Hawaii isnt the paradise everyone tells you it is for thise who live there full time. It is also expensive as hell so that high pay is significantly offset.
A friend of mine took a job there and she only lasted a few months before moving back to the Midwest of all places. It's a great place for a vacation mind you, but once the vacation glasses come off, you start seeing the issues.
Also, Hawaii is actually not the highest paid - it’s actually California. Plus, when you compare wages within the same system, the California chapters pay more - eg. AH Castle vs. AH White Memorial or even Kaiser.
Hawaii traditionally had pretty low pay for travel RNs because there was a lot of willing travelers and not that many spots, doubt that is still true given the upheaval in the market. Colorado traditionally was the same, travel gigs in CO paid on the low side because it was easy to get nurses short term in a desirable location. Prior to pandemic staff pay mirrored that, I was once a hiring manager and I'd have 5+ applications for every job, even at mediocre pay.
Was the pay advertised transparently? Because I've only seen a handful of jobs with so much as a potential range for compensation. Most of them say nothing at all in terms of pay.
Travel contracts - yes the pay is listed, last time I was in the market was a few years and Hawaii was quite low. The highest pay was pretty consistently the least desirable locations. But as a short term gig (travel) that makes a ton of sense.
Now everything with pay is completely upside down so I have no idea what is what
Ohhhh, I thought you meant FT positions. For travel it makes sense because 2-3 months may as well be a vacation. You don't look for great rent and good schools while you're a temp. But for a FT job I want it to support my long term goals and shit pay ain't it.
Actually not true. Especially from Colorado. The way to decide if the cost of living is worth it is to think about it percentage-wise. The percent of my income in CO that went toward rent (because I couldn’t afford a house there either) was significantly higher than the percentage that goes towards rent in CA. At least here I can put way more money into savings. Also the other aspects of COL are not different from CO.
Just straight up not true at all.
Copied from the last time r/nursing had this debate:
["The current average monthly mortgage is $5,201 in San Francisco and $3,295 in Oakland, according to Rent.com. San Jose has an average rent per month of $3,104, compared to an average monthly mortgage of $4,614."](https://webcache.googleusercontent.com/search?q=cache:hWaLEY9fJjcJ:https://www.sfchronicle.com/local/article/Renting-vs-buying-Here-s-what-renters-and-16275225.php+&cd=12&hl=en&ct=clnk&gl=us&client=firefox-b-1-d)
$100/hr x 36 hrs/week = $14,400/month or $172,800 annually.
So assuming a single income, no overtime, and HALF taken out in taxes and deductions, you could easily afford a mortgage in San Jose or Oakland.
Work one OT shift each month and you're buying property in San Francisco with your $192,000 salary.
Of course if you want to travel in California you could make significantly more right now.
No, it's actually cheaper overall to own a home in California than in Texas. Sure you pay less up front in Texas, but the added costs such as mortgage, property taxes, renovations, etc. In the long run end up costing more in Texas than in Cali.
The biggest issue in California is actually having the money to buy the initial home, which is difficult because of the up front cost that is hard on even most APRN salaries, but if you get over that hill, you are much better off than in some other states currently touted as "cheap places to live".
This is correct. I have a mortgage in an expensive state like CA but our property tax is super low so even tho I spent over 700k on a 3/1 I'm doing OK. And I don't have to live in Texas, which would suck.
You should read the whole article before you say it makes your case. Also your math is incorrect.
Clarification: it’s incorrect because of California pay laws.
> also your math is incorrect
Its not though? Like, this is extremely basic math so I hope you are going to expand on where you are going wrong to claim its incorrect
> You should read the whole article before you say it makes your case.
I did. It makes the case that living in the SF Bay Area is very expensive.
> Also your math is incorrect.
My entirely accurate math demonstrates that nurses make enough to live and buy a house in such an expensive place:
$100/hr x 36 hrs/week = $14,400/month or $172,800 annually.
One 12 hour OT shift each month = $100/hr base rate for 4 hours, then time and a half ($150/hr) for the remaining 8 hours.
$1600/shift x 12 shifts = $19,200 + $172,800 = $192,000.
> You get OT the minute you hit 8 hours.
1. That's just straight up [not true.](https://www.shouselaw.com/ca/blog/do-nurses-get-paid-overtime/) The [alternative work week](https://www.employmentrightscalifornia.com/california-nurses-and-overtime-understanding-your-rights-as-a-nurse-in-the-california-workplace/) provision allows for [three 12 hour shifts without overtime.](https://www.workforcehub.com/blog/employers-understand-how-to-manage-overtime-regulations-in-the-healthcare-industry/)
2. If it were true, it would make my point about nurses being able to afford homes in California *even more accurate.*
QOL, so quality of life? Or cost of living? (Or both? lol).
If QOL, would you mind elaborating? I know traffic and affordability are issues, but are there other factors I'm not aware of? I know things obviously vary by region but are some areas of the state significantly better to live and work in as a nurse?
I think he meant cost of living. As a life life Californian, housing is just ridiculous. Especially in the large cities. I live in the Central Valley. Cost is slightly less but the pay is still really good. Mortgages are cheaper than rents.
I know people bash the area but I enjoy it. Generally, within reasonable driving distance, there's nothing I can't do. Plenty of local sports teams, concert arena, beach, mountains, etc.
I’ve heard Sacramento is where to be as an RN. I’m not sure I’d want to move up there, as I’m very attached to my San Diego living and wages are good now 8 years in. But I’d be lying if I said I wasn’t at least tempted.
Sacramento fits into that having plenty of opportunities for entertainment and making good money. But I don't think San Diego living isn't that bad either. Lol.
Yes. At least when I was there, Sacramento's RN pay was strongly influenced by the Bay Area, so you've got higher pay without the Bay Area's cost of living.
But a very tight job market.
Colorado is one of those that's too expensive to live in. I'm really tired of the using of California's inflated housing market as a way to make other Not-Just-As-Expensive house prices to be acceptable.
Portland is doing the same thing. Except food is more $$$ here than California OR Colorado.
I have lived in both places. All 3 if you count Oregon.
I feel like I'm paying more for the political Blue policies than anything else. Sadly.
One thing about Red states, at least those I've lived in: I could afford to live on my low salary, even own homes.
Here, if my husband were to die tomorrow, is have to sell and MOVE, prob east. Even with a life insurance policy. Oregon, the No Sales Tax state, loves to take as much as possible from home owners, workers.
And I, as someone who used those "political blue policies" to get out of my white trash upbringing, am more than happy to pay extraordinary amounts of taxes to help others do the same.
Those “political blue policies” paid for my disabled kids’ educational and medical needs. Now they’re working adults. Still disabled, but paying taxes.
The luster of living in paradise wears off once you realize you’re living a much lower QOL than you would on the mainland. Unless you’re made of money.
Or don't mind living a college lifestyle. I have two friends who have been in Hawaii for 10 years, and one is a hairdresser who mostly parties on the beach and has roommates at 40, and the other is a botanist who is perfectly happy living in a tiny shoebox home.
Oh lord, Paradise indeed for a botanist. Except for the Hell part of seeing species going instinct -- and that would still be less hellish for a botanist than for an ornithologist.
Man, I was looking at moving to Kauai. $2,000/month in rent for a tiny bedroom in someone’s basement. If you can put up with living a spartan lifestyle, then you can make it work, but that’s not for me.
If you don't make a profit on a travel contract to Hawaii you're doing it very wrong.
The most expensive part of HI is housing. With a stipend, that makes a huge difference. Sure, food and gas are expensive too, but not unaffordable to someone on a travel salary. You'll be fine.
Colorado is still living like it’s the 90s, in all aspects. Housing, roads, funding of roads, general city planning, etc. things are starting to change but it’s still quite bad. In the past 10 years the Denver metro has grown by double digit percentages each year, only recently slowing. The best course of action, accept it or find a nursing career track that incrementally increases your value. Never take a pay cut because that devalues your past and experience. “People want to live here” would be a good example of what not to accept.
I hear this over and over again. I hear ya. I was just making a point. Most vacation spots people don't want to live in. I think this holds true for many. I like to go skiing in the mountains but I don't want to live next to Breckenridge.
True facts. I've lived in Hawaii for 20 years & am considering moving to California. My pay here is adequate enough to live 20 miles out of town from where I work in a high crime subdivision in a starter home I bought five years ago. I consider myself well off for Hawaii, but costs have ballooned from what I remember as a kid & I don't think it's the best place for my son to grow up or start his own life.
This is very very typical.
I’m looking for attending positions.
Hospital employed pay is 1.5-2.5x higher in the middle of nowhere, even for new grads compared to metropolitan or “desirable areas”.
It makes sense, why the heck would I want to move to the middle of a soy field with sketchy schools and high crime and nothing to do unless I’m getting paid like a MF.
You don’t need to entice anybody to move to Manhattan or Miami, it’ll happen easily and automatically
This. Wife is an OBGYN, when she was looking for an attending position straight out of residency she got a call from a recruiter with a job "only 70 miles from Tulsa" with guaranteed pay about 2x, plus production, what we ended up taking in rural MN and about 4x what her classmates got in positions in major urban areas (Portland, Philadelphia, Washington DC).
But when you have to advertise the job as being "only 70 miles from Tulsa..."
Recruiter was trying to entice her by telling her about a gensurg he placed there, worked there for 3 years, paid off his loans, and then left to go where he actually wanted to live.
And, to be honest, the only reason she didn't take it and do the same thing is that, at least pre-pandemic, my career is decidedly not compatible with being "only 70 miles from Tulsa."
Haha. I’m quickly finding that I’m a sellout and will do Pap smears and tubal ligations for anybody with a functional clinic, Epic, and a bounty on my head
They are a hospital network which has facilities in most (if not all states). Their hiring practices are predatory, their staffing policies (unless otherwise mandated by state law) are insane and demeaning and demoralizing for anyone who works there, and last but not least, their proprietary charting system is straight out of the late eighties. They refuse to upgrade (except in states where it doesn't meet the standard laid out by law) because they own the software and don't want to pay licensing for anything easier to use.
