If you asked ten nurses to name the best state for a nursing career, you probably wouldn’t get the same answer ten times. For one nurse, the deciding factor might be salary. Another may care more about job availability, housing costs, schedule flexibility, or the ability to use a multistate license. And an RN working in a large hospital may see a very different job market than an LPN or LVN whose strongest opportunities are in long-term care, home health, outpatient care, or other settings.
That is why the highest-paying state is not necessarily the best state for nursing jobs.
California offers a perfect example. According to the latest Bureau of Labor Statistics data, registered nurses in California earned an average annual wage of $150,280, the highest in the country. Yet that salary exists alongside some of the nation’s highest living costs, and California is not currently part of the Nurse Licensure Compact. At the same time, HRSA projects California could face the country’s largest numerical RN shortage by 2038, with an estimated shortage of 84,750 full-time-equivalent registered nurses.
Those numbers make California an important nursing market. They do not automatically make it the best nursing market for every nurse.
The same problem appears when we look at LPNs and LVNs. Their employment patterns, salaries, and projected workforce shortages differ considerably from those of registered nurses. In fact, HRSA projects that by 2038 the national supply of LPNs and LVNs could meet only 70% of projected demand, leaving a shortage of approximately 245,950 full-time-equivalent LPNs. By comparison, the projected national RN shortage is about 3% by that same year.
That means the states offering the strongest opportunities for RNs may not be the same states offering the strongest opportunities for LPNs and LVNs.
What Makes a State a Strong Nursing Job Market?
Salary matters. It just shouldn’t be the only number that matters.
For this article, we are looking at several factors together: current nursing wages, the size and strength of the employment market, projected workforce need, cost-of-living considerations, and licensure mobility. The goal is not to identify the state with the single highest number in any category, but to find places where several factors combine to create particularly strong opportunities for nurses.
Current wage and employment data come from the Bureau of Labor Statistics’ May 2025 Occupational Employment and Wage Statistics, the latest national state-level data available. BLS reports approximately 3.4 million registered nurses working across the country, with an average annual wage of $101,420. State RN wages vary dramatically, from approximately $77,000 at the lower end to more than $150,000 in California.
To understand where demand may be heading, we are also using the latest nursing workforce projections from the Health Resources and Services Administration. HRSA’s model looks ahead through 2038 and projects significant geographic differences in nurse supply and demand. For RNs, for example, projected shortages range from 22% in California and 20% in North Carolina and Georgia to 17% in Washington and 16% in Maryland among some of the states facing the greatest shortages.
Those projections require some context. A projected shortage does not mean there are currently that many vacant jobs waiting to be filled. HRSA models future supply and demand based on factors including workforce entry, departures, hours worked, population changes, healthcare utilization, and historical patterns. We are using those projections as an indication of longer-term workforce pressure, not as a count of current openings.
Licensure matters too. The Nurse Licensure Compact currently includes 43 jurisdictions, allowing eligible RNs and LPNs/LVNs who hold a multistate license to practice across participating states without obtaining a separate license in each one. For nurses interested in travel, relocation, telehealth, or simply greater career mobility, that flexibility can make one state more attractive than another even when compensation is similar.
Cost of living will be the final piece of the comparison. A $100,000 nursing salary in one state may provide considerably more purchasing power than $115,000 somewhere else. Housing, taxes, transportation, and everyday expenses can dramatically change what a salary actually buys, which is why we will distinguish between highest pay and best overall value rather than treating them as the same thing.
RNs and LPNs Are Entering Different Job Markets
There is another reason we should resist creating one universal list of the “best states for nurses.”
Registered nurses and licensed practical or vocational nurses frequently work in different parts of the healthcare system. Hospitals employ the majority of RNs—BLS reports that general medical and surgical hospitals account for roughly 56% of RN employment nationally. LPNs and LVNs have a much greater presence in long-term care, residential care, home health, physician offices, and other settings.
Those differences matter when local healthcare markets change. A state experiencing major hospital expansion may create particularly strong opportunities for RNs, while another state with an aging population and growing long-term-care needs could experience much greater demand for LPNs.
The national outlook underscores just how different these markets may become. HRSA projects that the overall RN shortage could narrow considerably between now and 2038, although major shortages remain in specific states and rural communities. For LPNs and LVNs, however, projected demand continues to outpace supply nationally, producing a much larger proportional shortage.
