Nursing careers are regulated at the federal level, which means that about 90% of the work you do will be consistent from state to state. That’s important. It’s why the people in Arizona and the people in California can expect the same basic quality of care.
This is also why it’s relatively easy to get licensed in one state after having worked in another.
However, there are some regional variations—both in law and in the scope of responsibility—that warrant consideration. So, how big of a role will the place you work play in your nursing career? Let’s get into it.
Rural Hospital
How Much Does Your State Influence Nursing Licensing Requirements?
To start with, you should note that the vast majority of states will allow you to get your license relatively easily. Pay a fee. Get your license. As long as you have your BSN and have passed the NCLEX, that’s all they will ask of you.
This thanks to the Nurse Licensure Compact. It’s an (almost) nationwide agreement designed to make nurses’ lives easier. Instead of getting recertified anytime you move, you can pay a fee and be ready to roll.
Not every state is “compact.” Those that don’t acknowledge the agreement vary in their requirements. Rarely will they need anything radical from you. The primary difference will be that you will need to submit to a manual review process. The steps will be roughly the same on your end. They will just take longer to complete.
In many cases, the hospital that has hired you will act as a resource to help you navigate the process.
Do Your Responsibilities Change Based on Location?
That’s an interesting question. The answer is far from definitive. There are variations, of course, but they don’t follow a neat, easily defined path.
For example, one might assume that nurses working in suburban or urban hospitals are radically busier than those in rural settings.
This assumption isn’t always correct. While urban areas may serve a larger population, rural hospitals are often the sole healthcare resource for multiple communities.
An urban hospital might serve several neighborhoods within a five-mile radius, while a rural hospital might cover several counties across fifty miles or more. In that way, the day-to-day reality of rural and urban nurses can be surprisingly similar.
You might also assume the type of care provided differs dramatically between the two. To a limited extent, this at least is true. Urban hospitals might treat more incidents of violence.
That said, rural hospitals still see their share of car accidents, farming or factory injuries, and yes, even violence. Rural communities have also been hit just as hard by public health crises like the opioid epidemic.
This, is all to say that rural nurses don’t have things easier than their urban counterparts. In many cases, they are stuck trying to do the same work with fewer resources.
Shortages
Staffing shortages are felt across the country. Unfortunately, though, they tend to hit rural hospitals the hardest. The reason is pretty straightforward: the pool of local candidates is much smaller. A rural area might produce one or two new nurses a year. A city might graduate dozens or even hundreds.
To fill the gap, rural hospitals often try to recruit from outside the area—but that’s easier said than done. What incentive does one have to become an RN in central Missouri, for example?
If you work in one of these settings, expect to feel that shortage in your day-to-day experience.
Ironically, these shortages are often self-perpetuating. The stress of working in an overtaxed hospital is often enough to make even passionate nurses look for new work.
Diversity of Opportunity
It’s not always easy to predict where the best nursing opportunities will be. Every community has the same essential healthcare needs. The real difference lies in which places can afford to staff accordingly.
Nursing is an incredibly diverse profession. A single community might employ dozens of different types of nurses.
Nurse practitioners. Forensic nurses. Gerontology nurses. If you’re aiming for career flexibility or know that you want to specialize eventually, it’s smart to start out in a location that offers room to grow.
Advanced Practice Positions
One of the biggest lifestyle differences in nursing comes into play for advanced practice nurses. In some states, nurse practitioners are granted nearly full autonomy—they can open their own practices, diagnose patients, prescribe medication, and create comprehensive treatment plans without physician oversight. In others, they perform similar work but must do so under the supervision of a doctor. Naturally, that creates two very different professional experiences. If you’re considering this route, it’s a good idea to look into your state’s laws ahead of time.
Conclusion
The state you live in isn’t really the deciding factor. Sure, that’s where you’ll see some initial variation—mostly in licensing fees or minor procedural differences.
But the much more influential factor is the type of community you’re working in. Rural and urban hospitals operate differently and tend to appeal to different kinds of people. The good news? Every state has both. The trick is figuring out which environment best matches your personality and your goals.
Photo Credit
Photo is Wikimedia Creative Commons
Guest Author Bio
Sarah Daren
With a Bachelor’s in Health Science along with an MBA, Sarah Daren has a wealth of knowledge within both the health and business sectors. Her expertise in scaling and identifying ways tech can improve the lives of others has led Sarah to be a consultant for a number of startup businesses, most prominently in the wellness industry, wearable technology and health education. She implements her health knowledge into every aspect of her life with a focus on making America a healthier and safer place for future generations to come.
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