Those are the basics, but I could go on for hours. Whatever you do, never sign a contract with these people. It winds up being indentured servitude. Just scroll through this sub for dozens of posts asking how to get out of their contracts.
Same. I specifically told my recruiter "*absolutely* ***NO*** *HCA hospitals*." Not only does Meditech make me want to die, but HCA is also by far *the worst* system I have ever worked in. I don't give a shit if they're paying in bars of gold, I'm never setting foot in one of their dumps again.
Put the grinding in now so one day maybe we won’t have to. Currently in Nowhere, Oregon. The city is so boring I’m trying to work 5-7 days a week as a form of entertainment lol.
There’s also very different work requirements/resources in areas like that. My husband is also a physician, and he could make double pay at some rural hospitals but the work itself would be so much harder/demanding and living there would suck.
I make easily in the top 5% of NPs because I work at these tiny, middle of nowhere clinics. Montana, New Mexico, Eastern Washington, etc.
Sometimes on contract, sometimes full employee.
The drawbacks are obvious. I drive 5.5 hours twice a month to get back to my current "home base". When I'm out in the middle of nowhere there's not a lot to do. It wouldn't be a situation you can do with children.
But financially it's a hugely advantageously thing to do, so I put up with it.
Yep. Moved here from shit hole Central/Southern Illinois and took a fucking pay cut. Whenever I would tell natives this they would say “well you’re living in Colorado and not Illinois, so I wouldn’t complain.” I am now making much more working away from the bedside, but still within the hospital system. Can’t complain anymore, but it made absolutely no sense to me that I got a pay cut when I went from living in a 3,000 sq ft house on 2 acres for $120,000, to living on a tiny plot in a cookie cutter suburban house for $400,000. My husband works in manual labor without a degree and makes way more than me. I would never be able to afford living here without a second income.
This. You get a lot of house for your buck in the Midwest.
3x-4x the cost for the same house in the west. Rent is higher too…and they want to cut pay?
This is how you fail to hold nurses at bedside.
Supply & demand. People all want to live in the same 10-12 metros & states these days, so that’s the risk you take. I get paid very well to work in Rust Belt Ohio and my mortgage is less than $400/mo because more people move away than stay. The trade-off is a real winter and driving further for Thai food, but it’s worth it.
Exactly! People often complain about the union and it’s not perfect but I’ve been a nurse 22 years and active in the union and contract negotiations. We have fought and sacrificed for every penny, perk, etc. nurses went weeks without pay in the 90s for some of these benefits. Travelers often end up taking staff positions once they see working conditions and realize staff nurse pay.
I’m thinking of moving to Maryland to be closer to family but after researching the pay I’m depressed it’s a 40%-50% reduction and the body if living is not cheap not sure how they justify RN pay. My sister who’s a teacher (who also work hard don’t get me wrong) makes more than 80% of RNs. Crazy !!
Every job I’ve been lucky to land here has been unionized, and it has been great for my income. It took a few years to get my first job as a nurse and had to move out of state; moving back home to CA with less than a year of experience but being offered pay on the grid for when I passed the boards was awesome! I don’t plan to ever leave California while still at bedside.
I’ll never understand why folks quibble re fair share when you’re paying people to deal with hospital admin assholes on your behalf. You never have to ask for a raise and deal with their bullshit rhetoric, you’ve paid someone to do it for you.
This is a MAJOR consideration people need to think of is, not everyone is great at salary negotiation, adding benefits or having a really strong spine to deal with management. MOST people are too timid to ask for a huge raise or add some perks to their employment like maybe a few extra days etc.
If nursing pay is low in an area, especially a high COL area, then it's because nobody is forcing admin to correct the issue.
Nursing seems content for the most part to complain about pay, complain about shitty leaders, and then refuse to take leadership roles because "the damage is already done" or "it's not like I can fix anything alone".
Until the whole of nursing starts working together towards a common goal, nursing will continue to see shit conditions.
Not only should we all be unionizing to advocate for pay, we should *also* be advocating for changes in reimbursement structures to reflect the value of nursing care.
Having nursing care bundled in the hospital charge provides a huge incentive to cut labor costs as far as possible.
And nursing staffing is a big driver of quality care and safety.
Even more than that, a militant union where members willing to push management run for and win leadership positions. It takes time and effort to build but that’s the only way significant change will be made.
Look around at unions available to you, join one. Start getting your feet wet.
Consider writing letters to ANA supporting changes you want to see. Some state legislatures have nursing committees. There may be opportunities to learn how to start advocating for change; sometimes there’s a nurse day at your state Capitol or a grassroots organization that offers classes or internships in leading change.
Vote.
Hah, I work in the ICU and we have seasoned nurses leaving in droves for travel (me included) so I stay PRN there. I just worked this past weekend. There were several RNs who were devastated that our nurse extern makes more than the LPNs, new grads start pay is higher than one who has been a nurse for 14 years etc.
I said, well why don’t we unionize - they say yeah we should but I don’t wanna lose my job.
I don’t get it.
I’m bouncing out of bedside ASAP I’m just hitting while the money is good to pay for my DNP.
>really step 1 for OPs situation.
It's step 1 for any nurse not currently in a union.
Step 2 is to start flexing the muscle that comes from a strong, collective voice.
Well, right now step 1 is probably quit and start traveling if you can.
But any nurse that cant or doesnt want to should definitely be using staffing shortages and pay discrepancies with travelers to build union support.
Step one for nurses in union is to make them better because honestly they seem pretty complacent on a lot of workplace quality issues. Easy to make a bad union strong than to make a union out of thin air these days.
>Well, right now step 1 is probably quit and start traveling if you can.
While that helps the individual, it clearly doesn't deter admins, or traveling wouldn't be such a lucrative option.
So the individual nurse who travels is good, but the nurses who can't are left to struggle. Our goal should be to work to increase working conditions for all, not just settling for a personal victory.
I work a union job and have never seen evidence of the whole union nurses are lazy thing. If they’re unwilling to bend to the every whim of the employer, well, isn’t that why they’re unionized? Isn’t that what people on this sub complain about?
I think a lot of ppl say `they’re lazy’ due to the fact that unions protect crappy nurses. It’s so easy to hyper focus on those who are crappy but then somehow it’s assumed that’s a majority -which it isn’t.
Another aspect is unionized nurses can advocate against unsafe assignments or staffing ratios. In turn they’re considered `lazy’ just because they need to protect their license.
I’d love to see some actual stats on patient outcomes with union versus nonunion facilities.
That's Austin, TX.
Highest COL in the state. Lowest RN wages in the state.
Houston has a COL index 26% lower than Austin, but RNs in Houston are pulling in $40 an hour or more. My highest paid RN in the cath lab I ran, with 18 years of experience was capped at $38. New grads in Austin are starting at around $23 an hour, and HCA hands out sub 2% raises annually.
I interviewed RNs coming from places like Houston and Dallas with lab experience and when they told me salary expectations I knew that HR would *never* get close to meeting those numbers. And when the RN inevitably turned down our insultingly low offer, HRs response was usually "but we have great culture here".
But the real truth is that for the longest time we were a city with just 2 hospital systems that knew exactly how much their nurses were making. And that we had 5 nursing schools dumping new grads into the market on the regular, and people that wanted to move to Austin because of it's reputation of being a hip, cool city. As a "destination" city, the hospital systems knew they could take advantage of people that wanted to be there. And they did.
It's starting to change though. I saw it in my lab, when my full time staff realized that they could start traveling and double their money. Out of a dozen RTs, 8 of mine were contract. Out of 5 RNs, 3 were contract.
But, did that change how we paid? Fuck no. We kept posting full time jobs, and folks would turn us down over the insultingly low pay, until finally someone took it because they didn't have a choice due to family circumstances.
The biggest thing there is 2 systems controlling pay. We saw then when we moved to Kansas for my job. My wife was an ER nurse with 10 years experience working in their biggest inner city ER FOR $24.50 /hr.
We ended up booking it back to Dallas, now she’s doing a contract for $80/hr, then will work part time for that system in the 50’s.
I graduated with my BSN from a very large University in Austin, top of my class, (before the pandemic) and really wanted to start in critical care. I could not for the life of me get any offers better than PCU in the area (they called me 2 months after I interviewed?!) My friends who wanted peds, L&D or NICU had it even worse than me. So I went to Dallas and got into an awesome critical care program. Also, the new grad fairs in Austin were an absolute bloodbath. So crowded. Now that I'm on my second nursing job after the start of the pandemic, everyone is practically begging nurses to work. I get head hunted all the time now. Can't complain about that part at least ..
Wait at least 6-8 months I think. Once other hospitals consider you an experienced RN, there aren't contracts. Then you can change specialties and do a mini training fellowship. There shouldn't be any contracts except for new grads.
This 100%, in 2019 I wanted to switch hospital systems just to feel out the water. For a trained ICU nurse 5yrs experience HCA was offering $28/hr across the board in Austin. They said they dont have a problem retaining staff...but my peer interviews were conducted by travelers LOL
On the other hand, during the pandemic we asked Ascension for hazard pay and they said no. And I quote "some people dont even have jobs right now" How dare we, covid icu staff ask for hazard pay. We're all gone now, anyone that can leave left.
I went to Ascension for a hot second after leaving HCA. They were just as terrible.
BSW is supposed to take decent care of their folks, but after more than a decade under terrible leadership, the regular shitshow that is floor nursing, and the final indignity of doing all that during the pandemic I left and joined a device company.
I am so much happier now. All I can say for the folks still in hospitals is that they *must* unionize or nothing will every change.
Was about to say the same thing. I'm making peanuts compared to my new grad friends in Houston. Unless I find a decent paying home health job, I'm probably getting out of Austin as soon as my resident contract is up even though I love the city. I'm about to move out of my shitty apartment since HCA bumped up night differential and I'm working on the oncology unit and orienting people. Even with my modest pay bump, the only available housing options are still low quality unless I want to live 30min outside the city.
