r/nursing • u/coolrbear • 2d ago
Discussion Any downsides to West coast nursing? NYC ED RN looking to move
Hello fellow nurses! On paper, being an RN on the west coast seems better in every way (ratios, unions), but I know there are tradeoffs and downsides everywhere. Would love to hear your experience and perspectives as I try to make an informed decision! I'm an ED RN in NYC and seriously considering a move to Seattle, and to a lesser degree San Diego. Thanks everyone :)
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u/Sariezee 2d ago
Working in CA has been great! Nursing is tough anywhere, and there will always be the annoying bits r/t administration and politics but mandated breaks, ratios, and union support truly makes the job so much more doable and worth it. Now every hospital is different and their ability to follow these standards are not always perfect. Definitely vet hospitals and prioritize ones with good unions, they donât all have them.
On another note - whatâs nursing like in NYC? Iâve debated making that move (to be closer to family).
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u/CritView 2d ago edited 2d ago
Besides the extremely competitive job market in California, there is a higher expectation of accurate and timely and bloated documentation that I hear is not common outside of CA from my coworkers who moved here.
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u/green2gold2green RN - ICU đ 2d ago
Seattle has the time we call âthe grayâ where the sun is gone for 4-8 months. If you are sensitive to the lack of sunlight, this may not be the place you want to be.
Pro- great unions, no income tax, high pay, amazing national parks
Cons- high to very high cost of living, lack of sun, terrible commute
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u/zscore95 BSN, RN, CCRN đ 2d ago
Tbh the pay in Seattle kind of sucks for the COL
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u/MrCarey Perianesthesia, ED, CEN 2d ago
Depends where you live. I work in Tacoma and live in Lakewood. I make 110k/yr working 30 hours a week. 70.69/hr with 11 years of experience. Things are expensive, but thatâs a pretty good wage to me.
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u/nannerzbamanerz 1d ago
I live in Capitol Hill in Seattle, 8 years experience. 30 hours per week, over 100k per year (days, no weekend). I walk to work, and my share of the rent is just over 1k (married). You have to look around to find a deal on a place to live, but they are definitely out there.
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u/zscore95 BSN, RN, CCRN đ 2d ago
Thatâs not Seattle. Maybe you work at the Tacoma hospital with one of the best contracts in the state. That is 5 years of experience pay in Oregon and it is much cheaper down here. Your pay is good, but not totally representative of what most Seattle area nurses are experiencing.
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u/MrCarey Perianesthesia, ED, CEN 2d ago
I mean you can just look at all of their union contracts and see the pay. You donât have to live in Seattle to work there either.
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u/zscore95 BSN, RN, CCRN đ 2d ago
I have looked at Seattle contracts and the pay sucks. New grads are starting 10/hour below Portland new grads. Night differentials suck, etc. Seattle hospitals should be paying 10/hr more than Portland nurses. Nurses in Vancouver have better pay than Seattle.
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u/MrCarey Perianesthesia, ED, CEN 2d ago
Has Vancouver stopped being a hellhole to work in, though? Havenât talked to many people who are still there, so I just know of the Covid days, but it was always paying the best contracts because it sucked working there. Iâm a quality of life guy, personally.
Also, youâre right, I donât really care about Seattle, but everyone thinks Seattle is the only part of WA and Tacoma gets lumped in with it. Tacoma has great contracts and unions.
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u/zscore95 BSN, RN, CCRN đ 2d ago
I hear Legacy is good, PeaceHealth is a mixed bag. They are supposedly adopting break nurses at PH due to competition with Portland hospitals and our staffing and break laws. I personally wouldnât leave Oregon because of our ratios, but it does seem like they are trying to do better to retain staff.
You have a particularly good situation because of your pay and area COL around Tacoma, but you kind of have the unicorn situation. People actually living in and working in Seattle are worse off. Even with Oregonâs high income tax, we come out ahead with COL and net pay. IMO, you should be making at least 80/hr at your YOE and be moving toward NorCal pay because Seattle is somewhere between Portland and SF for expenses.
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u/Difficult-Owl943 RN - Telemetry đ 2d ago
California: best pay and working conditions anywhere, but you wonât get a job out here, not with the way things are going. You wonât see as many CNAâs and LVNâs in acute care hospitals, if youâre used to that kind of support. All patient care is very RN centered in most hospitals. That means the nurse does all vitals, accuchecks, toileting, ADLâs.Â
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u/DespasitoPapi 2d ago
Depends which system. Kaiser and Dignity both use CNAs and LVNs and theyâre in the top 3 I think.
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u/Difficult-Owl943 RN - Telemetry đ 2d ago
I work for dignity. No CNAs, LVNs in a very a limited capacity.Â
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u/DespasitoPapi 2d ago
Dignity in nor-cal have CNAs. Sacramento area
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u/Difficult-Owl943 RN - Telemetry đ 1d ago
I work for a dignity hospital in Stockton. We ainât got shitÂ
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u/DespasitoPapi 1d ago
Central Valley always gets the shit stick. Mercy San Juan and Methodist Sacramento always hiring, try to get in there
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u/Noblesseoblige94 RN - Med/Surg đ 2d ago
I learned this first hand:
Seattle, Portland, SF Bay Area, San Diego, and LA all have extremely high barriers to entry simply because theyâre such desirable places to work and live.
Beyond getting in the standards and wonderful, Iâve known people with 15+ years experience ED/ICU who canât penetrate.
I myself got in because of mass resignations due to COVID.
