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The Best States to Be a Nurse for Advanced Practice Roles

Nurse practitioner

For nurses in advanced practice roles, there’s no shortage of job opportunities nationwide. However, compensation, scope of practice, and work environments vary by state. 

Advanced practice registered nurses (APRNs) include certified nurse practitioners (CNPs), clinical nurse specialists (CNSs), nurse anesthetists (CRNAs), and certified nurse-midwives (CNMs). And these nursing professionals are vital to the healthcare system. 

These highly skilled nursing professionals have at least a master’s degree in nursing and have completed graduate-level education and training based on a specific specialty. APRNs possess advanced clinical skills and expertise. This enables them to provide high-quality care across various settings. 

However, the professional landscape for APRNs can vary significantly from state to state. Let's explore the critical factors to consider when considering the best states to be a nurse for advanced practice roles.

States with full scope of practice

State-specific laws and regulations impact the practice environment for APRNs. Supportive legislative frameworks can enhance professional autonomy, for example. One of the most crucial factors for APRNs to consider is the scope of practice allowed in each state. 

Full Practice Authority allows APRNs to evaluate patients, order and interpret diagnostic tests, interpret diagnostic tests, and initiate and manage treatment plans independently. 

This enhances professional autonomy and enables nurses to utilize their full range of skills. According to the American Association of Nurse Practitioners (AANP), over half of states and U.S. territories have taken up these licensure laws for NPs.

Full Practice Authority states include:

AlaskaMontana
ArizonaNebraska
ColoradoNevada
ConnecticutNew Hampshire
DelawareNew Mexico
Washington D.C.New York
HawaiiNorth Dakota
IdahoOregon
KansasRhode Island
MaineSouth Dakota
MarylandUtah
MassachusettsVermont
MinnesotaWashington
Wyoming 

Conversely, other states impose reduced or restricted practice. In those states, APRNs must have a collaborative agreement with a physician, limiting certain aspects of their practice. 

Reduced Practice states include:

AlabamaMississippi
ArkansasNew Jersey
IllinoisOhio
IndianaPennsylvania
KentuckyWisconsin
Louisiana 

Restricted Practice states include: 

CaliforniaOklahoma
GeorgiaSouth Carolina
FloridaTennessee
MichiganTexas
MissouriVirginia
North Carolina 

Advanced practice nurses in these states may face limitations on their ability to prescribe medications, or to perform certain procedures independently.

States with competitive salaries

As far as the best states to be a nurse, salary is a significant consideration for APRNs. However, compensation can vary widely based on geographic location. 

States, such as California, New York, and Massachusetts, offer some of the highest salaries for APRNs. For instance, the mean annual wage for NPs in California is $161,540, which is significantly higher than in other states. 

Meanwhile, the mean annual wage for NPs in Tennessee is lower at $103,720, which is lower than the national annual mean salary of $129,480, according to the Bureau of Labor Statistics. 

While some states offer high salaries for APRNs, the cost of living in those areas can offset the financial benefits. States with a lower cost of living, such as Texas and North Carolina, may offer more affordable housing, transportation, and overall living expenses. This allows APRNs to stretch their salaries further. 

States with job opportunities and demand

For APRNs, demand for healthcare services and availability of job opportunities are critical factors that influence which states are considered the best states to be a nurse. 

States with growing populations and expanding healthcare systems tend to offer more job openings, which include:

  • Texas
  • Florida
  • Arizona
  • North Carolina
  • South Carolina
  • Tennessee

As an APRN, you’ll also need to consider the variety of employment settings available in different states. In terms of more opportunities in specialized fields or unique settings, the best states to be a nurse will offer a range of job opportunities in academic medical centers, research institutions, specialty clinics, and community health centers. 

States with more professional development opportunities

Continuing education is vital for APRNs to maintain their certification and stay current with medical advancements. States with robust healthcare systems, such as Massachusetts and Pennsylvania, offer ample opportunities for continuing education. APRNs can take advantage of opportunities at top-ranked nursing schools and medical institutions.

APRNs should also consider whether the state is supportive of professional growth. Employers in areas considered to be the best states to be a nurse provide tuition reimbursement, scholarships, and opportunities for advanced certifications are important for APRNs. Continuing education requirements for APRNs vary by state.

States with good work-life balance

As an APRN, your work environment can significantly impact your job satisfaction — and your overall well-being. Consider the state’s reputation for healthcare workplace conditions. Take into account factors such as staffing levels, administrative support, and workplace culture. 

You’ll also want to consider the lifestyle and recreational opportunities available in different states. States like Colorado and Washington offer outdoor activities like hiking, skiing, and water sports, contributing to a higher quality of life. 

States with positive community impact

Working in underserved areas can provide APRNs with a sense of purpose and fulfillment. For APRNs, there’s an opportunity to address healthcare disparities and improve access to care. States like Mississippi and West Virginia have significant underserved populations, giving APRNs the chance to make a meaningful impact on community health. 

APRNs should also consider the state’s commitment to public health initiatives and preventive care programs. This can enhance job satisfaction for APRNs interested in community health. States like Vermont and Massachusetts have strong public health programs and initiatives that promote preventive care and community well-being. 

Weighing multiple factors

What are the best states to be a nurse for APRNs? It requires careful consideration of multiple factors. Scope of practice, salary and compensation, job opportunities, professional development, work-life balance, legislative environment, and community impact are all important. Every state offers unique advantages and challenges for APRNs. 

By evaluating these factors and seeing how they align with personal and professional goals, APRNs can make an informed decision. By researching the best states to be a nurse, APRNs will ensure a rewarding and successful career in advanced nursing practice. 

Whether actively seeking a new role or assessing your next steps, explore Nurse.com's talent marketplace to help match your experience and skills to the best-fitting role.