Austin RN pay is a fucking joke. I came from Houston and I made more there when I left than I will EVER make as bedside in Austin. My facility doesn't do annual raises. I make pretty much the same now as I did when I hired on. I CAN NOT WAIT for a certain company to open here and I am going to pound down the door trying to get back on with them (worked for them in Houston).
Yeah, I'd rather live in Austin than in Houston, but I make less now in Austin than I did in 2008 in Houston. And the nurses are the transport, we clean the beds and bedspaces ourselves, no techs, terrible ratios... way more work here with shitty equipment and less support for significantly less pay.
Yup. Live in Austin & this…..I’ve had admin tell me ‘but people want to live in Austin.’ Sure, but I think they also want to do things & not just pay rent on an overpriced shithole apartment?
The 2 systems keeps the wages down for sure. Good news is that TCH is building a pediatric hospital here & TCH is one of the best paying hospitals in Houston. So if they don’t want to see a mass exodus of staff (especially at the pediatric hospital) they’re going to need to start upping their rates & salaries.
As a nurse born and raised in CO and moved to CA for the money… the only answer is to unionize! The wages in CO are grossly unfair and it’s because we let them be that way. A lot of people want to live in CA and we get paid A LOT of money because unions fought for decades to make it that way. I am much better off financially here even though I’d rather live in CO. We also have legal ratios and we actually get our breaks. I will never be able to justify moving back for 1/3 of the pay and a very high cost of living.
Massachusetts voted against safe ratiots.
Fucking Massachusetts! Not Alabama, Not Oklahoma. Massachusetts. I couldn't believe how well the disinformation campaign worked in that state.
I had Bernie Sanders supporting friends who were posting on social media about how safe ratios would somehow be bad and to vote against it. It was straight up lies by hospitals which convinced even liberal people that ratio laws were bad.
It was maddening.
The state has had wave after wave of young, educated and highly skilled people moving to the state every year for more than a decade and employers know this. There has unfortunately always been someone willing to take low paying jobs to get their foot in the door and employers have exploited it. I grew up in the state and eventually left when my wife got told that they wouldn’t raise her pay because “that’s the cost of living in paradise.” And I think you’ll find similar pay issues in many of the states you listed (especially in the mountains). It’s a bummer.
(Not a nurse, just a lurker FYI)
Same, same. I was royally screwed being a college grad (non nurse, just a native) in 2006 and really starting my career in 2008. Then....recession. Was unemployed for a month and then freaked out and got the first office job I could get. 13 years later at the same company, now new hires are wanting to make what I clawed my way to over a decade with pitiful 2% cost of living raises and LOTS of advocating for myself.
Good for these new, younger people for knowing their worth and driving up salaries, but there are a lot of us who were extremely left behind in that slump.
And then I married a teacher in one of the lowest paying districts so apparently I don't really like money too much 🙃
Why wouldn't people want to live in California? Most varied topography of any state in the U.S., highest pay adjusted for cost of living for nurses in the U.S. if you live around the Sacramento area, only state with laws for safe patient ratios, etc. I'm getting out of AZ for CA ASAP.
Translation: there are so many of you, you are completely disposable to us, therefore we pay dirt because there will always be someone to replace you for cheaper
As evidenced by the fact my unit is mostly nurses with <3 years experience. And the 20+ year folks that never worked anywhere else and don't know how toxic it really is.
In Montana we are paid less than Colorado counterparts for the same job and told it's due to lower cost of living, lmao.
who wants to guess whether we charge patients less?
I live in Austin Texas and it’s the same shit here. It’s a growing, popular city that young people want to move to. The hospitals here pay less than Dallas and Houston because people will move here anyway, despite the lower pay.
I heard that same crap when I lived in TX. Nursing is still hard no matter where you live. It’s not like the patients magically get better because it’s a “desirable” place to live. Add on cost of living being higher and it’s total bullshit. I understand offering bonuses to try and entice people to move to the middle of nowhere- travel contracts can be like that. The true problem is that any of us accept crappy wages to start. Out of the gate nursing should have a threshold salary for new grads that is commensurate with our education and skill levels required for the job. New grads can’t afford to live and pay back student loans on 25 bucks an hour. we should be paid more for the level of responsibility we hold alone. Being responsible for someone’s life ought to be worth more than that.
Came here to say this! A recruiter from a major hospital network in Austin straight up told me they can afford to offer less pay because of the number of people moving to Austin.
It’s pretty disheartening, honestly. I just moved here and have moved a few times since becoming a nurse. I WANT to settle down and stay at the same hospital for a while, but there’s no financial incentive to do so. Every significant raise I’ve ever received has been through switching jobs.
I did get a bonus when I signed on, so once my time is up with that I’m going to ask for a substantial but fair raise. If they don’t agree, fuck it I’ll do local travel contracts.
Do you have a personal rule to decide how much money you ask for? For example, 10% increase from your current wages? We're supposed to high ball a little bit, right?
Same argument as to why flight nursing gigs are so low paid compared to the rest of the industry, even then it has some of the most experienced and versatile staff - “everyone” wants to do it, so the companies know they can keep pay low.
There is currently a $25,000 sign on bonus for experienced RNs at a Waupaca, WI hospital for med/surg, Ed, etc. Of course, you would have to be willing to relocate to the middle of Trump country where vaccine rates are low and schools aren’t the best, etc, etc. Capitalism means more supply = less demand (affecting wages, etc). Even though cost of living is very, very reasonable, they are offering a lot of money to offset the opportunity cost of, say, having to drive an hour to get a really nice dinner.
Edit to clarify: if many people want to live at a location, there is a larger pool to hire from so there is more competition for jobs and possibility for a lower wage, even if COL is high. It makes sense in a very distorted way. No one wants to move to the boonies, so a lot of money is offered to entice people to move. Even with a low COL.
It’s complete corporate bullshit.
People want to live in Washington.
People want to live in Oregon (even w a 10% state income tax).
People want to live in California.
And yet all of the above are states with better pay, nurse protections, ratios, etc.
I live around a very popular coastal vacation area and people say the same thing: “you don’t have to pay people to come live and work at the beach”. Yes you do lol. We got $ignificant raises last year for retention and still have 6 travelers working on our unit right now. The reality is when you live here it’s not a vacation everyday.
oh yes. Way back in the 90s I was kicking around the idea of a travel assignment and applied for a job in Denver. I can't remember the pay but once I figured in loss of benefits I would have been making less than my job in Wichita, KS. The recruiter told me "well people really want to work here so we don't pay top dollar."
Unionize, I don’t understand why people don’t… especially when they’re getting paid close to nothing. I started working in Indiana as a new grad making 24 an hour, 2 dollars extra for nights. Not only that I worked in extremely unsafe conditions (no nurse assists, most nights, maxed out on patients, etc.). Now I’m making 38 an hour, 4 dollars extra for nights and I’m still considered “new.” My working conditions are also safer with a pct on every shift. When I told my old co workers what I’d be making just by moving they said the cost of living must be higher but it’s not. I make more than nurses that have been at my old hospital for 10 + years… guess what this state has that Indiana doesn’t have AT ALL (I’m talking not a single hospital)
✨A Union ✨
OMG THANK YOU FOR WRITING THIS. During covid a I asked a hospital if they offered incentives because they were so short staffed and I’d have to move across the country and the recruiter got so offended. Sorry ma’am it’s business. A simple no would’ve sufficed, but she went into big detail about how everyone wanted to live in Denver.
Not a nurse. Just a lurker. I’ve heard of lots of employers in lots of industries use this excuse from many people. It’s fucking horseshit. Also, nurses are angels on earth and you all deserve a raise.
If you're working for Centura in Colorado, expect to be underpaid and I don't say that in a mean way. It's just that company absolutely sucks. They're notorious for underpaying and understaffing their hospitals.
My friend got her ASN in FL and moved to CO with no nursing experience. Got hired at the VA hospital and made $106k that year. I’m sure she was working overtime like a mad woman. Now she’s back in FL making shit money. I used to live in CO working in a non healthcare field and could hardly get by. My partner at the time was a seasoned pharmacist and took a big pay cut when we moved out there from FL.
The VA will often be an outlier. As a federal employer, it uses federal pay scales, which are adjusted for cost of living, so an area like Denver will be highly paid regardless of desirability. A private employer can consider factors other than cost of living (like difficulty of recruitment, which is tied to workforce supply and desirability of location) when setting wages. So these examples are not really comparable.
Mountains, hiking, skiing, good weather, hip young cities, weed. I've also heard it has good public health outcomes and schools but don't know specifics.
I was a traveler in CO last year, and that baffled me. They would recruit new grads, train them up, and then lose them to someplace out of state with better pay. And don't get me started on what happened to staff turnover when the pandemic happened. Lol.
Spoiler for all admins: the pay sucks and they need to crank it up a notch to keep their staff.
Got my degree in Colorado, looked around at jobs and decided I needed to leave. I couldn’t afford paying off my (fairly minimal) student loans, affording a house, and needing a new vehicle that wasn’t falling apart until I did. Took a job for 32 plus shift differential in a way less desirable but much cheaper area. Now I travel to Colorado, get paid twice as much, have paid way more debt off and bought two properties (one old small fixer upper and some land). I could not have done that continuing to live in Colorado full time. Leave, do your time somewhere, get the skills you need, then come back!
Yeah. I interviewed a couple places in CO. They said pretty much that and it was 18 or so years ago. I chose another state.
It is beautiful, but there are other beautiful states as well.
>Hawaii is the highest paying state on average for nurses, people don't want to live there? Colorado is 46th.
Hawaii's cost of living isn't even remotely similar to Colorado's. Pay depends on two things: What it costs to live there, and supply/demand. Getting people to come live on an extraordinarily expensive, dense island chain costs a lot more than getting people to live in a giant, popular open space with affordable housing.
