Why are nurses flocking to California? While California still needs more RNs, the stream of nurses into the Golden State increased the nursing population by 8.3 percent in recent years.
Why?
California pays registered nurses (RNs) more than any other state, with an average annual wage of $133,340. Additionally, the state enforces safe nurse-to-patient ratios and offers an outstanding job outlook, projecting 43,330 new RN positions becoming available in CA by 2027. Find out what type of RN-to-patient staffing ratios you can expect in all states.
Nurse-to-Patient Ratios in California
California mandated nurse-to-patient ratios for each hospital unit in 2004 and reduced the number of patients per nurse further in 2008, resulting in benefits for nurses, patients, and hospital finances.
- RN injury and illness dropped more than 30 percent and even more for LPNs.
- Patient care quality improved with shorter in-patient stays at the hospital, reduced hospital-acquired infections, fewer intensive care unit (ICU) admissions, and fewer deaths.
- Healthcare recipients, providers, and even taxpayers save as a result of less nursing time off due to occupational injury, diminished readmissions, and less nurse turnover in response to better working conditions.
California is still the only state with legally defined safe ratios for various units, even though National Nurses United (NNU), an RN nursing union, determines and recommends safe ratios. The following table compares some of the recommended ratios with those actually in effect in California.
The control of the number of patients each nurse attends, educates, and encourages, with its implications for the well-being of patients, nurses, and healthcare systems, is an essential factor in California’s lure for RNs. However, the outstanding pay scale is just as important.
How Much Do RNs Earn in California?
RNs earn more in California than in any other state, with an annual mean wage of $133,340—fifty percent more than the national average—and reaching over $177,670 for the top-earning 10 percent.
Of course, the average RN salary in California varies by area within the state. The top three highest-paying areas for RNs are San Francisco-Oakland-Hayward, San Jose-Sunnyvale-Santa Clara, and Vallejo-Fairfield.
What Types of RN Jobs Are Most Common in the Golden State?
Of California’s 325,620 employed RNs, the majority—over 63 percent—work in hospitals, and 21 percent work in ambulatory care, a growing healthcare option that often focuses on individuals and communities in non-acute surgical and diagnostic outpatient settings. Some of the most common hospital jobs for RNs are the following:
Medical-Surgical (Med-Surg) RN Jobs in California
A med-surg registered nurse provides essential care for patients with diverse medical and surgical conditions. Working in this unit helps nurses acquire the knowledge and skills to work in other departments or healthcare settings. These nurses are well-skilled in monitoring diverse medical conditions, administering medications, managing treatments, and providing emotional support and guidance to patients and their families.
Med-surg is the most extensive nursing specialty in California and the entire country.
Emergency Room (ER) RN Jobs in California
Approximately 140 million patients appear in emergency rooms (ERs) in US hospitals each year. ER nurses are on the frontline to detect medical issues, determine urgency and severity, and give expeditious support to avoid or lessen adverse long-term effects and, in some cases, even sustain life.
Telemetry (TELE) RN Jobs in California
Telemetry RNs provide primary oversight over patients with cardiac conditions, monitoring and analyzing heart rhythms, interpreting ECGs, noting arrhythmias, and intervening in emergencies. Traditionally, telemetry nurses specialized in monitoring and care for cardiac patients, but now, with leading technological developments, their work includes monitoring and caring for patients with diabetes, a broader spectrum of coronary disease, and gastrointestinal diseases, as well as other conditions that call for acute monitoring and management.
Although the field is not new, it constantly evolves with the advances in healthcare technology.
ICU RN Jobs in California
An intensive care unit is a hospital department and system for critically ill patients with conditions such as trauma, organ failure, sepsis, cardiac arrest, respiratory distress, or post-surgical complications. Specialized equipment enhances the capacity for monitoring patients and providing life or organ support.
Some large hospitals have specialized ICUs, including the following:
- Trauma intensive care unit (TICU) for patients who have suffered severe trauma, such as major accidents, falls, or violence
- Neonatal ICU (NICU) for newborn infants with critical health conditions
- Pediatric ICU (PICU), where the hospital provides the highest level of care for the sickest children
ICU nurses rely on clinical judgment and critical thinking to anticipate interventions based on diagnostic tests, patient status, and other factors. Patients in the ICU can quickly take a turn for the worse, often requiring nurses to respond to emergencies.
