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The State Where Nurses Have the Lowest Pay

Douglas A. McIntyre

Published: December 11, 2023 9:20 am

There are 5.2 million registered nurses in America, a higher count than any other medical role. Nurses are the foundation of the health care system. One reason is that there are four times as many RNs as there are doctors. Yet, nurses’ pay does not reflect their essential role. RNs make a mean salary of $80,000 nationwide. Physician assistants make closer to $125,000.

The COVID-19 pandemic was hard on nurses, as they were on the front line of helping those who were very sick or dying. A third of nurses plan to exit the profession because of this pressure. As many as 800,000 could leave their jobs by 2027, creating a shortage. The upcoming shortage has not driven nurses’ pay higher.

Another way to measure nurse compensation is by the hour. The national mean is $42.80, against physician assistants at $60.23 and pharmacists at $66.22. (Here are 17 things you didn’t know your pharmacist could do.)

Nurses’ pay is uneven across the country. California is the state where they are paid the most, $64.10 an hour. That is much higher than second-place Hawaii at $54.43. The California number translates into an annual salary of $133,340.

The state where nurses are paid the least is South Dakota at $64,500. Generally, states where median income is low dominate the bottom of the list. Here are the worst mean hourly wages by state:

• South Dakota ($31.01)
• Arkansas ($31.98)
• Alabama ($32.17)
• Mississippi ($32.66)
• Iowa ($33.35)
• Missouri ($34.55)
• Kansas ($34.61)
• West Virginia ($34.73)
• Tennessee ($34.85)
• Nebraska ($35.34)