Taken together, these differences make it more useful to evaluate the RN and LPN/LVN job markets separately. The strongest opportunities for one group may not be the strongest for the other, even within the same state.
So where do pay, workforce need, affordability, and career opportunity come together most favorably in 2026?
The Best States for RNs in 2026
Once salary, affordability, workforce need, and the broader employment market are considered together, several states begin to stand out for registered nurses. Some offer exceptional compensation. Others combine more moderate salaries with lower living costs and substantial projected workforce shortages. A few manage to offer some of both.
Here are five states that deserve a particularly close look in 2026.
Washington: High Pay Meets Strong Demand
Washington offers one of the more compelling combinations of compensation and projected workforce need in the country.
Registered nurses earned an average $121,540 annually in Washington in May 2025, placing the state among the highest-paying markets for RNs. Washington is not inexpensive—the state's 2025 cost-of-living index was 112.9, or about 13% above the national average—but its RN compensation remains considerably above the national mean of $101,420.
Demand adds another dimension. HRSA projects Washington could face a shortage of approximately 15,020 full-time-equivalent RNs by 2038, leaving projected supply 17% below demand. That is one of the largest percentage shortages in the country.
For nurses who want strong earning potential without taking on California's substantially higher living costs, Washington deserves serious consideration.
Georgia: A Strong Combination of Affordability and Need
Georgia isn't near the top of the national RN salary rankings, but this is exactly why salary alone can be misleading.
RNs in Georgia earned an average $95,080 in May 2025. That's below the national mean, but Georgia's cost of living was also approximately 8% below the national average in 2025.
More importantly, Georgia is projected to have one of the country's most significant RN shortages. HRSA estimates the state could be short approximately 25,110 full-time-equivalent RNs by 2038, with supply meeting only about 80% of projected demand. Only California and North Carolina are projected to have larger numerical RN shortages.
That combination—below-average living costs, relatively strong compensation, and substantial long-term workforce need—makes Georgia one of the more interesting RN markets in this comparison.
Michigan: An Under-the-Radar Value
Michigan may be one of the less obvious states on this list.
The state's average RN wage was $94,300 in May 2025. While that doesn't compete with West Coast salaries, Michigan's cost-of-living index was just 91.9 in 2025, putting everyday costs approximately 8% below the national average.
At the same time, HRSA projects Michigan could face a shortage of approximately 20,290 full-time-equivalent RNs by 2038, equivalent to an 18% gap between projected supply and demand.
For an RN evaluating what a paycheck actually buys rather than simply comparing salary figures, Michigan makes a strong case for itself.
North Carolina: One of the Country's Strongest Demand Stories
North Carolina stands out primarily because of the scale of its projected nursing need.
HRSA projects a shortage of approximately 25,710 full-time-equivalent RNs by 2038, with projected supply falling 20% short of demand. That gives North Carolina the second-largest projected numerical RN shortage in the country, behind only California.
The average RN wage of approximately $90,470 is below the national mean, but North Carolina's overall cost of living was also slightly below the national average in 2025.
For nurses focused primarily on earning the highest possible salary, North Carolina probably won't rise to the top of the list. For those interested in a growing state where the need for registered nurses is projected to substantially outpace supply, however, it is difficult to ignore.
California: Still in a Category of Its Own
California presents the most complicated case in the ranking.
There is simply no getting around the compensation. At an average $150,280 annually, California RNs earned nearly $49,000 more than the national RN mean in May 2025. No other state came particularly close.
There is also enormous projected workforce need. HRSA estimates California could be short approximately 84,750 full-time-equivalent RNs by 2038, a 22% gap between projected supply and demand. Both figures are the largest among the states highlighted by HRSA.
But California also illustrates why we aren't simply ranking states by salary. Its 2025 cost-of-living index was 143.1, meaning overall costs were about 43% above the national average. Housing is an especially significant part of that difference.
California therefore remains an extraordinary nursing market—but not automatically the best financial choice for every RN. A nurse considering a move would need to look well beyond the statewide salary and compare the actual offer, local housing costs, benefits, commute, and region of the state.
What These Five States Tell Us
There isn't one formula for a strong RN job market.
