Becoming a Registered Nurse is a solid career choice when it comes to job security, salary potential, and fulfillment. For nurses who plan to work in California, the rewards and opportunities are even more promising.
Part 1 Why Work In California?
California tops the nation when it comes to RN salaries. The U.S. Bureau of Labor Statistics reports registered nurses earning an average median salary of $101,750 in the Golden State. California also employs the most RNs in the nation, with over 250,000 nurses working in the state.
In fact, over 70,000 RNs work in just the Los Angeles-Long Beach-Glendale metropolitan area.
The other thing that sets nursing jobs in California apart is its unique nurse-to-patient ratio law. It mandates that there has to be a minimum ratio of one nurse for every five patients (1:5), and within Intensive Care Units, the ratio is one to two (1:2). This helps ensure that nurses are not overwhelmed and overworked, and ultimately improves patient care outcomes.
Thinking of becoming a Registered Nurse in California? Read on to find out more about what it's all about.
Part 2 Demand And Outlook
California is facing a nursing shortage more severe than any other state, making it more vital than ever that a new generation of RNs step in to fill this need.
According to one study, California has only produced 50 percent of the nurses it needs over the last couple of decades. This is just one of the reasons demand for nurses is so high in California. Employers are doing all they can to attract and retain nursing talent in the state.
One of the drivers behind this incredible demand is the state's robust Medicaid program called Medi-Cal. With over 13 million enrollees, it's a public health insurance program for low-income individuals including families, children, seniors, persons with disabilities, foster care, and those with specific diseases such as tuberculosis, breast cancer, or HIV/AIDS.
A recent study by the Health Resources and Services Administration (HRSA) projected one of the largest nursing shortages in the country for California. In addition, our data shows that the highest demand specialty is in the ICU.
HRSA nursing workforce projections predict a significant shortage for California.
By 2030, California will have 253,400 nurses in the state.
However, the need for CA nurses will be 269,300, leaving the state with an overall shortage of 15,900 nurses.
Highest Demand Specialties
- Intensive Care Unit
- Operating Room
- Labor & Delivery
- Progressive Care
Beyond job numbers, California is also a desirable place to live with a strong economy. Whether you want to settle in beautiful wine country or the sunny Southern California coastline, there are many highly sought after areas to call home.
Part 3 Salary & Benefits
California consistently ranks as the highest paying state in the nation for nurses. In addition to a robust state Medicaid program, the golden state also has a mandatory staffing ratio which forces many hospitals to utilize the services of travel nurses in order to fill their nursing rosters.
Most staff nurses who work full-time earn an hourly wage with a benefits package. These rates vary by hospital, experience level, and specialty. Many hospitals in California are unionized so these rates may not be negotiable.
Administrative nurses such as Directors and Assistant Directors generally receive salaries and may work more typical office hours.
Beyond the strong salaries of RNs in California, there is usually the opportunity to also earn overtime pay. In fact, in a nationwide survey, 47 percent of RNs reported working overtime. Of those, 54 percent said they added on an extra one to five hours per week; 32 percent worked six to 10 hours overtime weekly, and 15 percent put in 11 hours or more.
In 2014, about 1 out of 6 registered nurses worked part-time. According to the BLS, 61% of RNs worked in hospitals, with smaller percentages working at physicians’ offices, home healthcare services, and nursing care facilities, and for government agencies.
Nurses on staff in hospitals and even nursing homes usually work in shifts, since 24 hours of care needs to be covered. Therefore, RNs usually have to work some nights, weekends, and holidays. Typical shifts are 12 hours long and nurses work 3 - 4 days a week.
For those seeking 9-to-5 type hours, RNs who work for medical offices, schools, and daytime clinics offer more traditional work hours.
Although the median salary for RNs in California is already high, nurses who provide specialized care, work in advanced units, or who take on supervisory positions have the potential to earn even more.
The need for RNs is particularly strong in for the following cities and reflect the highest salaries for registered nurses in the entire country:
|Metro Area||Average Hourly Wage|
San Francisco-Redwood City
Santa Cruz - Watsonville
As far as benefits, full-time RNs almost always get at least paid time off and health insurance – 96 percent of respondents in the survey above said they received both. Additional benefits that might be available to RNs include educational reimbursement (67 percent); professional society membership dues (14 percent); and paid parental leave (20 percent).
Even after adjusting for the cost of living, which is relatively high, California still appears to be the state where a nurse’s salary will go the farthest. See a full ranking of all 50 states salaries adjusted for the cost-of-living.
