A new study by WalletHub has found that Oklahoma is the worst state in the country for nurses, ranking at No. 50 in both work environment and competition, with a total score of 37.3, nearly six points behind North Dakota. Despite ranking the lowest, Oklahoma is not in the bottom five for the lowest job openings per capita, the lowest annual nursing salary adjusted for cost of living or the fewest health care facilities per capita. The study's total score is based on opportunity and competition and work environment. The five best states for nurses in the United States are Maine, New Hampshire, Washington, Oregon and Arizona.