, the median annual wages for nurses was $75,330 in 2020. In all 25 cities on this list, most nurses earned less than $70,000 — in some cases, much less. Even when accounting for the relatively low cost of living in the South and Midwest, the nurses in those parts of the country still had relatively low incomes.
Of the 25 worst cities for nurses, 16 are located in the South, with Florida and Tennessee having four apiece, more than any other state. Seven of the worst cities are in the Midwest, and two located in the West. Even though the southern and midwestern metro areas on this list have relatively low costs of living, the nurses there still have relatively little purchasing power compared to the typical American nurse, as their wages are well below the typical earnings of just over $75,000 for a U.S. registered nurse.
There were nearly 3 million nurses working in 2020 in the U.S., and that number is projected to increase quickly in the coming years. Due to the aging population, there will be more and more older people who may need medical care. In addition to registered nurses, the numbers of nurse practitioners, physician assistants, personal care aides, and other similar jobs are projected to increase significantly in the coming years. These are America’s fastest growing jobs.
Click here to see the 25 worst cities for nurses.
Click here to see our detailed methodology.
Source: cosmonaut / Getty Images
25. Dubuque, IA
> Median annual wage for registered nurses: $58,800
> Median annual wage for all occupations: $39,110
> Change in health care employment (2015-2020): +16.6% (4,890 to 5,700)
> Total registered nurses: 1,270
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24. Hattiesburg, MS
> Median annual wage for registered nurses: $54,260
> Median annual wage for all occupations: $31,370
> Change in health care employment (2015-2020): +15.7% (7,150 to 8,270)
> Total registered nurses: 1,820
Source: bjones27 / Getty Images
23. Warner Robins, GA
> Median annual wage for registered nurses: $64,720
> Median annual wage for all occupations: $39,400
> Change in health care employment (2015-2020): +5.2% (5,030 to 5,290)
> Total registered nurses: 950
Source: RobHainer / Getty Images
22. Auburn-Opelika, AL
> Median annual wage for registered nurses: $60,000
> Median annual wage for all occupations: $32,780
> Change in health care employment (2015-2020): +10.3% (4,290 to 4,730)
> Total registered nurses: 1,040
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21. Columbus, IN
> Median annual wage for registered nurses: $62,210
> Median annual wage for all occupations: $40,760
> Change in health care employment (2015-2020): +16.2% (3,020 to 3,510)
> Total registered nurses: 600
Source: RobHainer / Getty Images
20. Lakeland-Winter Haven, FL
> Median annual wage for registered nurses: $63,410
> Median annual wage for all occupations: $36,350
> Change in health care employment (2015-2020): +6.6% (18,310 to 19,520)
> Total registered nurses: 4,030
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Source: Courtesy of the City of Burlington, NC
19. Burlington, NC
> Median annual wage for registered nurses: $64,780
> Median annual wage for all occupations: $33,950
> Change in health care employment (2015-2020): -6.4% (7,370 to 6,900)
> Total registered nurses: 980
Source: Arrangements-Photography / Getty Images
18. Deltona-Daytona Beach-Ormond Beach, FL
> Median annual wage for registered nurses: $58,810
> Median annual wage for all occupations: $33,120
> Change in health care employment (2015-2020): +16.9% (19,580 to 22,880)
> Total registered nurses: 4,780
Source: SeanPavonePhoto / Getty Images
17. Knoxville, TN
> Median annual wage for registered nurses: $58,490
> Median annual wage for all occupations: $36,810
> Change in health care employment (2015-2020): +12.8% (34,550 to 38,970)
> Total registered nurses: 7,960
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16. Cedar Rapids, IA
> Median annual wage for registered nurses: $60,550
> Median annual wage for all occupations: $42,480
> Change in health care employment (2015-2020): +9.0% (10,530 to 11,480)
> Total registered nurses: 2,420
Source: Michael Munster / Getty Images
15. Joplin, MO
> Median annual wage for registered nurses: $46,210
> Median annual wage for all occupations: $33,660
> Change in health care employment (2015-2020): +45.1% (6,970 to 10,110)
> Total registered nurses: 2,500
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14. Kingsport-Bristol-Bristol, TN-VA
> Median annual wage for registered nurses: $56,180
> Median annual wage for all occupations: $35,650
> Change in health care employment (2015-2020): +8.1% (12,010 to 12,980)
> Total registered nurses: 2,500
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13. Bremerton-Silverdale, WA
