North Dakota Struggles With Nursing Job Opportunities And Pay

A new report from WalletHub shows North Dakota near the bottom nationally when it comes to conditions for nurses, even as the state continues to maintain a strong health care presence.

In the 2026 rankings, North Dakota placed 49th overall, ahead of only Oklahoma. The study compared all 50 states across 20 factors, including pay, job availability, and workplace conditions.

The state’s biggest drawback comes from its opportunity and competition ranking, where it placed last. That category reflects job availability, long-term demand, and how competitive the field is expected to be. At the same time, North Dakota performed better in work environment, coming in 18th, which points to more stable day-to-day conditions for nurses already in the field.

There are some bright spots. North Dakota ranks among the top states for health care facilities per capita, putting it in the same conversation as Montana and Minnesota in terms of access to care infrastructure.

Still, the regional comparison is hard to ignore. Minnesota ranks 7th overall, while Montana comes in at 8th. Wyoming sits closer to the middle at 21st. Even South Dakota, which ranks 46th, lands a few spots ahead of North Dakota.

Looking ahead, the outlook remains challenging. North Dakota ranks last in projected competition for nursing jobs by 2032, suggesting the state could face continued pressure when it comes to attracting and retaining workers.

Nationally, the top spots went to Maine, New Hampshire, and Washington, driven by strong pay, better working conditions, and more job opportunities.

“Nurses are among the most essential workers in the country, as we’ve seen all too well over the past few years,” said Chip Lupo. “Since they work in such a demanding profession, nurses deserve to work in places that will compensate them appropriately and offer them reasonable working conditions. The best states for nurses have high salaries, mandatory overtime limits, high-quality health care facilities and plenty of job opportunities.”

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For North Dakota, the report paints a mixed picture. The foundation is there, especially when it comes to facilities and access, but the broader job market challenges continue to drag down its overall standing.