The registered nurse (RN) category will post more jobs than any other profession in the United States, with California leading the nursing shortage. The widespread need for nurses affects quality of care, access to care and patient outcomes. The word “shortage” creates more demands, work and stress. But with planning, a shortage can also be positive, providing more overtime pay, better salaries, more employment opportunities and a better job outlook.

Why Is There Such a Nursing Shortage in California?

California is home to 40 million residents and counting, as well as a growing elderly population with more healthcare needs. Compared to Medicaid programs in other states, California’s version (Medi-Cal) is a “public health insurance program that provides free or low-cost medical services for children and adults with limited income and resources.”

California employs one of the highest numbers of nurses. The California Board of Registered Nursing (CBRN) reported almost 360,000 registered nurses (RNs) with an active license and a California address in 2019. Yet, this number keeps changing based on nurses who are graduating, retiring, migrating in or out of state, deciding not to work or reducing their hours.

One concern is that the percentage of licensed nurses over 65 years old is outpacing the number of nurses younger than 30. This age shift could make the nursing shortage worse than projections, leaving the next generation without adequate healthcare.

What Are the Requirements to Practice Nursing in California?

Like all other states, RNs must pass the standard National Council Licensure Examination (NCLEX), and the CBRN handles all regulatory issues. If you hold a valid license in another state, then you can often apply to practice in California through an endorsement (reciprocity) process.

Be sure to allow plenty of time for reciprocity, as it may take anywhere between 12 weeks and six months. Consider using Live Scan to speed up the fingerprinting procedure. With a temporary RN license, you can practice while your permanent licensure is processing.

Is California a Compact State?

No. But recent California legislation may make it a compact license state. The Enhanced Nursing Licensure Compact (eNLC) agreement streamlines the licensure process to enable nurses to practice through a multi-state compact license. eNLC is critical in times of natural disasters, outbreaks, shortages, strikes, telehealth and practice in border areas. You can sign up to Nursys for real-time notifications about the status of California.

What Is the Job Outlook?

California’s nurse supply is not meeting current demand. California tops the list as the state needing the most nurses by 2030. Approximately 44,500 nurses are required — nearly three times as many as the state with the next-highest demand, Texas. Overall, almost 800,000 new RNs will be needed in the next decade, with California adding over 110,000 new RN positions. Even with these numbers, the demand will not be easily met.

How Much Do California Nurses Make?

California nurses are among the highest-paid in the country, mostly due to the high cost of living and unionization, mandatory staffing ratios and a robust state Medicaid program. The California Nurses Association/National Nurses Organizing Committee/ALF-CIO (CNA/NNOC) is one of the country’s largest, most powerful nursing unions. It provides nurses with a collective voice for higher pay, safer working conditions, better benefits and healthcare accessibility and quality.

Since the Golden State geography and population density vary across the state, so does the salary range for RNs. The annual RN salary ranges from $90,490 to $140,684, with a median annual wage of $112,993 or $54.32 hourly. Nurses working in metroplex areas like San Francisco often command better pay, some as high as $170,000 per year.

Nursing shortages continue to have a significant role in the future of healthcare, particularly in states like California. Be sure to have several self-care strategies to help manage the stress of a shortage, but also think of positive change. Consider joining committees, professional organizations and even going back to school to maximize your impact. Think of creative ways to meet your needs while providing the best and safest care to patients.

Earning a BSN degree can help you gain the skills and critical thinking abilities to not only navigate a nursing shortage, but also to take advantage of the opportunities it may create.

Learn more about Nevada State College’s RN to BSN online program.


Department of Health Care Services: Medi-Cal

University of California San Francisco: Forecasts of the Registered Nurse Workforce in California

Nursing The RN Licensing Process

California Board of Registered Nursing: Processing Times

Complete Guide to Nursing in California

Nurses Unionizing: Benefits of Working in a Union Hospital

Compact Nursing State List 2021

State of California Department of Justice: Live Scan Locations

CA Board of Registered Nursing: Online RN Endorsement Application SB 1053

Nursys States with the Largest Nursing Shortages

The Press Enterprise: California Nurses are Best-Paid in U.S.

National Nurses United: Nurses Building Power

Employment Development Department: Registered Nurses in California

California Board of Registered Nurses

NCSBN Leading Regulatory Excellence: NCLEX & Other Exams