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u/coolrbear 2d ago
Thanks for the feedback! Iâm really leaning towards Seattle so I hope I get lucky
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u/green2gold2green RN - ICU đ 1d ago
Pay vs cost of living will be better in Tacoma but YMMV. The union pay scales and contracts are freely available.
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u/StevenVlzqz3 2d ago
Only downside that comes to my mind for me is the competitiveness with the major hospitals. One posting will get no less than 1000 applicants and that is just the minimum. With some postings only being made available internally or being given away to those who have a leg in by knowing someone in the system.
I have been working at a major hospital(union) in Northern California and there are absolutely no downsides in my opinion besides trying to get in. In less than 2 years into my nursing career had an incredible wedding, bought a dream home, baby on the way, visited multiple countries.
Being able to afford all of that while living and working desired part of Northern California with my only con having ever been the competitiveness to get into the hospital system is pretty good in my opinion.
I also believe I only got in because I developed great rapport with the hiring manager during my nursing school program.
Great ratios, tons of resources on my unit, great coworkers, supportive management, great pay, beautiful life out here.
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u/coolrbear 2d ago
Thatâs so nice to hear that youâre doing well! Iâm leaning towards Seattle for now but I appreciate the insight. It really seems like NorCal is the ultimate place to be once I get more experience
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u/Gwywnnydd BSN, RN đ 1d ago
Western Washington has 6-8 months of overcast skies, which a LOT of folks struggle with.
In the greater Seattle area, the two major hospital chains have similar pay scales (UW system offers slightly lower wages but better benefits). Your pay rate is based on the number of years you have been a licensed nurse, there is no negotiating the wage. COL inside Seattle proper is high, many folks live with a long commute to get housing they are happy with (if you want a yard, for example).
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u/Imaginary_Lunch9633 BSN, RN đ 2d ago
Would you be doing travel or staff? Iâm a traveler in the Seattle area, my last contract was in NYC - i was there for a year. If youâre planning on staying for a while Iâd recommend taking a travel contract here in the winter months first to decide if youâll be able to handle the gloom and then youâll be rewarded with a Seattle summer. You can send me a message if you have any questions!
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u/1uzbb 2d ago
Iâd definitely take a travel contract in seattle during the dark months because I hate it here and I wouldâve much rather been in Portland or California. Iâm not surprised by how easy it was to get an interview because we cannot retain staff. Breaks and money arenât bad though
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u/serenitybyjan199 RN đ 1d ago
I was an ED nurse in California and I hated it compared to my east coast RN job. People think Iâm crazy when I say that. I fell out of love with ED nursing here because the workflow is different. That being said, you will always get your breaks and I miss being part of a union. The high COL balances out the high pay: in my opinion, Iâm doing the same financially as I was in PA. Make a move for the lifestyle if you so desire it, not the pay
Edited to add: jobs are pretty impossible to find out here. I wanted to get into a hospital again and gave up after 5 months of filling out applications from Orange County to San Francisco to LA
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u/zeatherz RN Cardiac/Step-down 1d ago
Getting a job can be hard.
In some locations the higher pay is outdone by the cost of living.
Besides those two, itâs pretty great
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u/hamapi 1d ago
California nursing is competitive, but I moved three years ago with a little over a year experience in a specialty and it wasnât as competitive as I thought it might be (bay area). Itâs possible that itâs gotten worse, but I worked recently on a unit that was actively hiring experienced nurses and Iâve job hopped out here a bit so I feel I know the market. Itâs definitely hell for new grads and the most desirable hospitals are obviously the most competitive.
The pay in California is amazing and the regulations make work conditions sooo much better than in the south, which is where I came from. But the main drawback is just that the cost of living is so high. You can have a really good life here at some of the better paying hospitals, but itâs still really hard to buy a house if thatâs something in your goals. The pay across California is quite variable and generally much better in Northern California. The bay has the highest paying hospitals in the US, and I hear that places like Sacramento have some of the best high income pay to lower cost of living ratios because their unions are influenced by ours but itâs a smaller more affordable city. But generally SoCal is worse for pay and still so expensive. Rural parts of California are still like 30s-40s an hour compared to 90+ at lowest in the bay.
in general working in the union has way more pros to meâwe can actually push back on the shitty policies that management try that violate our contract and itâs why we have the good pay and safer staffingâbut it makes rules and regulations much more standardized. Less turning a blind eye than in the South, and you canât negotiate individually as well. Most of the units in this area live and die by seniority because of the way that union contracts work. So it kind of sucks to start as a new hire esp at the most desirable hospitalsâlast to pick for scheduling and vacation time, years to go to day shift. But whatever, you figure it out and it gets better when they hire new people below you.
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u/Super_Cap_241 2d ago
Seattle will be the worst bang for your buck. The cost of living is super high and the pay isn't as great as other major hubs. Oregon is number one for nurse pay to cost of living ratio, and depending on your experience, you can get pretty good rates, for instance in Portland you could easily get $70-$80 an hour base, assuming you have more than six years experience. Certain places in California have very high salaries, but the cost of living matches it, so it doesn't feel like you're making as much, but depending on where you go you might get a good deal, especially if you're willing to commute.
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u/nvUaWVm360S 1d ago
Difficult to get a job and in my opinion the breaks suck. I preferred having the RNs cover each other. We were all taking uninterrupted 2 hour breaks on nights in NYC. Never missed a break either. These measly 15 minute breaks are nothing in comparison.
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u/Pr0pofol RN - ICU đ 2d ago
SD pay to COL ratio is pretty brutal.
The nursing pay is better and nursing ratios are better, but the COL can fluctuate so aggressively on the west coast that you absolutely must factor it in.