Part 4 California Nursing Licenses
The California Board of Registered Nursing (CBRN) regulates and issues all registered nursing licenses in the state. California is not part of the Nurse Licensure Compact, so every nurse must apply for a separate California license to practice there.
HOW LONG DOES IT TAKE TO GET A CALIFORNIA NURSING LICENSE?
Licensure in California can be a long, time-consuming process. Processing times vary based on how long it takes for the board to receive and review documents from schools, agencies, and other states or countries. The estimated processing time can be anywhere from 10 - 16 weeks for an initial license and 2 - 8 weeks for license renewal. However, we’ve seen this process take up to 6 months!
For the latest estimates, see their processing times page at the following address:
Read on to learn about the application and best practices.
WHY DOES CALIFORNIA LICENSURE TAKE SO LONG?
It may seem obvious but, for starters, the California Board Of Nursing receives overwhelming amounts of applications. Secondly, snail mail and college transcripts can slow the process - especially if they are requested from multiple schools. However, we’ve found that the most prevalent factor to slow down licensure is fingerprinting. They offer two methods for fingerprinting:
- Manual fingerprints
As a rule of thumb - manual fingerprints will slow down the process. The probability of error is high - manual fingerprints can be easily smudged and consequently deemed unreadable. However, nurses may not know this until their fingerprints have already been received by the CBRN - with snail mail this process can take weeks. We suggest taking great care to ensure that your fingerprints are clear and readable. Additionally, the CBRN charges an additional $50 for manual fingerprinting and this doesn’t include the fee that the fingerprinting service agency may charge.
If you want your license fast - we suggest LiveScan. But, you’ll have to be in California to complete this method. LiveScan is an electronic fingerprinting reader and results are received within seconds - it typically costs around $75. Since the LiveScan is completed in California (and, there is actually a LiveScan office located a few blocks from the California Board Of Nursing) you’ll be able to quickly complete the fingerprints and turn in your entire application all at once. Licensure processing times for those who complete LiveScan are usually around 4-6 weeks - during normal processing times.
A tip to get ahead of the game is to download the LiveScan required forms and throw them in your suitcase now! The overall peace of mind may be worth the trip to California if you’re from out-of-state. Better yet, if you’re a travel nurse, some travel nursing agencies will pay for your flight to California and also cover your licensing fees.
If you need updates on your college transcripts, fingerprints or the status of your application do not hesitate to call the CBRN because “the squeaky wheel gets the grease.” Also, if you are flying into Sacramento to complete your licensure application, it is a good idea to call the CBRN ahead of time to make sure you have everything you need. They can be reached at 1-800-838-6828.
There are two methods of obtaining licensure - Licensure by Examination and Licensure by Endorsement. California also offers the option to obtain a temporary license - good for 6 months.
Here’s a breakdown of each of those processes:
LICENSURE BY EXAMINATION
This method is often used by nurses who are obtaining their first RN license. To obtain licensure by examination a nurse must complete the application packet found here:
In addition to the completed forms in the packet, the applicant must also include the following:
- Appropriate fees, including fingerprint and interim permit fees, if applicable (see the current Fee Schedule)
- Completed “Application for Licensure by Examination”, including U.S. Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN)
- Completed fingerprints using either Live Scan or fingerprint card (Hard Card) processing method
- One recent 2” x 2” passport-type photograph attached to the reverse side of the “Application for Licensure by Examination”
- Completed “Request for Accommodation of Disabilities” and accompanying form(s), if applicable
- “Request for Transcript” form(s) completed and forwarded directly from your nursing school(s) with certified transcripts
- If applicable, documents and/or letters explaining prior convictions or disciplinary action and attesting to your rehabilitation as directed in the “Reporting Prior Convictions or Discipline Against Licenses” section of the application packet
After the application is approved, you will be able to take the NCLEX and obtain your RN license.
LICENSURE BY ENDORSEMENT
If you already have a valid RN license in another state, you will need to apply for Licensure by Endorsement. To qualify for endorsement (reciprocity) into California as an RN, you must hold a current and active RN license in another state, U.S. territory, or Canada, have completed an educational program meeting all California requirements, and have passed the NCLEX-RN.
To obtain licensure using this method download the Licensure by Endorsement packet found here:
If you want to speed up the process, we suggest completing LiveScan fingerprints and applying for both the permanent license and the temporary license to avoid any delays related to the college transcripts.