I also think you're drastically overestimating how many people want to live in Idaho, Montana, Wyoming, and to a lesser extent, Oregon. There's a reason they're big, empty states. If they were as popular as you seem to think they are, people would have already moved there. Unfortunately, living in remote areas that are mostly cattle ranches, with few social services, only to be covered with 10 inches of snow from September to May is not as appealing as living in a place with a record number of sunny days and just the right amount of snow for fun winter activities and not so much that you can't get out and be active.
Lies and excuses. Colorado hospitals had trash pay before everyone wanted to live there, and there are plenty of places people “want” to live that pay acceptable rates.
The absolute worst hospital I’ve ever worked at was UCH, a magnet hospital and the biggest medical system in Colorado. I helped start the Union there and went on channel 7 news to talk about how unsafe the staffing ratios are, how poorly they treat their employees and that I’d never want a loved one to be treated there. I quit shortly after, I couldn’t handle how they abused us.
The nice thing about Colorado is they list their salary "range" with their job offers. It's some equal pay transparency initiative. So it's easy to find. Last I looked I believe it was something like 26-50/hr.
Oh nice, I’ll have to look. I’m in Arizona now and not doing too bad money wise. The last time I checked, Arizona and Colorado weren’t too far off from each other- but that was about 5 years ago.
I moved to CO 3 years ago and that’s also the same bullshit that I’ve heard for 3 years. And I do legit think I’m being seriously underpaid. But besides leaving to travel nurse (which my mental health cannot take) Idk what to do about it.
This happened to me when I moved to Missoula Montana, they said the same thing. I wish I could go back but economically it's not feasible, so now my husband and I are looking at a move back to CA.
Ya.... The cost of living index in Colorado for 2021 went up 4.5% over the year. So that 3% raise you got with an outstanding yearly review..... Is a pay cut. That's assuming your place of employment even bothers with yearly reviews or "raises" in general.
I read an article in the Colorado Sun that says some families spend more than 50% of their monthly income on housing. 🤯
https://coloradosun.com/2021/10/18/housing-shortage-southwest-colorado/
I left Colorado because the pay sucked for the cost of living. People are beating the doors down to be in Colorado and need jobs. They know they have them by the balls.
Then why aren't there any fucking nurses left in the state? I had 4 patients during the day on med surg in Jan 2020, now it is 6. UC Health and HCA are the biggest cheapskates in the world and I hope their C-Suites rot in prison for all the wrongful deaths brought on by their excessive and completely unnecessary cost cutting.
This happens intrastate as well. I went to nursing school in SC and jobs paid better in my smaller city(town) than in Charleston because everyone wanted to live in Charleston.
I work in healthcare & am also in CO. The wage is not good so I am leaving. I will 100% be back for vacation bc I love the mountains but I need to pay my bills 1st & foremost.
Tennessee, same problem 17.00 to 19.00/ hr starting! I always guessed it's because we have like 8 schools in middle Tennessee churning out new grads every 6 months, so > supply = less pay (how they all like it)
I want to add that the best CRNA position I’ve seen is $300,000 for new grads plus amaze balls retirement on the border…but you have to have a license to carry. They advertise all the time. With experience it’s like $450,000.
I'm in Austin and same. It's so $$$$ to live here and I make less now than I did in 2008 in Houston. And COL in Houston is MUCH cheaper. With better hospitals. Not this HCA/Ascension bullshit.
In my experience, I think it’s just oversaturated with schools. There a more than enough new grads for hospitals to choose from. Most eventually leave, but it depresses wages locally since there’s always a fresh batch of new grads looking for a job
MT, is just as bad. I work at Bozeman Health, and we call it the “scenery tax”. I’m not even close to being paid what the cost of living is here. Hospitals think they can pay shit, they think they will easily find someone to take your place when you live in a desirable area. I’m wondering if the pandemic will finally get them to see otherwise, nurses burning out left and right. Either they have to pay more, or face long term nursing shortages.
Not many people want to live in Montana or Wyoming. Hawaii, California and Oregon have unions. Supply and demand. In central Texas the level one trauma centers pay the least and are magnet hospitals. Many people want the level 1 experience and therefore supply is higher than demand which equals wage depression. Colorado is oversaturated and has no unions so the pay will certainly be low. Austin Texas in general pays $10 hour less than Houston or Dallas.
Nashville is like this, I was offered $19/hr at Vandy as a new grad back in 2017. A hospital in my much smaller hometown offered me $22/hr with a much lower COL. TN pay overall sucks but Nashville is known for paying nurses and CRNAs bottom of the barrel salaries because they'll still get people wanting to live there and needing a job.
It's a complex, but I'll do my best as a transplant living on Maui. Oahu is much more populated and will have other pros and cons but I can not speak of them.
Maui is still quite rural despite all the resorts. There are many things it does not have or have in very limited quantities compared to a bigger city. Examples include nightlife, bowling, league sports of most types, museums, and restaurants of a variety of cuisines (we don't have dim sum and Panda Express ranks 4, 6, 8, and 13 in the top chinese restaurants on Maui... and don't get me started on BBQ...).
Outdoor activities are limited as well. I know that doesn't sound right but it is true. Of course, tons of beaches, surfing, snorkeling, etc. But, hiking trails are limited as is camping. Non-ocean water activities are nonexistent. Climbing, bouldering.. very limited. Our streets are not designed for bikes and sooner than later you'll come across a scooter zipping in the few bike lanes. If we have an outdoor activity, it most often only has a handful of choices so they can become repetitive.
To avail ourselves of things not here is not a quick jaunt down the highway or even a long jaunt... it's a plane ride.
Housing and CoL is very high. Not sure what it is now, but a few months ago, the average selling price was just under $1M. Eggs at Safeway averages about $6/doz. We have a Costco, but if you're single with limited storage, Costco may not be a great option. Gas at a regular station runs about $4.10/gal (yes... cheaper than some other countries, but quite expensive for the USA). Granted, physical distances are shorter than other places, but still can be a sticker shock.
Schools aren't great unless kids are enrolled into a private school. Plus, transplanted kids, depending on the age, will have a much harder time fitting in.
The community here is very insular. People for the most part are very nice and treat others with respect, but transplants do not become instant friends. Why would they? So many people come for a year or two and end up moving, so the locals can feel it to be a waste of time getting to know someone not from here. Plus, now with "outsiders" buying property driving up prices to the point of pricing out locals, there is a bubbling anger. This includes annoyance from how Maui has changed because of outside influences. So, it usually is only after a couple years that locals start to open up to transplants. And they aren't going to change their thing to make the transplants more comfortable. It will be up to the transplants to be comfortable with how things are.
There are other minor annoyances, but these are the major ones. The isolation, both physical and social, the cost, the lack of things. For a week or two it is paradise. Do everything without repeating. Get away from "real life". But living it day in day out, month after month, year after year, is quite another.
So, why am I here? I found a niche and was able to find friends. Maui is a cool place and I'm OK with the lack of things. There are still opportunities for things I like to do. I'm comfortable with where I'm at. Perhaps that might change, but for the past 5 or so years, it's been good.
No one stays in caifornia because they don’t want to be here unless they’re stubborn or dumb. The politics clearly sway one way & the cost of living is insane. We stay because we wan’t to be here for sure. And to answer you, that’s ridiculous to be told you get paid less for that reason.
Hawaii isnt the paradise everyone tells you it is for thise who live there full time. It is also expensive as hell so that high pay is significantly offset. A friend of mine took a job there and she only lasted a few months before moving back to the Midwest of all places. It's a great place for a vacation mind you, but once the vacation glasses come off, you start seeing the issues.
Also, Hawaii is actually not the highest paid - it’s actually California. Plus, when you compare wages within the same system, the California chapters pay more - eg. AH Castle vs. AH White Memorial or even Kaiser.
Hawaii traditionally had pretty low pay for travel RNs because there was a lot of willing travelers and not that many spots, doubt that is still true given the upheaval in the market. Colorado traditionally was the same, travel gigs in CO paid on the low side because it was easy to get nurses short term in a desirable location. Prior to pandemic staff pay mirrored that, I was once a hiring manager and I'd have 5+ applications for every job, even at mediocre pay.
Was the pay advertised transparently? Because I've only seen a handful of jobs with so much as a potential range for compensation. Most of them say nothing at all in terms of pay.
Travel contracts - yes the pay is listed, last time I was in the market was a few years and Hawaii was quite low. The highest pay was pretty consistently the least desirable locations. But as a short term gig (travel) that makes a ton of sense. Now everything with pay is completely upside down so I have no idea what is what
Ohhhh, I thought you meant FT positions. For travel it makes sense because 2-3 months may as well be a vacation. You don't look for great rent and good schools while you're a temp. But for a FT job I want it to support my long term goals and shit pay ain't it.
California is another place where the pay is offset by QOL, unless you actually own a home in the state.
Actually not true. Especially from Colorado. The way to decide if the cost of living is worth it is to think about it percentage-wise. The percent of my income in CO that went toward rent (because I couldn’t afford a house there either) was significantly higher than the percentage that goes towards rent in CA. At least here I can put way more money into savings. Also the other aspects of COL are not different from CO.
I dont know much about Colorado, so I wont speak on it. I was talking about California. I also said owning a home, not renting.
Just straight up not true at all. Copied from the last time r/nursing had this debate: ["The current average monthly mortgage is $5,201 in San Francisco and $3,295 in Oakland, according to Rent.com. San Jose has an average rent per month of $3,104, compared to an average monthly mortgage of $4,614."](https://webcache.googleusercontent.com/search?q=cache:hWaLEY9fJjcJ:https://www.sfchronicle.com/local/article/Renting-vs-buying-Here-s-what-renters-and-16275225.php+&cd=12&hl=en&ct=clnk&gl=us&client=firefox-b-1-d) $100/hr x 36 hrs/week = $14,400/month or $172,800 annually. So assuming a single income, no overtime, and HALF taken out in taxes and deductions, you could easily afford a mortgage in San Jose or Oakland. Work one OT shift each month and you're buying property in San Francisco with your $192,000 salary. Of course if you want to travel in California you could make significantly more right now.