Working as an ICU RN will test your composure and emotional strength.
Certifications Give Recognition to Your Nursing Experience
You can obtain certifications related to your work through the following reliable organizations:
- The American Nurses Credentialing Center (ANCC) and the Academy of Medical-Surgical Nurses (AMSN) grant med-surg certification.
- The American Association of Critical Care Nurses (AACN) offers a variety of certifications for ICU and telemetry nurses.
- The Board of Certification for Emergency Nursing (BCEN) grants the Emergency Nurse Certificate (CEN) for ER RNs.
All the mentioned hospital units or departments depend on the know-how and compassion of registered nurses and often provide specific orientation and training for jobs.
You can find per diem shifts in these specialties if you have experience related to the unit. With Nursa, you can take advantage of your experience and pick up per diem RN shifts in Med-Surg, Telemetry, ICU, ER, or other healthcare settings near you.
How Can I Become a Registered Nurse in California?
Like other states, California requires graduating from an approved RN program, passing the National Licensure Examination for Registered Nurses (NCLEX-RN), completing a background check, and paying licensure fees to become an RN. If you are considering an RN program in California, see the list approved by the California Board of Registered Nursing (BRN) updated as of 2024.
Licensure through Endorsement: High Standards
If you hold an RN license from another state, consider that California is not part of the Nurse Licensure Compact (NLC). The NLC allows nurses to practice in 41 jurisdictions with one multistate license. Since California is not a compact state, nurses with valid out-of-state licenses must apply for reciprocity to practice in California.
Partly due to California’s relatively high requirements for supervised practice hours, the RN program you completed may not meet all the state standards, and you may have some gaps that you must address to obtain your California nurse license.
Consider additional clinical practice options if your program lacks the stipulated number of clinical hours. Your experience might fill the gap if you are actively working as an RN. If not, some schools or healthcare facilities offer nurse refresher courses or supervised practice to enhance your skills further.
You can also consider enrolling in a California-approved RN program to close the gaps, perhaps a bridge program that grants you credit for your previous nursing education. Make sure that the program covers all the required coursework and clinical hours.
Seek advice from the California Board of Registered Nursing directly. Explain your situation and inquire about possible pathways for licensure based on your specific case. The California BRN evaluates each applicant individually.
Be proactive, seek guidance, and find solutions.
Temporary Practice Permit
Once you submit your application for endorsement, you can request a six-month temporary practice permit. This option is only open to RNs who have already applied for licensure by endorsement.
With this permit, you can work under supervision while completing the requirements for a California RN license.
License and Certificate Verification
All nursing licenses require periodic renewal; once a license has expired, it is invalid. Therefore, verify the status of your license online and renew it on time.
- Registered nurses can use the RN license lookup service on the California BRN verification page or Nursys, a national database.
Where Can I Find RN Jobs in California?
Healthcare centers all over California need RNs. The table below provides links to PRN, or per diem, RN shifts in some of California’s major metropolitan areas. PRN jobs generally offer significantly higher hourly pay, and the hunt is much faster with Nursa.
Table 2: Locations with Per Diem Shifts
A few more locations with per diem jobs that might interest you are the following:
California’s Premier Medical Centers
Five of the 22 hospitals on the Best Hospitals Honor Roll—the best of the best, according to the U.S. World and News Report for 2023-24—are located in California.
- Cedars-Sinai Medical Center, Los Angeles
- Stanford Health Care-Stanford Hospital, Stanford
- UC San Diego Health-La Jolla and Hillcrest Hospitals, San Diego
- UCLA Medical Center, Los Angeles
- UCSF Health-UCSF Medical Center, San Francisco
See much more about California’s leading health organizations and the state’s best nursing schools in Nursa’s guide to nursing jobs in California.
Stay up-to-date with the latest nursing trends by reading our blogs about the best water bottles for nurses and which scrubs are most popular for healthcare workers.
Look into Per Diem RN Shifts close to Home
RN jobs in California offer safe nurse-to-patient ratios and competitive compensation at some of the country’s top healthcare centers. Use Nursa to find high-paying RN shifts and craft your own schedule. To learn more about unlocking opportunities, read our article about the ban on noncompetes.
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