California – The Next Gold Rush for RNs

California – The Next Gold Rush for RNs


This article is sponsored by: Valley Healthcare Staffing

CaliforniaCalifornia has become widely recognized as the highest paying state for travel nursing.  To obtain a California Registered Nurse license by endorsement can take as long as six months and a great deal of aggravation.  But to the victor go the spoils with fast-response-rate travel assignments for most specialties offering weekly net paychecks between $2,000 and $2,800 in Northern California and $1,900 and $2,400 for Southern California.  If the need goes to a crisis rate, some specialties, such as Labor and Delivery, produce weekly net paychecks approaching $3,500.

Valley Healthcare Staffing

You may be able to find help through a travel nurse agency.  One such agency, Valley Healthcare Staffing (, is located one block from the CA BRN and advertises that they will fly you out to California, walk you through the process, and pay for your licensing fees if you accept one of their 1,000 winter needs assignments before flying.  This could potentially save you thousands of dollars, and even better, have you earning that sizeable paycheck that only California offers.  Learn more about their program on their website at


Why Does California Pay Higher than Other States?
The influences on California’s amplified pay rates are several.  The most basic of these is the disproportion of licensed RN’s to the census days of general acute care hospitals. California’s Office of Statewide Health Planning and Development (OSHPD) tracks such data.  If the statistics for any of California’s 58 counties warrant, the county could receive the Registered Nurse Shortage Area (RNSA) designation.  Today, 26 counties have this designation.

Projections of RN demand in California have been relatively high since California implemented regulations requiring minimum nurse-to-patient ratios in 2004. These regulations increased the demand for RNs, and this greater demand resulted in faster RN wage growth in California than in other states. The minimum staffing regulations make it likely that there will be relatively rapid growth in RN demand as California’s population ages and more often requires hospital and other health care services. Thus, the projections based on patterns of hospital utilization are likely the most accurate.

Type of Care RN to Patients
Intensive/Critical Care 1:2
Neo-natal Intensive Care 1:2
Operating Room 1:1
Post-anesthesia Recovery 1:2
Labor and Delivery 1:2
Antepartum 1:4
Postpartum couplets 1:4
Postpartum women only 1:6
Pediatrics 1:4
Emergency Room 1:4
ICU Patients in the ER 1:2
Trauma Patients in the ER 1:1
Step Down 1:3
Telemetry 1:4
Medical/Surgical 1:5
Other Specialty Care 1:4
Psychiatric 1:6


These ratios further exacerbate the shortage crisis California continues to experience.

Also driving up the rates is the cost of living.  According to online cost-of-living tracking site,, four of California’s cities are listed in the nation’s top fifteen most expensive cities, with San Francisco occupying the number one position for the continental US. Travelers should take advantage of shared housing or private rooms on sites such as AirBNB if they are to deposit their earnings rather than spend them on housing.

The Licensing Process
There are two types of Registered Nurse licenses issued by California’s Board of Registered Nurses; temporary and permanent.

Item Requested Timeframe
Licensure by Endorsement / Permanent 10-12 Weeks
Licensure by Endorsement / Temporary 8-12 Weeks
Advanced Practice Certification
(Nurse Practitioner/Furnishing, Nurse Midwife/Furnishing, Nurse Anesthetist, Clinical Nurse Specialist, Psychiatric/Mental Health Nurse)
12-14 Weeks
Public Health Nurse Certification 10-12 Weeks


(In this author’s experience, by mail a permanent license by endorsement takes closer to 6 months to process and issue.)

There are two distinct differences in these licenses; temporary licenses do not require school transcripts and they expire after 6 months from the date of issue.  The temporary licenses also adds $50 to the application fee.

Tip: In order to receive your license the soonest, you should only apply for your temporary license and do not send your school transcripts.  Once you receive your temporary license, you can then apply for your permanent license.


One important factor to consider is fingerprints.  There are two ways to submit your fingerprints for criminal background clearance; by mail with a fingerprint card, or by LiveScan.  The best choice is LiveScan as it reduces processing time by 3-5 weeks according to the CA BRN.  LiveScans, however, can only be submitted in California as the CA BRN does not accept LiveScans from other states.  The reason?  The prints are automatically routed to California’s Department of Justice and the FBI.  Other states are not likely setup to send prints to other states’ agencies.  You should expect to pay $55 to $85 for your fingerprints to be taken by LiveScan.

Tip: It is a common misconception that your LiveScan fingerprints need to be submitted in Sacramento.  They can be submitted from any LiveScan vendor in California.  So, if you are flying to California just to submit your LiveScan fingerprints, select the city that has the lowest cost airfare.  Check to find LiveScan providers and locations.


California projections of RN demand and supply
The nursing shortage experienced in California from the late 1990s through 2008 was reportedly the most severe in the nation.  California’s ratio of employed RNs per capita is consistently among the lowest in the United States. California has developed excellent data with which the RN labor market in the state can be tracked. Since national data on the RN workforce are of comparatively low quality, some policy analysts prefer to focus on California data, and extrapolate findings to the nation.

Demand for RNs in California
As the California economy has recovered, there has been a rapid shift from an overall perception of RN surplus to a widespread perception of RN shortage. Approximately 18 percent of hospitals reported a perception of high demand for RNs (difficult to fill open positions), which is double the share reported in 2013. More than 68 percent of hospitals reported demand for RNs being greater than the available supply.

How Long Will This Demand Last?
The present divergence of the supply of RNs and the demand for patient care is expected to last until 2025.  Contingent clinical labor must fill that gap until then.  If you have ever considered California for your next travel assignment, you would find a variety of climates and opportunity in the nation’s most populated state.  Generally, you will find the highest paying assignments during the fall and winter, from October to April.


Valley Healthcare StaffingAbout Valley Healthcare Staffing: At Valley, our goal is to be the last company you will ever travel with, and better, the last company you will ever want to work for. We match your perfect balance of lifestyle and income to ensure your travel nurse assignment is not just a job, but a gateway to adventure. We take care of our travel nurses by providing them with premier assignments at prestigious medical facilities. 

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