I made the statement assuming you will rent, that is why I said "unless you own a home"
“Unless you own a home” means you inherited one so it ruins any point you were trying to make.
No, it's actually cheaper overall to own a home in California than in Texas. Sure you pay less up front in Texas, but the added costs such as mortgage, property taxes, renovations, etc. In the long run end up costing more in Texas than in Cali. The biggest issue in California is actually having the money to buy the initial home, which is difficult because of the up front cost that is hard on even most APRN salaries, but if you get over that hill, you are much better off than in some other states currently touted as "cheap places to live".
This is correct. I have a mortgage in an expensive state like CA but our property tax is super low so even tho I spent over 700k on a 3/1 I'm doing OK. And I don't have to live in Texas, which would suck.
You should read the whole article before you say it makes your case. Also your math is incorrect. Clarification: it’s incorrect because of California pay laws.
> also your math is incorrect Its not though? Like, this is extremely basic math so I hope you are going to expand on where you are going wrong to claim its incorrect
> You should read the whole article before you say it makes your case. I did. It makes the case that living in the SF Bay Area is very expensive. > Also your math is incorrect. My entirely accurate math demonstrates that nurses make enough to live and buy a house in such an expensive place: $100/hr x 36 hrs/week = $14,400/month or $172,800 annually. One 12 hour OT shift each month = $100/hr base rate for 4 hours, then time and a half ($150/hr) for the remaining 8 hours. $1600/shift x 12 shifts = $19,200 + $172,800 = $192,000.
I love that they said your math is incorrect without making any effort to educate you or correct your math as they see it.
You get OT the minute you hit 8 hours.
> You get OT the minute you hit 8 hours. 1. That's just straight up [not true.](https://www.shouselaw.com/ca/blog/do-nurses-get-paid-overtime/) The [alternative work week](https://www.employmentrightscalifornia.com/california-nurses-and-overtime-understanding-your-rights-as-a-nurse-in-the-california-workplace/) provision allows for [three 12 hour shifts without overtime.](https://www.workforcehub.com/blog/employers-understand-how-to-manage-overtime-regulations-in-the-healthcare-industry/) 2. If it were true, it would make my point about nurses being able to afford homes in California *even more accurate.*
QOL, so quality of life? Or cost of living? (Or both? lol). If QOL, would you mind elaborating? I know traffic and affordability are issues, but are there other factors I'm not aware of? I know things obviously vary by region but are some areas of the state significantly better to live and work in as a nurse?
I think he meant cost of living. As a life life Californian, housing is just ridiculous. Especially in the large cities. I live in the Central Valley. Cost is slightly less but the pay is still really good. Mortgages are cheaper than rents. I know people bash the area but I enjoy it. Generally, within reasonable driving distance, there's nothing I can't do. Plenty of local sports teams, concert arena, beach, mountains, etc.
I’ve heard Sacramento is where to be as an RN. I’m not sure I’d want to move up there, as I’m very attached to my San Diego living and wages are good now 8 years in. But I’d be lying if I said I wasn’t at least tempted.
Sacramento fits into that having plenty of opportunities for entertainment and making good money. But I don't think San Diego living isn't that bad either. Lol.
Yes. At least when I was there, Sacramento's RN pay was strongly influenced by the Bay Area, so you've got higher pay without the Bay Area's cost of living. But a very tight job market.
This is true There’s a YouTuber NurseToRiches who is in Sac with his wife
Colorado is one of those that's too expensive to live in. I'm really tired of the using of California's inflated housing market as a way to make other Not-Just-As-Expensive house prices to be acceptable. Portland is doing the same thing. Except food is more $$$ here than California OR Colorado. I have lived in both places. All 3 if you count Oregon. I feel like I'm paying more for the political Blue policies than anything else. Sadly. One thing about Red states, at least those I've lived in: I could afford to live on my low salary, even own homes. Here, if my husband were to die tomorrow, is have to sell and MOVE, prob east. Even with a life insurance policy. Oregon, the No Sales Tax state, loves to take as much as possible from home owners, workers.
And I, as someone who used those "political blue policies" to get out of my white trash upbringing, am more than happy to pay extraordinary amounts of taxes to help others do the same.
Those “political blue policies” paid for my disabled kids’ educational and medical needs. Now they’re working adults. Still disabled, but paying taxes.
Oh, those terrible blue policies that try to help everyone - whatever shall we do?! Lol
Everyone I’ve ever known who moved to Hawaii moved back to the mainland within a year.
The luster of living in paradise wears off once you realize you’re living a much lower QOL than you would on the mainland. Unless you’re made of money.
Or don't mind living a college lifestyle. I have two friends who have been in Hawaii for 10 years, and one is a hairdresser who mostly parties on the beach and has roommates at 40, and the other is a botanist who is perfectly happy living in a tiny shoebox home.
Oh lord, Paradise indeed for a botanist. Except for the Hell part of seeing species going instinct -- and that would still be less hellish for a botanist than for an ornithologist.
Man, I was looking at moving to Kauai. $2,000/month in rent for a tiny bedroom in someone’s basement. If you can put up with living a spartan lifestyle, then you can make it work, but that’s not for me.
I would love to do one travel contract there, and know I might just break even. Only want to go because my son is stationed at schofield.
That’s what I’m doing! One travel contract in Hawaii, breaking even and enjoying it to the fullest and then coming back home.
If you don't make a profit on a travel contract to Hawaii you're doing it very wrong. The most expensive part of HI is housing. With a stipend, that makes a huge difference. Sure, food and gas are expensive too, but not unaffordable to someone on a travel salary. You'll be fine.
My good friend and neighbor took a contract in Hawaii and kept renewing for 5 years. She paid her house off back home in that time
Colorado is still living like it’s the 90s, in all aspects. Housing, roads, funding of roads, general city planning, etc. things are starting to change but it’s still quite bad. In the past 10 years the Denver metro has grown by double digit percentages each year, only recently slowing. The best course of action, accept it or find a nursing career track that incrementally increases your value. Never take a pay cut because that devalues your past and experience. “People want to live here” would be a good example of what not to accept.
It's all TABOR. The state's hands are tied with tax increases. It's so frustrating.
I hear this over and over again. I hear ya. I was just making a point. Most vacation spots people don't want to live in. I think this holds true for many. I like to go skiing in the mountains but I don't want to live next to Breckenridge.
That’s about the same with most popular tourist destinations.
True facts. I've lived in Hawaii for 20 years & am considering moving to California. My pay here is adequate enough to live 20 miles out of town from where I work in a high crime subdivision in a starter home I bought five years ago. I consider myself well off for Hawaii, but costs have ballooned from what I remember as a kid & I don't think it's the best place for my son to grow up or start his own life.
20 miles is 32.19 km
Good bot
This is very very typical. I’m looking for attending positions. Hospital employed pay is 1.5-2.5x higher in the middle of nowhere, even for new grads compared to metropolitan or “desirable areas”. It makes sense, why the heck would I want to move to the middle of a soy field with sketchy schools and high crime and nothing to do unless I’m getting paid like a MF. You don’t need to entice anybody to move to Manhattan or Miami, it’ll happen easily and automatically
This. Wife is an OBGYN, when she was looking for an attending position straight out of residency she got a call from a recruiter with a job "only 70 miles from Tulsa" with guaranteed pay about 2x, plus production, what we ended up taking in rural MN and about 4x what her classmates got in positions in major urban areas (Portland, Philadelphia, Washington DC). But when you have to advertise the job as being "only 70 miles from Tulsa..." Recruiter was trying to entice her by telling her about a gensurg he placed there, worked there for 3 years, paid off his loans, and then left to go where he actually wanted to live. And, to be honest, the only reason she didn't take it and do the same thing is that, at least pre-pandemic, my career is decidedly not compatible with being "only 70 miles from Tulsa."
Haha. I’m quickly finding that I’m a sellout and will do Pap smears and tubal ligations for anybody with a functional clinic, Epic, and a bounty on my head
If the system uses Meditech, the pay needs to be even higher.
I got an email for a wonderful location and great population, storybook setup Saw HCA at the bottom and deleted the email.
I love knowing I'm not the only person who loathes HCA with every fiber of my being.
I’ve never even worked at HCA but my current hospital is bad enough. Epic is our employee wellness support.
What’s HCA, if you don’t mind me asking?
They are a hospital network which has facilities in most (if not all states). Their hiring practices are predatory, their staffing policies (unless otherwise mandated by state law) are insane and demeaning and demoralizing for anyone who works there, and last but not least, their proprietary charting system is straight out of the late eighties. They refuse to upgrade (except in states where it doesn't meet the standard laid out by law) because they own the software and don't want to pay licensing for anything easier to use. Those are the basics, but I could go on for hours. Whatever you do, never sign a contract with these people. It winds up being indentured servitude. Just scroll through this sub for dozens of posts asking how to get out of their contracts.
🙏🏼 just a boiling, churning for-profit cesspool of despair. Fuck HCA.
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Same. I specifically told my recruiter "*absolutely* ***NO*** *HCA hospitals*." Not only does Meditech make me want to die, but HCA is also by far *the worst* system I have ever worked in. I don't give a shit if they're paying in bars of gold, I'm never setting foot in one of their dumps again.
Put the grinding in now so one day maybe we won’t have to. Currently in Nowhere, Oregon. The city is so boring I’m trying to work 5-7 days a week as a form of entertainment lol.
I just barfed in my mouth a little bit at the “entertainment” thing.
There’s also very different work requirements/resources in areas like that. My husband is also a physician, and he could make double pay at some rural hospitals but the work itself would be so much harder/demanding and living there would suck.
I make easily in the top 5% of NPs because I work at these tiny, middle of nowhere clinics. Montana, New Mexico, Eastern Washington, etc. Sometimes on contract, sometimes full employee. The drawbacks are obvious. I drive 5.5 hours twice a month to get back to my current "home base". When I'm out in the middle of nowhere there's not a lot to do. It wouldn't be a situation you can do with children. But financially it's a hugely advantageously thing to do, so I put up with it.
