Nurses faced with low pay, high cost of living. These cities are worst
(NEXSTAR) – A variety of factors have contributed to the national nursing shortage that has affected the U.S. over the past several years. One of these factors in particular is adequate pay, or lack thereof.
The search for a better salary has caused some nurses to travel the country or to drop out of the profession altogether. Uncompetitive pay has also caused nurses across the country to grab their picket signs and go on strike for raises and better working conditions.
According to MoneyGeek, which analyzed nurses’ salaries in over 100 metro areas in the U.S., compensation can vary drastically based on location, tax implications, and living costs. Not to mention local governments in some states make decisions that either help or hurt nurses in the area.
The average salary for a registered nurse in the U.S. is $86,070 in gross pay. Of the metro areas that MoneyGeek analyzed, less than one-third surpass that average. When adjusted for taxes and the cost-of-living index, you’re left with $65,414 on average.
For metro areas where registered nurses are making the least, it isn’t always that the salary is low. In many cases, it’s that the cost of living and taxes in these areas affect take-home pay drastically.
For example, at No. 1, Washington D.C.’s pre-tax salary is $98,000, but the adjusted take-home pay is $48,000, according to MoneyGeek’s analysis. That’s nearly half of the salary lost to high cost of living and taxes.
Honolulu isn’t far behind D.C. with $50,000 adjusted take-home pay, but in this case the gross pay is much higher: almost $134,000.
The metro areas that are toughest for registered nurses, after you consider taxes and local cost of living, are:
| Metro Area | Pre-Tax Average Salary | Adjusted Take-Home Pay |
|---|---|---|
| 1. Washington-Arlington-Alexandria, DC-VA-MD-WV | $98,000 | $48,079 |
| 2. Honolulu, HI | $133,820 | $50,134 |
| 3. Boston-Cambridge-Newton, MA-NH | $100,360 | $52,591 |
| 4. Huntsville, AL | $63,480 | $54,633 |
| 5. Salt Lake City, UT | $80,060 | $55,510 |
| 6. New Orleans-Metairie, LA | $81,400 | $55,804 |
| 7. Chicago-Naperville-Elgin, IL-IN-WI | $85,160 | $56,044 |
| 8. Miami-Fort Lauderdale-Pompano Beach, FL | $83,590 | $56,442 |
| 9. Provo-Orem, UT | $78,580 | $57,359 |
| 10. Portland-South Portland, ME | $83,540 | $58,555 |
On the other end, two states in particular had several metro areas that surpassed the average salary for registered nurses: California and Texas.
California has four cities ranked in the top 10 for registered nurse salaries after the cost of living and taxes are taken out. The Sacramento area finished No. 1, with registered nurses taking home $88,847, almost $10,000 more than any other metro area in the country.
Texas had three cities in the top 10, with Houston sliding into No. 2 at $79,520.
Here’s the top 10 list of metro areas where registered nurses are taking home the most money:
| Metro Area | Pre-Tax Average Salary | Adjusted Take-Home Pay |
|---|---|---|
| 1.Sacramento-Roseville-Folsom, CA | $157,810 | $88,847 |
| 2. Houston-The Woodlands-Sugar Land, TX | $93,330 | $79,520 |
| 3. Modesto, CA | $131,060 | $78,942 |
| 4. Las Vegas-Henderson-Paradise, NV | $96,500 | $78,860 |
| 5. Minneapolis-St. Paul-Bloomington, MN-WI | $100,800 | $78,513 |
| 6. Stockton, CA | $136,090 | $78,339 |
| 7. Bakersfield, CA | $125,350 | $77,027 |
| 8. McAllen-Edinburg-Mission, TX | $76,160 | $74,961 |
| 9. Austin-Round Rock-Georgetown, TX | $93,470 | $74,389 |
| 10. Little Rock-North Little Rock-Conway, AR | $79,300 | $74,161 |
With the salary for nurses varying so much depending on where in the country they work, there has been a growing trend in travel nurses across the U.S. The latest National Health Care Retention & RN Staffing Report from NSI (Nursing Solutions, Inc.) shows that the average travel nurse can make up to $102 an hour, or a little over $212,000 annually, depending on where they work. That’s more than double what the average registered nurse makes.
Most travel nurses work 13-week contracts and are free to move from one role to another with each new contract, according to Trusted Nurse Staffing, meaning they can choose where to go to make the most money by year’s end.
Factors such as the time of year or a crisis in an area can also boost pay for travel nurses. During COVID, some travel nurses were making up to $5,000 per week.
A look at the demographics for travel nurses by Zippia shows what they would make on average in each county in the country if they were to work there for the year.
Source: Zippia.com 
Zippia also found that almost 59% of all travel nurses are over the age of 40, with 28% between 30 and 40 years old, and 14% under 30.
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