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New Hampshire ranks as one of the best states in the country to be a nurse, even as providers like hospitals and assisted living facilities struggle to staff up.

A new WalletHub analysis ranks New Hampshire as the fifth best state to be a nurse based on the strong opportunities for advanced training, high pay, and good working environments. Jan Carney, associate dean for Public Health and Health Policy at the University of Vermont, said this is an excellent time to enter nursing.

“The long-term outlook for the nursing field is outstanding,” Carney said.

Though Maine came in as the second-best overall state, the Granite State easily outperformed the rest of New England. Connecticut ranked 13, Rhode Island 25, Massachusetts 29, and Vermont is near the bottom at 42.

Among the data points used for the rankings, New Hampshire placed first when it comes to the number of nursing job openings per capita. The Granite State isn’t alone in New England when it comes to needing more nurses. Massachusetts, Maine, and Vermont all land in the top five states with the most openings per capita.

According to Susan Reeves, the executive vice president of Dartmouth-Hitchcock Medical Center, the state’s nursing shortage is driven by an aging population, high housing costs, and a lack of affordable child care. 

Reeves recently told WMUR that Dartmouth-Hitchcock, the state’s largest healthcare system, uses temporary staff and employment agencies to fill as many as 400 nursing positions because it cannot find permanent staff. New Hampshire faced a nursing shortage before the COVID-19 pandemic, and factors like the state’s lack of workforce housing have only worsened the situation.

“We’re dealing with issues such as child care and housing, which is a huge constraint to bring talent to our areas to serve in our hospitals,” she said.

Dartmouth-Hitchcock Medical Center in Lebanon is in the middle of one of the more expensive housing markets in the state. The healthcare leader is taking the housing issues head-on, developing its workforce housing developments in the hospital’s surrounding area.

Brendan Williams, president of the New Hampshire Healthcare Association, also saw a connection between housing and healthcare jobs. He supports Gov. Chris Sununu’s workforce housing initiative. 

“The governor is on the right track working to increase housing stock, though that will not produce immediate relief, obviously,” Williams said. But it is not enough by itself, he added.

“In the near term, the Medicaid increase the House authorized is essential to making caregiving more attractive. Wages have soared to record highs and are outside Medicaid means. The Senate, we hope, will do as much as the House, if not more.”

And more should be done to bring new nurses into the field and keep them working, says Rebecca Sutter, George Mason University nursing professor. Between the nurses in the Baby Boom generation retiring and the high burnout rate for new nurses, the need for nurses will continue to be a concern for years to come. Public policy leaders and healthcare facilities need to focus on a sustainable strategy to train and retain nurses.

“Healthcare organizations and policymakers need to address the nursing shortage through strategies such as increasing funding for nursing education programs, providing incentives for nurses to remain in the workforce, and improving working conditions for nurses,” Sutter said.