> Median annual wage for registered nurses: $66,920
> Median annual wage for all occupations: $51,060
> Change in health care employment (2015-2020): +13.6% (7,300 to 8,290)
> Total registered nurses: 1,410
Source: TonyLMoorePhoto / Getty Images
12. Hickory-Lenoir-Morganton, NC
> Median annual wage for registered nurses: $61,680
> Median annual wage for all occupations: $35,100
> Change in health care employment (2015-2020): -7.2% (16,490 to 15,300)
> Total registered nurses: 2,710
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11. Crestview-Fort Walton Beach-Destin, FL
> Median annual wage for registered nurses: $59,400
> Median annual wage for all occupations: $37,080
> Change in health care employment (2015-2020): +24.6% (6,700 to 8,350)
> Total registered nurses: 1,780
Source: ghornephoto / Getty Images
10. Bloomington, IL
> Median annual wage for registered nurses: $62,230
> Median annual wage for all occupations: $42,010
> Change in health care employment (2015-2020): +4.2% (5,890 to 6,140)
> Total registered nurses: 1,290
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9. Davenport-Moline-Rock Island, IA-IL
> Median annual wage for registered nurses: $57,180
> Median annual wage for all occupations: $39,600
> Change in health care employment (2015-2020): +8.0% (14,910 to 16,100)
> Total registered nurses: 3,820
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Source: DenisTangneyJr / Getty Images
8. Lake Charles, LA
> Median annual wage for registered nurses: $60,930
> Median annual wage for all occupations: $38,390
> Change in health care employment (2015-2020): +5.2% (8,900 to 9,360)
> Total registered nurses: 1,560
Source: Robin Zeigler / iStock Editorial via Getty Images
7. Florence-Muscle Shoals, AL
> Median annual wage for registered nurses: $51,340
> Median annual wage for all occupations: $33,040
> Change in health care employment (2015-2020): +10.3% (4,840 to 5,340)
> Total registered nurses: 1,400
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Source: RobHainer / Getty Images
6. Panama City, FL
> Median annual wage for registered nurses: $64,940
> Median annual wage for all occupations: $35,220
> Change in health care employment (2015-2020): -14.1% (7,020 to 6,030)
> Total registered nurses: 1,230
Source: Dee / iStock Editorial via Getty Images
5. Morristown, TN
> Median annual wage for registered nurses: $57,160
> Median annual wage for all occupations: $31,890
> Change in health care employment (2015-2020): +1.9% (3,720 to 3,790)
> Total registered nurses: 630
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Source: DenisTangneyJr / Getty Images
4. Decatur, AL
> Median annual wage for registered nurses: $48,720
> Median annual wage for all occupations: $35,380
> Change in health care employment (2015-2020): +26.1% (3,870 to 4,880)
> Total registered nurses: 1,030
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3. Bellingham, WA
> Median annual wage for registered nurses: $65,210
> Median annual wage for all occupations: $42,570
> Change in health care employment (2015-2020): -5.2% (5,910 to 5,600)
> Total registered nurses: 460
Source: DenisTangneyJr / Getty Images
2. Jackson, MI
> Median annual wage for registered nurses: $68,350
> Median annual wage for all occupations: $40,470
> Change in health care employment (2015-2020): -71.3% (6,470 to 1,860)
> Total registered nurses: 480
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1. Cleveland, TN
> Median annual wage for registered nurses: $54,480
> Median annual wage for all occupations: $30,330
> Change in health care employment (2015-2020): -43.6% (3,420 to 1,930)
> Total registered nurses: 520
Methodology
To determine the best and worst cities for nurses, 24/7 Wall St. developed an index consisting of several measures related to nurse wage and employment. Data on the annual median wage for registered nurses in a given metropolitan area came from the Bureau of Labor Statistics’ May 2020 Occupational Employment and Wage Statistics program and was included in the index at full weight. Data on the annual median wage for all registered nurses was also adjusted for cost of living using regional price parity in 2019 from the Bureau of Economic Analysis and was included in the index at full weight. Data on the location quotient of registered nurses — the ratio of registered nurses as a percentage of total employment in a given metropolitan statistical area relative to the national registered nurse workforce as a percentage of the total national workforce, a measure of relative concentration — came from the BLS OEWS and was included in the index at full weight. Finally, the employment growth of all health care workers from 2015 to 2020 was calculated using data from the BLS OEWS and was included in the index at full weight.
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