In addition to the completed forms in the packet, you’ll need to provide the following:
- Appropriate Fees (see the current Fee Schedule)
- Completed “Application for Licensure by Examination”, including U.S. Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN)
- Completed fingerprints using either LiveScan or fingerprint card (Hard Card) processing method as directed in the INSTRUCTIONS FOR SUBMITTING FINGERPRINT CARD. Submit the non-refundable TOTAL FEE as directed on the Applicable Fee Schedule.
- One recent 2” x 2” passport-type photograph
- Completed Verification of License form OR if your board of nursing participates in Nursys®, visit www.nursys.com to complete a paperless verification online. International graduates must submit license verification from the board of nursing where the examination was taken.
- Request for Transcript form - completed and forwarded directly from the nursing school(s) with certified transcripts. To speed up the process, especially if you are flying to California, ask the college to overnight the transcripts to the California Board of Registered Nursing.
- If applicable, documents and/or letters explaining prior convictions or disciplinary action and attesting to your rehabilitation as directed in Section II of the General Information and Instructions.
Note that your nursing education must meet all the requirements of California’s State Board of Nursing. See Part Five for nursing education requirements.
California offers a temporary license for an additional fee of $50 - it is good for 6 months. To obtain a temporary license you’ll still need to complete the entire application packet as the license by endorsement - except for the college transcripts. College transcripts will still need to be verified in order to receive a permanent license. The benefit of obtaining a temporary license is that you can start working while your permanent license is still being processed. Your college transcripts will be processed within those 6 months and the permanent license will be issued.
However, if you elect to complete manual fingerprints and not LiveScan, it may not be worth it to apply for a temporary license. The time it takes to process the manual fingerprints, especially if there are errors, could take longer than the temporary license is even good for!
LICENSURE FOR MILITARY MEDICAL CORPS
Unfortunately, California does not accept military medical corps training as equivalent to accredited schooling. Anyone seeking a nursing license in the state must complete an accredited program approved by the board of nursing. Military corps members may be able to receive credit towards these approved programs, however.
See Part 8 for further information on nursing programs in California.
HOW DO I RENEW MY CALIFORNIA NURSING LICENSE?
Your first California RN license is issued for two birthdays, so it will expire the last day of the month following your birth date. From that date on, it will expire every two years. Maintaining an active license requires the completion of 30 contact hours of continuing education.
For more information on CEU requirements, see Part 8.
As of September 2017, the general renewal fee for active licenses is $190. For expired licenses, the fee to renew is $280.
Part 5 State Board Contact Information
For the most accurate information on licensure in California, we recommend contacting the board directly through the following methods:
Board of Registered Nursing
1747 N. Market Blvd., Suite 150
Sacramento, CA 95834-1924
Board of Registered Nursing
PO Box 944210
Sacramento, CA 94244-2100
License applications should be sent to this mailing address.
PHONE AND EMAIL
Part 6 Best Hospitals For Nurses
Nurse.org analyzed over 1,800 surveys of nurses from 314 hospitals to rank the best hospitals in the state. Here are the results:
1. Eisenhower Medical Center
Rancho Mirage, CA
4.8 Average Rating
“Great education department with ongoing training. Teamwork is rewarded and expected.”
“Great teamwork, amazing technology, fair scheduling, magnet facility, and nice benefits package.”
2. Ronald Reagan UCLA Medical Center (tie)
Los Angeles, CA
4.7 Average Rating
“Employees are extremely nice. Collaborative work of management, surgeons, and employees. Very customer service oriented. Managers are caring and willing to work with employees.”
“Very professional, knowledgeable staff, strong union for protection, and lots of variety.”
“The UCLA nursing staff is very diverse. You will have the opportunity to learn how to work with people from all over the world.”
2. UC Davis Medical Center (tie)
4.7 Average Rating
“Excellent atmosphere. Staff is very helpful and teamwork is what they do.”
“Academically based and very into continuous learning.”
4. Providence Holy Cross Medical Center
Mission Hills, CA
Average Rating 4.6
“Great people to work with, and [they] have a wonderful work ethic. Safe working environment. Scheduling was also very reasonable to work.”
“Knowledgeable [and] hard working staff. Great support. Feels like another family.”
5. Sharp Memorial Hospital (tie)
San Diego, CA
4.5 Average Rating
“Friendly staff who enjoy their workplace. They recognize their employees for their achievements.”
“The patient population is very diverse and enjoyable to work with. My co-workers are awesome.”