California and Washington stand out for compensation. Georgia and Michigan become much more attractive once affordability enters the picture. North Carolina makes the list because projected workforce demand is difficult to overlook. And several of these states combine more than one advantage.
That is also why a nurse shouldn't interpret a statewide average as a likely starting salary. BLS figures describe the broader workforce, including nurses at different experience levels, specialties, employers, and locations. Compensation within a state can vary considerably between metropolitan and rural areas and among hospitals, outpatient facilities, long-term care organizations, home health employers, and other settings.
The more useful question is not simply, Which state pays nurses the most?
It is: Where does the nursing market give you the strongest combination of compensation, opportunity, and purchasing power for the career and life you want?
For RNs, the answer may be one of the states above. For LPNs and LVNs, however, the picture changes—and in some ways, the workforce need becomes even more striking.
The Best States for LPNs and LVNs in 2026
For licensed practical and vocational nurses, the national workforce picture looks considerably tighter.
HRSA projects demand for LPNs/LVNs will grow faster than supply through 2038. By then, the country could have approximately 565,690 full-time-equivalent LPNs available to meet demand for 811,640, leaving a projected shortage of 245,950 LPNs/LVNs. Put another way, projected supply would meet only about 70% of demand.
The shortage won't be distributed evenly. HRSA's state projections range from a projected 79% shortage in Alaska to a projected 39% oversupply in Oklahoma by 2038. That enormous variation is another reason national nursing statistics don't tell an individual nurse everything they need to know about the opportunities where they live—or where they might consider moving.
For LPNs and LVNs, these states are particularly worth watching.
Texas: A Large Market With Affordable Living Costs
Texas has long been an important market for LPNs—known as LVNs in the state—and its combination of scale and affordability makes it worth a close look.
Unlike some of the country's highest-paying nursing markets, Texas remains relatively affordable. MERIC's first-quarter 2026 cost-of-living index places Texas at 90.7, meaning overall costs were about 9% below the national average.
Texas also gives LVNs access to an unusually large and varied healthcare market. Opportunities extend well beyond hospitals into skilled nursing, long-term care, home health, physician practices, outpatient care, and other settings where practical and vocational nurses play a substantial role.
That doesn't make every Texas LVN position attractive. Pay, staffing, benefits, and working conditions can vary significantly by employer and region. But for nurses looking for a large employment market in a comparatively affordable state, Texas deserves consideration.
Georgia: Affordability Strengthens the Case
Georgia appeared on our RN list, and it remains interesting when we turn to LPNs.
Its biggest advantage is the combination of a substantial healthcare market and relatively affordable living costs. Georgia's first-quarter 2026 cost-of-living index was 90.6, putting it roughly 9% below the national average.
For an LPN comparing opportunities, that matters. A higher salary in an expensive coastal market may not necessarily leave a nurse with more disposable income than a somewhat lower salary in Georgia.
Georgia also has a substantial LPN workforce and the mix of healthcare settings where practical nurses are commonly employed. That gives nurses options across long-term care, home health, outpatient practices, and other areas rather than tying opportunity to a single type of employer.
Indiana: A Strong Value Proposition
Indiana illustrates why the highest-paying state and the best-value state aren't necessarily the same thing.
The state had the sixth-lowest cost of living in the country in the first quarter of 2026, according to MERIC, with an index of just 88.3. Housing was particularly affordable, with an index of 73.0 compared with the national benchmark of 100.
That gives LPN salaries considerably more context. Indiana won't compete with California or Washington on nominal wages, but nurses also aren't facing California or Washington living costs.
For an LPN interested in maximizing purchasing power rather than simply finding the largest number on a paycheck, Indiana is exactly the kind of state that deserves a second look.
Washington: Higher Pay, With a Higher Price Tag
Washington represents the other side of the equation.
Nursing wages tend to be substantially higher than in many Southern and Midwestern states, making it an attractive market for nurses focused on earning potential. But those wages need to be viewed alongside Washington's cost of living.
MERIC placed Washington's first-quarter 2026 cost-of-living index at 114.6, making it roughly 15% more expensive than the national average. Housing and transportation were particularly costly.