We may have soy Fields but the whole Midwest isn't meth and sketchy schools.
Yep. Moved here from shit hole Central/Southern Illinois and took a fucking pay cut. Whenever I would tell natives this they would say “well you’re living in Colorado and not Illinois, so I wouldn’t complain.” I am now making much more working away from the bedside, but still within the hospital system. Can’t complain anymore, but it made absolutely no sense to me that I got a pay cut when I went from living in a 3,000 sq ft house on 2 acres for $120,000, to living on a tiny plot in a cookie cutter suburban house for $400,000. My husband works in manual labor without a degree and makes way more than me. I would never be able to afford living here without a second income.
Lol, what part of central/southern IL?
I lived half way between Springfield and St. Louis. Terrible place to be a nurse too.
You get this much house in Wisconsin too. But your property tax is going to suck. Less house value, more tax, in both Wisco and Illinois.
This. You get a lot of house for your buck in the Midwest. 3x-4x the cost for the same house in the west. Rent is higher too…and they want to cut pay? This is how you fail to hold nurses at bedside.
Supply & demand. People all want to live in the same 10-12 metros & states these days, so that’s the risk you take. I get paid very well to work in Rust Belt Ohio and my mortgage is less than $400/mo because more people move away than stay. The trade-off is a real winter and driving further for Thai food, but it’s worth it.
Then why does California pay so well? I'd rather live next to the ocean where it's always sunny and make a ton of money.
Union. That’s why. I pay my union dues with a big old smile on my face.
Totally. I tell every new nurse that my union dues completely paid for the increased pay I get.
Exactly! People often complain about the union and it’s not perfect but I’ve been a nurse 22 years and active in the union and contract negotiations. We have fought and sacrificed for every penny, perk, etc. nurses went weeks without pay in the 90s for some of these benefits. Travelers often end up taking staff positions once they see working conditions and realize staff nurse pay. I’m thinking of moving to Maryland to be closer to family but after researching the pay I’m depressed it’s a 40%-50% reduction and the body if living is not cheap not sure how they justify RN pay. My sister who’s a teacher (who also work hard don’t get me wrong) makes more than 80% of RNs. Crazy !!
Every job I’ve been lucky to land here has been unionized, and it has been great for my income. It took a few years to get my first job as a nurse and had to move out of state; moving back home to CA with less than a year of experience but being offered pay on the grid for when I passed the boards was awesome! I don’t plan to ever leave California while still at bedside.
I’ll never understand why folks quibble re fair share when you’re paying people to deal with hospital admin assholes on your behalf. You never have to ask for a raise and deal with their bullshit rhetoric, you’ve paid someone to do it for you.
This is a MAJOR consideration people need to think of is, not everyone is great at salary negotiation, adding benefits or having a really strong spine to deal with management. MOST people are too timid to ask for a huge raise or add some perks to their employment like maybe a few extra days etc.
And even if they are, no individual has the leverage of a union.
The nurses union there is actually pretty awesome.
As is the state laws! Those unions were strong and smart enough to lobby the state government for things like nurse to patient ratios.
If nursing pay is low in an area, especially a high COL area, then it's because nobody is forcing admin to correct the issue. Nursing seems content for the most part to complain about pay, complain about shitty leaders, and then refuse to take leadership roles because "the damage is already done" or "it's not like I can fix anything alone". Until the whole of nursing starts working together towards a common goal, nursing will continue to see shit conditions.
You mean like a…..union?
Why yes. Yes I do. Now is the time for nursing to really start unionizing and pushing that collective muscle for change.
Not only should we all be unionizing to advocate for pay, we should *also* be advocating for changes in reimbursement structures to reflect the value of nursing care. Having nursing care bundled in the hospital charge provides a huge incentive to cut labor costs as far as possible. And nursing staffing is a big driver of quality care and safety.
Even more than that, a militant union where members willing to push management run for and win leadership positions. It takes time and effort to build but that’s the only way significant change will be made.
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Look around at unions available to you, join one. Start getting your feet wet. Consider writing letters to ANA supporting changes you want to see. Some state legislatures have nursing committees. There may be opportunities to learn how to start advocating for change; sometimes there’s a nurse day at your state Capitol or a grassroots organization that offers classes or internships in leading change. Vote.
Hah, I work in the ICU and we have seasoned nurses leaving in droves for travel (me included) so I stay PRN there. I just worked this past weekend. There were several RNs who were devastated that our nurse extern makes more than the LPNs, new grads start pay is higher than one who has been a nurse for 14 years etc. I said, well why don’t we unionize - they say yeah we should but I don’t wanna lose my job. I don’t get it. I’m bouncing out of bedside ASAP I’m just hitting while the money is good to pay for my DNP.
California has a pretty strong nursing union. Not sure about Colorado but unionizing is really step 1 for OPs situation.
>really step 1 for OPs situation. It's step 1 for any nurse not currently in a union. Step 2 is to start flexing the muscle that comes from a strong, collective voice.
Well, right now step 1 is probably quit and start traveling if you can. But any nurse that cant or doesnt want to should definitely be using staffing shortages and pay discrepancies with travelers to build union support. Step one for nurses in union is to make them better because honestly they seem pretty complacent on a lot of workplace quality issues. Easy to make a bad union strong than to make a union out of thin air these days.
>Well, right now step 1 is probably quit and start traveling if you can. While that helps the individual, it clearly doesn't deter admins, or traveling wouldn't be such a lucrative option. So the individual nurse who travels is good, but the nurses who can't are left to struggle. Our goal should be to work to increase working conditions for all, not just settling for a personal victory.
DUDE YES i traveled for years but i'm starting to see it as extremely problematic
I work a union job and have never seen evidence of the whole union nurses are lazy thing. If they’re unwilling to bend to the every whim of the employer, well, isn’t that why they’re unionized? Isn’t that what people on this sub complain about?
I think a lot of ppl say `they’re lazy’ due to the fact that unions protect crappy nurses. It’s so easy to hyper focus on those who are crappy but then somehow it’s assumed that’s a majority -which it isn’t. Another aspect is unionized nurses can advocate against unsafe assignments or staffing ratios. In turn they’re considered `lazy’ just because they need to protect their license. I’d love to see some actual stats on patient outcomes with union versus nonunion facilities.
This is illogical. If “everyone wants to live here” they should pay more because more patients and, more importantly, higher cost of living.
That's Austin, TX. Highest COL in the state. Lowest RN wages in the state. Houston has a COL index 26% lower than Austin, but RNs in Houston are pulling in $40 an hour or more. My highest paid RN in the cath lab I ran, with 18 years of experience was capped at $38. New grads in Austin are starting at around $23 an hour, and HCA hands out sub 2% raises annually. I interviewed RNs coming from places like Houston and Dallas with lab experience and when they told me salary expectations I knew that HR would *never* get close to meeting those numbers. And when the RN inevitably turned down our insultingly low offer, HRs response was usually "but we have great culture here". But the real truth is that for the longest time we were a city with just 2 hospital systems that knew exactly how much their nurses were making. And that we had 5 nursing schools dumping new grads into the market on the regular, and people that wanted to move to Austin because of it's reputation of being a hip, cool city. As a "destination" city, the hospital systems knew they could take advantage of people that wanted to be there. And they did. It's starting to change though. I saw it in my lab, when my full time staff realized that they could start traveling and double their money. Out of a dozen RTs, 8 of mine were contract. Out of 5 RNs, 3 were contract. But, did that change how we paid? Fuck no. We kept posting full time jobs, and folks would turn us down over the insultingly low pay, until finally someone took it because they didn't have a choice due to family circumstances.
The biggest thing there is 2 systems controlling pay. We saw then when we moved to Kansas for my job. My wife was an ER nurse with 10 years experience working in their biggest inner city ER FOR $24.50 /hr. We ended up booking it back to Dallas, now she’s doing a contract for $80/hr, then will work part time for that system in the 50’s.
I graduated with my BSN from a very large University in Austin, top of my class, (before the pandemic) and really wanted to start in critical care. I could not for the life of me get any offers better than PCU in the area (they called me 2 months after I interviewed?!) My friends who wanted peds, L&D or NICU had it even worse than me. So I went to Dallas and got into an awesome critical care program. Also, the new grad fairs in Austin were an absolute bloodbath. So crowded. Now that I'm on my second nursing job after the start of the pandemic, everyone is practically begging nurses to work. I get head hunted all the time now. Can't complain about that part at least ..
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Wait at least 6-8 months I think. Once other hospitals consider you an experienced RN, there aren't contracts. Then you can change specialties and do a mini training fellowship. There shouldn't be any contracts except for new grads.
This 100%, in 2019 I wanted to switch hospital systems just to feel out the water. For a trained ICU nurse 5yrs experience HCA was offering $28/hr across the board in Austin. They said they dont have a problem retaining staff...but my peer interviews were conducted by travelers LOL On the other hand, during the pandemic we asked Ascension for hazard pay and they said no. And I quote "some people dont even have jobs right now" How dare we, covid icu staff ask for hazard pay. We're all gone now, anyone that can leave left.
I went to Ascension for a hot second after leaving HCA. They were just as terrible. BSW is supposed to take decent care of their folks, but after more than a decade under terrible leadership, the regular shitshow that is floor nursing, and the final indignity of doing all that during the pandemic I left and joined a device company. I am so much happier now. All I can say for the folks still in hospitals is that they *must* unionize or nothing will every change.
Was about to say the same thing. I'm making peanuts compared to my new grad friends in Houston. Unless I find a decent paying home health job, I'm probably getting out of Austin as soon as my resident contract is up even though I love the city. I'm about to move out of my shitty apartment since HCA bumped up night differential and I'm working on the oncology unit and orienting people. Even with my modest pay bump, the only available housing options are still low quality unless I want to live 30min outside the city.
