California has the most severe nursing shortage among 30 states, while Hawaii has the least severe, according to a Nurse.org report published Nov. 3.
The Nurse.org Nursing Workforce Benchmark scored states using three sources: hospital staffing reports on open RN positions as a share of total budgeted positions, state-commissioned or peer-reviewed studies on RN workforce projections and federal Health Resources and Services Administration shortage area designations. Twenty states with no publicly available workforce study or hospital vacancy data were excluded.
Each state also received a confidence tier based on its data sources. High means employer data from multiple independent sources, medium means one strong source and low means federal records only.
California ranked No. 1 despite being the only state with mandatory nurse-to-patient ratios and having the largest nursing workforce in the country.
Here are the 30 states ranked by shortage severity score, with each state’s confidence tier:
| Rank | State | Score | Confidence |
| 1 | California | 84.1 | High |
| 2 | Wisconsin | 79.1 | High |
| 3 | Virginia | 72.8 | High |
| 4 | Louisiana | 72.2 | High |
| 5 | Texas | 71.8 | High |
| 6 | Alaska | 67.2 | Medium |
| 7 | Arizona | 66.8 | Medium |
| 8 | Pennsylvania | 66.5 | Medium |
| 9 | Maryland | 66.4 | High |
| 10 | Washington | 66.3 | Medium |
| 11 | Tennessee | 64.1 | Medium |
| 12 | New York | 64.0 | High |
| 13 | North Carolina | 62.1 | High |
| 14 | South Carolina | 58.2 | Medium |
| 15 | Oklahoma | 57.4 | Medium |
| 16 | Georgia | 56.8 | Medium |
| 17 | Oregon | 55.0 | Medium |
| 18 | Nebraska | 53.7 | Medium |
| 19 | Minnesota | 53.4 | Medium |
| 20 | New Mexico | 50.9 | Medium |
| 21 | New Jersey | 50.1 | Medium |
| 22 | New Hampshire | 47.5 | Medium |
| 23 | Missouri | 46.2 | Medium |
| 24 | Kentucky | 45.4 | Medium |
| 25 | Kansas | 42.7 | Medium |
| 26 | Florida | 40.9 | Medium |
| 27 | Maine | 40.8 | Medium |
| 28 | Mississippi | 37.0 | High |
| 29 | Massachusetts | 33.6 | Medium |
| 30 | Hawaii | 28.7 | Medium |
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