Arizona is the best state for nurses, according to a report from WalletHub released earlier this month.

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Report details

For the report, WalletHub researchers assessed all 50 states on 22 weighted metrics grouped into two dimensions, "Opportunity & Competition" and "Work Environment."

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Researchers based 70% of a state's score on 10 metrics related to opportunity and competition, including:

• Overall nursing school quality;
• The monthly average starting salary for nurses in a state, adjusted for cost of living;
• The number of nursing-job openings per capita; and
• The number of nurses per 1,000 residents.

The researchers based the remaining 30% of the score on 12 metrics related to work environment, including:

• Any mandatory overtime restrictions;
• The quality of a state's public hospital system;
• The ratio of nurses to hospital beds; and
• Whether a state has a nursing licensure compact law.

State rankings

WalletHub gave every state an overall ranking, as well as separate "Opportunity & Competition" and "Work Environment" rankings.

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According to the report, the overall five best states for nurses in 2021 are:

1. Arizona;
2. Washington;
3. Nevada;
4. Wyoming; and
5. New Mexico.

Meanwhile, the five worst states for nurses in 2021, according to the report, are:

50. Maryland;
51. Delaware;
52. Vermont;
53. New Jersey; and
54. Alabama.

According to the report, Nevada ranked as the top state for "Opportunity & Competition," while Maryland ranked last. Meanwhile, Alaska ranked as the top state for "Work Environment," while Michigan ranked last, the report showed.

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According to the report, some states showed significant gaps in their attractiveness to nurses across the two subrankings. For example, while Montana ranked No. 2 in "Opportunity & Competition," it ranked No. 36 in "Work Environment." Conversely, while New Hampshire ranked No. 4 in "Work Environment," it ranked No. 42 in "Opportunity & Competition."

WalletHub explores how to help nurses mitigate burnout

In coordination with its latest rankings, WalletHub also asked experts about the best ways to combat nurse burnout—an especially significant issue given that, even before the pandemic, about 25% of nurses were reporting feelings of burnout.

One expert, Helen Baker, assistant clinical professor at the Nell Hodgson Woodruff School of Nursing at Emory University, recommended helping nurses restore their work-life balance, such as by "providing subsidized dependent care, house cleaning services, meal prep, etc." She also recommending offering nurses "flexible working schedules" and ensuring they "are adequately protected with PPE."

Separately, Christine Kovner, the Mathy Mezey Professor of Geriatric Nursing at Rory Meyers College of Nursing at New York University, said strategies to mitigate burnout should be "the same whether there is a pandemic or not." For instance, she recommended "[e]asy access to free mental health services, 'services' at work—drop off dry cleaning, shoe repair, car service," and "flexible hours in general" (Kiernan, "2021's Best & Worst States for Nurses," WalletHub, 5/5).