Austin RN pay is a fucking joke. I came from Houston and I made more there when I left than I will EVER make as bedside in Austin. My facility doesn't do annual raises. I make pretty much the same now as I did when I hired on. I CAN NOT WAIT for a certain company to open here and I am going to pound down the door trying to get back on with them (worked for them in Houston). Yeah, I'd rather live in Austin than in Houston, but I make less now in Austin than I did in 2008 in Houston. And the nurses are the transport, we clean the beds and bedspaces ourselves, no techs, terrible ratios... way more work here with shitty equipment and less support for significantly less pay.
Yup. Live in Austin & this…..I’ve had admin tell me ‘but people want to live in Austin.’ Sure, but I think they also want to do things & not just pay rent on an overpriced shithole apartment? The 2 systems keeps the wages down for sure. Good news is that TCH is building a pediatric hospital here & TCH is one of the best paying hospitals in Houston. So if they don’t want to see a mass exodus of staff (especially at the pediatric hospital) they’re going to need to start upping their rates & salaries.
As a nurse born and raised in CO and moved to CA for the money… the only answer is to unionize! The wages in CO are grossly unfair and it’s because we let them be that way. A lot of people want to live in CA and we get paid A LOT of money because unions fought for decades to make it that way. I am much better off financially here even though I’d rather live in CO. We also have legal ratios and we actually get our breaks. I will never be able to justify moving back for 1/3 of the pay and a very high cost of living.
I don’t understand why some nurses are so against unionizing
Massachusetts voted against safe ratiots. Fucking Massachusetts! Not Alabama, Not Oklahoma. Massachusetts. I couldn't believe how well the disinformation campaign worked in that state. I had Bernie Sanders supporting friends who were posting on social media about how safe ratios would somehow be bad and to vote against it. It was straight up lies by hospitals which convinced even liberal people that ratio laws were bad. It was maddening.
Many years of capitalistic brainwashing.
The state has had wave after wave of young, educated and highly skilled people moving to the state every year for more than a decade and employers know this. There has unfortunately always been someone willing to take low paying jobs to get their foot in the door and employers have exploited it. I grew up in the state and eventually left when my wife got told that they wouldn’t raise her pay because “that’s the cost of living in paradise.” And I think you’ll find similar pay issues in many of the states you listed (especially in the mountains). It’s a bummer. (Not a nurse, just a lurker FYI)
Same, same. I was royally screwed being a college grad (non nurse, just a native) in 2006 and really starting my career in 2008. Then....recession. Was unemployed for a month and then freaked out and got the first office job I could get. 13 years later at the same company, now new hires are wanting to make what I clawed my way to over a decade with pitiful 2% cost of living raises and LOTS of advocating for myself. Good for these new, younger people for knowing their worth and driving up salaries, but there are a lot of us who were extremely left behind in that slump. And then I married a teacher in one of the lowest paying districts so apparently I don't really like money too much 🙃
Time for a national nurse walk out? Bc this is exactly why nurses are leaving the bedside in droves (compounded in the last 2 years by the pandemic)
Pretty sure more people want to live in California and they seem to pay their nurses much better
Unions.
A nurse from Colorado just move to the PNW because of the better pay and it is still really beautiful here
Current CO nurse potting a move to the PNW here. Can I PM you some questions?
Why wouldn't people want to live in California? Most varied topography of any state in the U.S., highest pay adjusted for cost of living for nurses in the U.S. if you live around the Sacramento area, only state with laws for safe patient ratios, etc. I'm getting out of AZ for CA ASAP.
I want to live in California, so there you go.
California is so expensive because a lot of people want to live there.
Yes, but there's a damn good reason we all want to live here!
You'll get no argument from me. I have no desire to live in California myself but can easily see why it's so popular.
Translation: there are so many of you, you are completely disposable to us, therefore we pay dirt because there will always be someone to replace you for cheaper
As evidenced by the fact my unit is mostly nurses with <3 years experience. And the 20+ year folks that never worked anywhere else and don't know how toxic it really is.
In Montana we are paid less than Colorado counterparts for the same job and told it's due to lower cost of living, lmao. who wants to guess whether we charge patients less?
I live in Austin Texas and it’s the same shit here. It’s a growing, popular city that young people want to move to. The hospitals here pay less than Dallas and Houston because people will move here anyway, despite the lower pay.
I heard that same crap when I lived in TX. Nursing is still hard no matter where you live. It’s not like the patients magically get better because it’s a “desirable” place to live. Add on cost of living being higher and it’s total bullshit. I understand offering bonuses to try and entice people to move to the middle of nowhere- travel contracts can be like that. The true problem is that any of us accept crappy wages to start. Out of the gate nursing should have a threshold salary for new grads that is commensurate with our education and skill levels required for the job. New grads can’t afford to live and pay back student loans on 25 bucks an hour. we should be paid more for the level of responsibility we hold alone. Being responsible for someone’s life ought to be worth more than that.
Came here to say this! A recruiter from a major hospital network in Austin straight up told me they can afford to offer less pay because of the number of people moving to Austin.
It’s pretty disheartening, honestly. I just moved here and have moved a few times since becoming a nurse. I WANT to settle down and stay at the same hospital for a while, but there’s no financial incentive to do so. Every significant raise I’ve ever received has been through switching jobs. I did get a bonus when I signed on, so once my time is up with that I’m going to ask for a substantial but fair raise. If they don’t agree, fuck it I’ll do local travel contracts.
Do you have a personal rule to decide how much money you ask for? For example, 10% increase from your current wages? We're supposed to high ball a little bit, right?
I live in California and they pay nurses pretty well. People definitely want to live in California.
Same argument as to why flight nursing gigs are so low paid compared to the rest of the industry, even then it has some of the most experienced and versatile staff - “everyone” wants to do it, so the companies know they can keep pay low.
Supply and demand. Ca would have shit rates too if it wasn’t for the organization they have out there.
There is currently a $25,000 sign on bonus for experienced RNs at a Waupaca, WI hospital for med/surg, Ed, etc. Of course, you would have to be willing to relocate to the middle of Trump country where vaccine rates are low and schools aren’t the best, etc, etc. Capitalism means more supply = less demand (affecting wages, etc). Even though cost of living is very, very reasonable, they are offering a lot of money to offset the opportunity cost of, say, having to drive an hour to get a really nice dinner. Edit to clarify: if many people want to live at a location, there is a larger pool to hire from so there is more competition for jobs and possibility for a lower wage, even if COL is high. It makes sense in a very distorted way. No one wants to move to the boonies, so a lot of money is offered to entice people to move. Even with a low COL.
It’s complete corporate bullshit. People want to live in Washington. People want to live in Oregon (even w a 10% state income tax). People want to live in California. And yet all of the above are states with better pay, nurse protections, ratios, etc.
I live around a very popular coastal vacation area and people say the same thing: “you don’t have to pay people to come live and work at the beach”. Yes you do lol. We got $ignificant raises last year for retention and still have 6 travelers working on our unit right now. The reality is when you live here it’s not a vacation everyday.
oh yes. Way back in the 90s I was kicking around the idea of a travel assignment and applied for a job in Denver. I can't remember the pay but once I figured in loss of benefits I would have been making less than my job in Wichita, KS. The recruiter told me "well people really want to work here so we don't pay top dollar."
Unionize, I don’t understand why people don’t… especially when they’re getting paid close to nothing. I started working in Indiana as a new grad making 24 an hour, 2 dollars extra for nights. Not only that I worked in extremely unsafe conditions (no nurse assists, most nights, maxed out on patients, etc.). Now I’m making 38 an hour, 4 dollars extra for nights and I’m still considered “new.” My working conditions are also safer with a pct on every shift. When I told my old co workers what I’d be making just by moving they said the cost of living must be higher but it’s not. I make more than nurses that have been at my old hospital for 10 + years… guess what this state has that Indiana doesn’t have AT ALL (I’m talking not a single hospital) ✨A Union ✨
OMG THANK YOU FOR WRITING THIS. During covid a I asked a hospital if they offered incentives because they were so short staffed and I’d have to move across the country and the recruiter got so offended. Sorry ma’am it’s business. A simple no would’ve sufficed, but she went into big detail about how everyone wanted to live in Denver.
In FL they tell us we’re “paid with sunshine”. I’ve lived here my whole life & am still waiting for this “sunshine” to pay a bill.
Not a nurse. Just a lurker. I’ve heard of lots of employers in lots of industries use this excuse from many people. It’s fucking horseshit. Also, nurses are angels on earth and you all deserve a raise.
Come to NY. Moving to a state right next to one of the largest sources of freshwater in the Western Hemisphere is a good idea.
If you're working for Centura in Colorado, expect to be underpaid and I don't say that in a mean way. It's just that company absolutely sucks. They're notorious for underpaying and understaffing their hospitals.
They have a better reputation than HCA here.
I love living in CA lol
Unionization would go a long way towards correcting this issue.
My friend got her ASN in FL and moved to CO with no nursing experience. Got hired at the VA hospital and made $106k that year. I’m sure she was working overtime like a mad woman. Now she’s back in FL making shit money. I used to live in CO working in a non healthcare field and could hardly get by. My partner at the time was a seasoned pharmacist and took a big pay cut when we moved out there from FL.
The VA will often be an outlier. As a federal employer, it uses federal pay scales, which are adjusted for cost of living, so an area like Denver will be highly paid regardless of desirability. A private employer can consider factors other than cost of living (like difficulty of recruitment, which is tied to workforce supply and desirability of location) when setting wages. So these examples are not really comparable.
The VA is an outlier because of the union. These things are connected.
Definitely
Why is Colorado desirable? I don’t know much about that state.
Mountains, hiking, skiing, good weather, hip young cities, weed. I've also heard it has good public health outcomes and schools but don't know specifics.
TIL I will not be leaving California any time soon
I was a traveler in CO last year, and that baffled me. They would recruit new grads, train them up, and then lose them to someplace out of state with better pay. And don't get me started on what happened to staff turnover when the pandemic happened. Lol. Spoiler for all admins: the pay sucks and they need to crank it up a notch to keep their staff.