5. Children’s Hospital Los Angeles (tie)
Los Angeles, CA
4.5 Average Rating
“Great experience working here. You will see all sorts of medical diagnoses. It’s a very busy teaching hospital, but an awesome experience.”
“Managers are amazing and the staff is also wonderful!”
5. El Camino Hospital (tie)
Mountain View, CA
4.5 Average Rating
“Mangement cares about patient safety.”
“Teamwork is good amongst the nurses.”
5. UCSF Medical Center (tie)
San Francisco, CA
4.6 Average Rating
“Awesome working environment and great learning environment.”
“Busy but challenging. Fun and dynamic co-workers. Competitive pay.”
Part 7Magnet Hospitals In California
The American Nurses Credentialing Center (ANCC), in its aim to promote nursing excellence, evaluates healthcare organizations through its credentialing programs. The Magnet designation is the highest credential awarded to healthcare institutions based on their work environment, nursing excellence, innovations in nursing practice, and quality patient outcomes. For RNs seeking work with best-in-class medical institutions, choosing one with Magnet status is a smart move.
|Organization Name||City||State||Year Recognized|
|Cedars-Sinai Medical Center||Los Angeles||CA||2000|
|Children’s Hospital Los Angeles||Los Angeles||CA||2008|
|CHOC Children’s Hospital||Orange||CA||2008|
|Eisenhower Medical Center||Rancho Mirage||CA||2015|
|El Camino Hospital||Mountain View||CA||2005|
|Hoag Memorial Hospital Presbyterian||Newport Beach||CA||2005|
|John Muir Medical Center, Concord||Concord||CA||2010|
|John Muir Medical Center, Walnut Creek||Walnut Creek||CA||2008|
|Kaiser Permanente Irvine Medical Center||Irvine||CA||2017|
|Long Beach Memorial Medical Center/Miller Children’s & Women’s Hospital||Long Beach||CA||2013|
|Mission Hospital||Mission Viejo||CA||2012|
|NorthBay Healthcare Group||Fairfield||CA||2014|
|Orange Coast Memorial||Fountain Valley||CA||2016|
|Providence Holy Cross Medical Center||Mission Hills||CA||2007|
|Providence Little Company of Mary Medical Center Torrance||Torrance||CA||2016|
|Rady Children’s Hospital - San Diego||San Diego||CA||2017|
|Ronald Reagan UCLA Medical Center||Los Angeles||CA||2005|
|Santa Monica UCLA Medical Center and Orthopaedic Hospital||Santa Monica||CA||2016|
|Scripps Memorial Hospital La Jolla||La Jolla||CA||2015|
|Sharp Grossmont Hospital||La Mesa||CA||2006|
|Sharp Mary Birch Hospital for Women and Newborns||San Diego||CA||2015|
|Sharp Memorial Hospital||San Diego||CA||2008|
|St. Joseph Hospital||Orange||CA||2007|
|St. Jude Medical Center||Fullerton||CA||2015|
|Stanford Health Care||Palo Alto||CA||2007|
|Torrance Memorial Medical Center||Torrance||CA||2011|
|UC Davis Medical Center||Sacramento||CA||2014|
|UC Irvine Health||Orange||CA||2003|
|UC San Diego Health||San Diego||CA||2011|
|University of California, San Francisco Medical Center||San Francisco||CA||2012|
|Valley Children’s Hospital||Madera||CA||2004|
Part 8 Continuing Education Requirements
Like most other states, California requires continuing education for nurses to maintain an active license. Requirements are quite simple across the board for LPNs, RNs and NPs: 30 contact hours every two years.
The most important thing to remember when choosing a continuing education course is to make sure you’ll be able to credit for it. The state board defines acceptable course content as the following:
The content of all courses of continuing education must be relevant to the practice of nursing. Learning experiences are expected to enhance the knowledge of the registered nurse at a level above that required for licensure. Courses must be related to the scientific knowledge and/or technical skills required for the practice of nursing, or be related to direct and/or indirect patient/client care.
For further information on continuing education units including finding, paying, and getting credit for your courses, see the Nurse.org Continuing Education Guide.
Part 9 Nursing Schools In California
There are several education paths to becoming a nurse in California. We’ve summarized them, included a list of great nursing schools in the area, and laid out some unique options to pay off your student loans.