That doesn't negate the value of a strong salary. It simply means an LPN considering Washington should compare an actual job offer with the local cost of housing and transportation rather than assuming that a higher statewide wage automatically produces greater purchasing power.
For nurses who can secure strong compensation in a part of the state where living costs are manageable, however, Washington can still offer an attractive combination.
Alaska: Extraordinary Need, but an Unusual Market
Alaska may be the most interesting LPN market in the entire comparison—not because it is the obvious place for every nurse to relocate, but because of the magnitude of its projected workforce gap.
HRSA projects that by 2038, Alaska's LPN supply could meet only 21% of projected demand, equivalent to a 79% shortage. That is the largest projected percentage shortage among the states.
That kind of projected need deserves attention. But Alaska also demonstrates why shortage data cannot be treated as a relocation recommendation.
The state has a relatively small population and healthcare workforce, and living costs are high. MERIC's first-quarter 2026 index puts Alaska at 129.0, or roughly 29% above the national average. Geography, travel, housing, climate, and the realities of practicing in remote communities can all affect whether an opportunity makes sense for an individual nurse.
Alaska therefore belongs on this list as a high-need market, not necessarily as the best overall financial choice.
The LPN/LVN Opportunity Is Bigger Than Any One State
The most important finding for LPNs and LVNs may not be which five states make a list. It's that the projected shortage is national and substantial.
BLS counted approximately 648,410 LPNs and LVNs employed across the United States in May 2025, with an average annual wage of $67,050. HRSA's projections suggest the workforce could become increasingly unable to keep pace with demand over the coming decade.
That doesn't guarantee better jobs, higher salaries, or improved working conditions. Workforce shortages can create leverage, but they can also reflect difficult staffing environments, high turnover, geographic challenges, or jobs that employers have struggled to fill.
For LPNs and LVNs evaluating a new market, the better question is therefore not simply, Where are nurses needed most?
It is: Where does that need translate into an opportunity that is actually better for you?
Salary, benefits, staffing ratios, schedules, employer type, housing costs, commute, advancement opportunities, and scope of practice can all matter more than a statewide shortage percentage.
Where RNs and LPNs/LVNs Both Have Strong Opportunities
Looking at the two nursing markets side by side reveals something important: there isn't a single state that wins every measure for every nurse. Some of the same themes do emerge, however.
Georgia is particularly interesting because affordability strengthens the value of nursing compensation while the state maintains a large and growing healthcare market. It also appeared among HRSA's states with the largest projected RN shortages.
Washington offers stronger earning potential for both nursing groups, although nurses have to weigh those salaries against living costs that remain above the national average.
Other states may be compelling primarily for one license type. California's extraordinary RN salaries and projected RN shortage make it difficult to leave off an RN list, while Alaska's projected LPN shortage makes it particularly noteworthy for practical nurses.
And then there are states that illustrate why we need more than one data point. HRSA projects Oklahoma could have a 39% LPN oversupply by 2038, even as it projects a 13% RN shortage. The same state could therefore look quite different depending on whether the person searching for work is an RN or an LPN.
That may be one of the most useful lessons in all of these numbers.
A strong nursing market isn't simply a state with a nursing shortage. And it isn't simply a state with a high average salary. The best opportunities tend to emerge where employer demand, compensation, affordability, and the needs of your particular nursing license intersect.
Before You Move for a Nursing Job
State rankings can help narrow your search, but they shouldn't make the decision for you.
Start with the actual offer. Compare base pay, differentials, overtime expectations, bonuses, retirement contributions, health insurance, paid time off, tuition assistance, and other benefits. Then compare what it will actually cost to live within a reasonable distance of the job.
Look at the employer as closely as the state. A strong statewide nursing market does not guarantee a well-staffed unit, supportive management, reasonable patient assignments, or opportunities to advance.
Licensure should also be part of the calculation. Nurses with a multistate license through the Nurse Licensure Compact may have considerably more flexibility when exploring jobs across participating states, while moving to a noncompact state can require obtaining another license before practicing.
Finally, consider what you want the move to accomplish. A nurse relocating primarily for higher pay may make a different decision from someone seeking a lower cost of living, a different specialty, greater schedule flexibility, or a clearer path to advancement.
The data can tell you where opportunity appears to be growing. Only you can decide whether the job attached to that opportunity makes your career—and your life—better.
Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.