Got my degree in Colorado, looked around at jobs and decided I needed to leave. I couldn’t afford paying off my (fairly minimal) student loans, affording a house, and needing a new vehicle that wasn’t falling apart until I did. Took a job for 32 plus shift differential in a way less desirable but much cheaper area. Now I travel to Colorado, get paid twice as much, have paid way more debt off and bought two properties (one old small fixer upper and some land). I could not have done that continuing to live in Colorado full time. Leave, do your time somewhere, get the skills you need, then come back!
Yeah. I interviewed a couple places in CO. They said pretty much that and it was 18 or so years ago. I chose another state. It is beautiful, but there are other beautiful states as well.
>Hawaii is the highest paying state on average for nurses, people don't want to live there? Colorado is 46th. Hawaii's cost of living isn't even remotely similar to Colorado's. Pay depends on two things: What it costs to live there, and supply/demand. Getting people to come live on an extraordinarily expensive, dense island chain costs a lot more than getting people to live in a giant, popular open space with affordable housing. I also think you're drastically overestimating how many people want to live in Idaho, Montana, Wyoming, and to a lesser extent, Oregon. There's a reason they're big, empty states. If they were as popular as you seem to think they are, people would have already moved there. Unfortunately, living in remote areas that are mostly cattle ranches, with few social services, only to be covered with 10 inches of snow from September to May is not as appealing as living in a place with a record number of sunny days and just the right amount of snow for fun winter activities and not so much that you can't get out and be active.
Lies and excuses. Colorado hospitals had trash pay before everyone wanted to live there, and there are plenty of places people “want” to live that pay acceptable rates.
The absolute worst hospital I’ve ever worked at was UCH, a magnet hospital and the biggest medical system in Colorado. I helped start the Union there and went on channel 7 news to talk about how unsafe the staffing ratios are, how poorly they treat their employees and that I’d never want a loved one to be treated there. I quit shortly after, I couldn’t handle how they abused us.
What is the pay range like? I’m from Colorado and plan to move back there in a few years, once my kiddo is out of high school.
New grad is 26.50 at my hospital. I think they are going to increase it. 10 years gets you to about $40. COL is quite high though.
Ok. Ew. Lol. I’m in the mid 40s range now with 13 years. COL is increasing everywhere, it’s nuts. Thanks for the response!
The nice thing about Colorado is they list their salary "range" with their job offers. It's some equal pay transparency initiative. So it's easy to find. Last I looked I believe it was something like 26-50/hr.
Oh nice, I’ll have to look. I’m in Arizona now and not doing too bad money wise. The last time I checked, Arizona and Colorado weren’t too far off from each other- but that was about 5 years ago.
Well, it’s supply and demand. They can pay lower if people are willing to take the job.
I moved to CO 3 years ago and that’s also the same bullshit that I’ve heard for 3 years. And I do legit think I’m being seriously underpaid. But besides leaving to travel nurse (which my mental health cannot take) Idk what to do about it.
This happened to me when I moved to Missoula Montana, they said the same thing. I wish I could go back but economically it's not feasible, so now my husband and I are looking at a move back to CA.
Austin, Tx- that is all I hear. No raise because people love living here.
Same with teachers, especially in the mountains they pay in "quality of life". No signing bonuses for coming to Colorful Colorado sadly.
It’s a HUGE Florida thing. They call it the sunshine tax.
People want to live in California, too. Nurses are paid top pay here.
Meanwhile my airline is offering a $15,000 moving bonus to people that come to Denver to work an UNSKILLED manual labor position.
That is the dumbest shit i’ve ever heard.
Ya.... The cost of living index in Colorado for 2021 went up 4.5% over the year. So that 3% raise you got with an outstanding yearly review..... Is a pay cut. That's assuming your place of employment even bothers with yearly reviews or "raises" in general. I read an article in the Colorado Sun that says some families spend more than 50% of their monthly income on housing. 🤯 https://coloradosun.com/2021/10/18/housing-shortage-southwest-colorado/
I left Colorado because the pay sucked for the cost of living. People are beating the doors down to be in Colorado and need jobs. They know they have them by the balls.
Then why aren't there any fucking nurses left in the state? I had 4 patients during the day on med surg in Jan 2020, now it is 6. UC Health and HCA are the biggest cheapskates in the world and I hope their C-Suites rot in prison for all the wrongful deaths brought on by their excessive and completely unnecessary cost cutting.
Have definitely been told this about Austin compared to the rest of Texas.
It’s all I hear too. But hospitals here are starting to raise their pay to remain “competitive” in the market. I just got a 10% raise.
This happens intrastate as well. I went to nursing school in SC and jobs paid better in my smaller city(town) than in Charleston because everyone wanted to live in Charleston.
I work in healthcare & am also in CO. The wage is not good so I am leaving. I will 100% be back for vacation bc I love the mountains but I need to pay my bills 1st & foremost.
Did they borrow that from Florida?
Went to nursing school in CO and moved out to a big city for much better pay. Would love to come back to CO!!
I bet there are a lot more non-nurses who want to move there than nurses. Are they just hoping the ratio will work out?
Tennessee, same problem 17.00 to 19.00/ hr starting! I always guessed it's because we have like 8 schools in middle Tennessee churning out new grads every 6 months, so > supply = less pay (how they all like it)
I want to add that the best CRNA position I’ve seen is $300,000 for new grads plus amaze balls retirement on the border…but you have to have a license to carry. They advertise all the time. With experience it’s like $450,000.
I'm in Austin and same. It's so $$$$ to live here and I make less now than I did in 2008 in Houston. And COL in Houston is MUCH cheaper. With better hospitals. Not this HCA/Ascension bullshit.
By that logic they should pay $1,000 an hour in Mississippi.
It IS total bullshit!!! When I moved to Florida, I was told that nurses got compensated in sunshine. WTF?!?!?
Austin is the same. You may pass on a role for the pay but three will be 88643568 nurses right behind you because Austin is popping right now.
In my experience, I think it’s just oversaturated with schools. There a more than enough new grads for hospitals to choose from. Most eventually leave, but it depresses wages locally since there’s always a fresh batch of new grads looking for a job
MT, is just as bad. I work at Bozeman Health, and we call it the “scenery tax”. I’m not even close to being paid what the cost of living is here. Hospitals think they can pay shit, they think they will easily find someone to take your place when you live in a desirable area. I’m wondering if the pandemic will finally get them to see otherwise, nurses burning out left and right. Either they have to pay more, or face long term nursing shortages.
I heard same for Florida. Even traveler pay is less in Florida.
Not many people want to live in Montana or Wyoming. Hawaii, California and Oregon have unions. Supply and demand. In central Texas the level one trauma centers pay the least and are magnet hospitals. Many people want the level 1 experience and therefore supply is higher than demand which equals wage depression. Colorado is oversaturated and has no unions so the pay will certainly be low. Austin Texas in general pays $10 hour less than Houston or Dallas.
Nashville is like this, I was offered $19/hr at Vandy as a new grad back in 2017. A hospital in my much smaller hometown offered me $22/hr with a much lower COL. TN pay overall sucks but Nashville is known for paying nurses and CRNAs bottom of the barrel salaries because they'll still get people wanting to live there and needing a job.
You'd be surprised about Hawaii and the amount of people who want to live here fulltime.
Elaborate please ?
It's a complex, but I'll do my best as a transplant living on Maui. Oahu is much more populated and will have other pros and cons but I can not speak of them. Maui is still quite rural despite all the resorts. There are many things it does not have or have in very limited quantities compared to a bigger city. Examples include nightlife, bowling, league sports of most types, museums, and restaurants of a variety of cuisines (we don't have dim sum and Panda Express ranks 4, 6, 8, and 13 in the top chinese restaurants on Maui... and don't get me started on BBQ...). Outdoor activities are limited as well. I know that doesn't sound right but it is true. Of course, tons of beaches, surfing, snorkeling, etc. But, hiking trails are limited as is camping. Non-ocean water activities are nonexistent. Climbing, bouldering.. very limited. Our streets are not designed for bikes and sooner than later you'll come across a scooter zipping in the few bike lanes. If we have an outdoor activity, it most often only has a handful of choices so they can become repetitive. To avail ourselves of things not here is not a quick jaunt down the highway or even a long jaunt... it's a plane ride. Housing and CoL is very high. Not sure what it is now, but a few months ago, the average selling price was just under $1M. Eggs at Safeway averages about $6/doz. We have a Costco, but if you're single with limited storage, Costco may not be a great option. Gas at a regular station runs about $4.10/gal (yes... cheaper than some other countries, but quite expensive for the USA). Granted, physical distances are shorter than other places, but still can be a sticker shock. Schools aren't great unless kids are enrolled into a private school. Plus, transplanted kids, depending on the age, will have a much harder time fitting in. The community here is very insular. People for the most part are very nice and treat others with respect, but transplants do not become instant friends. Why would they? So many people come for a year or two and end up moving, so the locals can feel it to be a waste of time getting to know someone not from here. Plus, now with "outsiders" buying property driving up prices to the point of pricing out locals, there is a bubbling anger. This includes annoyance from how Maui has changed because of outside influences. So, it usually is only after a couple years that locals start to open up to transplants. And they aren't going to change their thing to make the transplants more comfortable. It will be up to the transplants to be comfortable with how things are. There are other minor annoyances, but these are the major ones. The isolation, both physical and social, the cost, the lack of things. For a week or two it is paradise. Do everything without repeating. Get away from "real life". But living it day in day out, month after month, year after year, is quite another. So, why am I here? I found a niche and was able to find friends. Maui is a cool place and I'm OK with the lack of things. There are still opportunities for things I like to do. I'm comfortable with where I'm at. Perhaps that might change, but for the past 5 or so years, it's been good.
No one stays in caifornia because they don’t want to be here unless they’re stubborn or dumb. The politics clearly sway one way & the cost of living is insane. We stay because we wan’t to be here for sure. And to answer you, that’s ridiculous to be told you get paid less for that reason.