Education Paths For Becoming An RN in California
1. Associate Degree program in Nursing (ADN)
The shortest route to becoming an RN is an ADN program, which typically takes 2-3 years to complete. While earning this degree will allow you to take the NCLEX, not having a higher-level degree could take you out of the running for more competitive positions since many institutions prefer to hire RNs with more education. However, many RNs start off with their associate degree so they can begin working and gaining experience in the field, while they go back and pursue further education.
2. Bachelor of Science in Nursing (BSN)
This is perhaps the most common degree pathway that today’s RNs take. A bachelor’s degree is typically a four-year program. Many top hospitals list a BS as a minimum job requirement. If you intend to seek administrative or supervisory positions down the line, or specialize in a specific area of nursing, it’s likely that you will need at least a bachelor’s, and more likely, an advanced degree.
There are also RN to BSN programs, which are specifically designed for working nurses who have an associate degree, and then head back to school to earn their bachelor’s.
3. Entry Level Masters Program in Nursing (ELM)
For adults who have a bachelor’s degree in a field other than nursing, but who want to change careers to become RNs, these master’s level programs take one or two years to complete.
4. LVN 30 Unit Option
For those who are already California Licensed Vocational Nurses that aspire to become registered nurses, these programs pave the way. In about 18-24 months, students can become RNs. However, it is worth noting that a degree is not awarded, and some states might not recognize the license should you ever wish to transfer your license and practice elsewhere.
5. Military Medical Corps
While there is not a formal transfer program for military medics, many schools will work with veterans to give credit for equivalent courses. Make sure to contact your school’s academic advisor to see if this is possible.
Best Nursing Programs
There are more than 140 California nursing schools that award degrees that are recognized by the California Board of Registered Nursing. According to CollegeAtlas.org, the top ranking California nursing schools are:
- Sonoma State University
- California State University, Sacramento
- California State University, Los Angeles
- California State University, San Marcos
- California State University. Bakersfield
Top Master’s Degree in Nursing programs in California (according to US News and World Report rankings) are:
- University of California—Los Angeles
- University of San Diego
- University of California—Davis
- University of California—Irvine
- University of San Francisco
Although rankings are a good way to get a headstart into your research, it’s up to you to find the program of study that fits your needs, lifestyle, and budget. As long as your program of choice is State Board-approved and you work hard, you will be well prepared for your licensing exam.
State Loan Repayment Program
If you had to borrow funds for your nursing education, it could pay to look into the State Loan Repayment Program (SLRP). The program is available to both RNs and NPs (nurse practitioners), but there are specific eligibility requirements.
To be eligible for the Bachelor of Science in Nursing Loan Repayment, the applicant must have a license that is current and in good standing in California, a BSN degree, and be practicing as an RN in a Medically Underserved Area (MUA), Health Professional Shortage Area - Primary Care (HPSA-PC), County, State, prison, or Veteran’s facility. In addition, the applicant must also have outstanding educational debt from a commercial or U.S. government lending institution, and be willing to work in a medically underserved area for one year.
You can find the application here CalREACH. If approved, you may receive up to $10,000.
For NPs, applicants may receive up to $50,000, depending on if they offer full- or part-time service.
Part 10 Labor Unions
In California, right to work laws, which aim to protect the rights of non-union workers, do not exist. Chances are, if you plan to work as an RN in California, you might be obligated to become part of a major union. These include:
SEIU Nurse Alliance of California – With 35,000 members, it serves as a leading voice for RNs in California and is part of the Service Employees International Union (SEIU), the largest and fastest-growing healthcare union in California and in the nation.
California Nurses Association/National Nurses Organizing Committee/AFL-CIO (CNA) – CNA is one of the nation’s fastest-growing labor and professional organizations in the U.S. with more than 86,000 members in hospitals, clinics, and home health agencies in all 50 states. CNA/NNOC is also a founding member of the 150,000-member National Nurses United, which in 2009 united CNA/NNOC, the United American Nurses, and the Massachusetts Nurses Association to create the largest union and professional association of nurses in U.S. history.
United Nurses Association of California (UNAC) - The United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP) represents over 28,000 registered nurses and other healthcare professionals.
Part 11 California Nursing News
The demand for quality RN care in California (and in the rest of the nation) will depend in part on the outcome of the healthcare debate that continues to rage on in Congress. In California, nurses have been advocating for single-payer healthcare for some time since it will give more people access to preventative care that can promote lifelong health.
In addition, advances in the medical field and an aging population will continue to contribute to the fact that RNs will become a more integral part of the healthcare system.
Read more about the fate of Single-Payer Healthcare.