31.5% of U.S. registered nurses leave the profession due to burnout.1 According to the World Health Organization (WHO),2 burnout is characterized by feelings of exhaustion, increased mental distance or negativism toward one's job, and reduced professional efficacy.
With this in mind, Nursa set out to determine which U.S. states nurses could experience the highest levels of nurse burnout. To do so, they developed a burnout score by combining indices, data sources, and metrics designed to reflect the WHO’s definition. The findings reveal surprising insights into how compensation, job satisfaction, and cost of living intersect for nurses across the country.
Key findings
- Colorado is the nurse burnout capital of the United States, with a burnout score of 8.42/10
- Idaho has 186 patients per nurse, the highest of all states analyzed
- Nurses in Rhode Island have the highest job satisfaction, at 93%
- Nurses in California receive higher than average compensation for their hours worked, according to the Compensation Index
The nurse burnout capitals of the U.S.
A higher Compensation Index score indicates that nurses must work more to earn the average nurse compensation. Find the full dataset here.
Nursa gathered and analyzed data to quantify nurse burnout across the United States. The key components of burnout (exhaustion, job-related negativity, and reduced professional efficacy) served as the foundation for their analysis. To represent these elements clearly, Nursa developed specific indices, including the Compensation Index and Satisfaction Index (as shown above).
Colorado has the highest risk of nurse burnout
The data reveals that nurses in Colorado are most at risk of burning out. With an alarming burnout score of 8.42/10, Colorado nurses face some of the harshest working conditions in the country. Each nurse is responsible for approximately 155 patients - the second highest patient-to-nurse ratio nationwide. While their average workweek is slightly shorter at 37 hours, this is offset by a cost of living 2% higher than the national average, and only moderate compensation (6.6/10 on the Compensation Index). As a result, job satisfaction is worryingly low, with Colorado nurses reporting an average satisfaction score of 3.4/10.
Arizona ranks second in burnout risk, with a nurse burnout score of 8.31/10. In Arizona, each nurse cares for an average of 148 patients at once, again reflecting heavy workloads. The situation is compounded by a cost of living that's 11.2% higher than the national average, and low compensation (6.0/10), leading to a job satisfaction score of 4.9/10, and an alarmingly high risk of burnout.
In third place is New York, with a burnout risk score of 8.14/10. While the average patient load is lighter at 107 patients per nurse, other stressors drive burnout levels higher. Nurses in New York work longer hours (39 per week) and contend with a cost of living 23% above the national average. Compensation remains low also - 4.1/10 on the compensation index - resulting in a job satisfaction score of 3.10/10 and solidifying its place as an at risk state.
Rhode Island is least at risk of nurse burnout
Rhode Island currently stands as the state least at risk of nurse burnout, with a burnout score of 4.46/10. Despite working longer hours on average (40 per week) and having a high cost of living (12.2% above the national average), nurses in Rhode Island care for significantly fewer patients each on average, currently standing at 91 patients per nurse. Most notably, 93% of nurses surveyed from this state report high job satisfaction, earning a perfect Satisfaction Index score of 10.0/10.
This goes to show that burnout among nurses is most likely to occur when staff are responsible for large numbers of patients each. Therefore, the key to sustaining low levels of nurse burnout may not be generous compensation, but rather the ability to maintain a manageable workload within one’s working hours.
Methodology
Nursa sought to identify which U.S. states exhibit the highest potential for nurse burnout. The research combined multiple data sources and metrics, both direct and indirect indicators of burnout, using the most recent data available.
Nursa first calculated three distinct indices to support the representation of burnout data. These included:
- Compensation Index: This index identifies how long nurses need to work to earn $1 in their state, relative to the national average. States with a higher index score indicate less favourable compensation to nurses, while states with a lower score represent a greater appreciation for nurses through higher pay relative to hours worked. In the full dataset, this is labelled as the Overworked Index.
- Satisfaction Index: An index score out of 10 was calculated from a statewide nurse satisfaction survey.
Cost of Living Index: This index first considered indices of grocery costs, housing costs, utilities costs, transportation costs, health costs, and miscellaneous costs. Each state’s index score was then normalised from a scale of 0 to 1, ultimately creating a score out of 10 for this press release.
Other metrics in the final burnout score include:
- Emotional strain: A numerical score blending satisfaction, workload, and affordability stress.
- Patients per nurse: Inferred from population-to-nurse ratios
- Google search data: For terms “Nurse Retirement” and “Nurse Burnout” per state
Other considerations
- Metrics with stronger ties to burnout risk, such as the Compensation Index and Satisfaction Index, were given higher weights, while Google Trends data was assigned a lower weight due to data sparsity.
- The final burnout score for each state was computed using weighted percentile rankings across all derived metrics and search trends.
- Find the full dataset here.
- The data was collected and reviewed on 05/21/2025 and is correct as of then.
Sources
- National Library of Medicine | Prevalence of and Factors Associated With Nurse Burnout in the US
- World Health Organization | Burn-out an "occupational phenomenon": International Classification of Diseases
