Registered Nurse in Hilo CDP, HI

The Salary Picture: Where Hilo CDP Stands

As a local, let's be blunt about the math: Hilo is an expensive place to live, but the local nursing salaries are built to match. The median salary for a Registered Nurse (RN) in Hilo CDP is $110,083/year, translating to an hourly rate of $52.92/hour. This puts Hilo RNs significantly above the national average of $86,070/year, a premium that reflects both the high cost of living and the unique demands of island healthcare.

The job market here is stable but tight. There are approximately 434 nursing jobs in the Hilo metro area at any given time, and the 10-year job growth for the profession is projected at 6%. This isn't explosive growth, but it indicates a steady demand that outpaces many other regions, driven by a growing retiree population and the need to replace retiring staff.

To understand where you might fit in, here’s a breakdown by experience level. Note that these are general estimates based on local data and industry standards; specific rates can vary by employer and specialty.

Experience Level	Typical Role in Hilo	Estimated Annual Salary Range
Entry-Level (0-2 years)	Staff Nurse, Med/Surg, L&D	$90,000 – $105,000
Mid-Career (3-7 years)	Charge Nurse, Specialty Unit (ICU, ER)	$105,000 – $125,000
Senior (8-15 years)	Nurse Manager, Clinical Educator	$125,000 – $145,000
Expert (15+ years)	Director of Nursing, APRN (Nurse Practitioner/CRNA)	$145,000 – $170,000+

How does Hilo stack up against other Hawaiian cities? While Honolulu offers a higher salary ceiling due to its larger metropolitan scale and more hospital systems, the cost of living is also more extreme. On the other side, Maui (Kahului/Wailuku) and Kona have comparable nursing salaries, but job availability can be more volatile due to their heavy reliance on tourism and seasonal fluctuations. Hilo’s advantage is its stability; it’s the medical hub for the entire Big Island, with Hilo Medical Center serving as the primary safety-net hospital. For nurses who want a blend of competitive pay and a slightly less frenetic pace than Oahu, Hilo is a strong contender.

Insider Tip: The $110,083 median is a solid baseline, but your actual offer will hinge heavily on shift differentials (nights and weekends can add $8-$12/hour) and specialty certifications (like ACLS, PALS, or OCN for oncology). Always negotiate these differentials—they’re non-negotiable for many local hospitals.

The Real Take-Home: After Taxes and Rent

Let’s run the numbers for a single RN earning the median salary of $110,083. This is a realistic scenario for a mid-career professional.

Monthly Take-Home Pay (Estimate):
After federal taxes, FICA (7.65%), Hawaii state income tax (which is progressive and can be high), and health insurance premiums, a typical take-home pay for an RN in Hilo is around $5,800 - $6,200 per month.

Monthly Budget Breakdown:

• Gross Monthly Income: ~$9,173
• Estimated Taxes & Deductions: ~$3,000
• Net Take-Home: $6,173

Now, let’s allocate that take-home pay. The average rent for a 1-bedroom apartment in Hilo CDP is $3,570/month. This is a significant portion of your income.

Expense Category	Estimated Monthly Cost (Hilo)	Notes
Rent (1BR Apartment)	$3,570	This is for an average unit. Older buildings or areas farther from town (e.g., Panaʻewa) can be cheaper, while new complexes near the hospital command more.
Utilities	$250 - $400	Electricity is the biggest variable; AC usage drives this up.
Food & Groceries	$500 - $700	Groceries are expensive; shopping at KTA or Foodland can help.
Car & Transportation	$400 - $600	Includes gas (high), insurance, and maintenance. Public transit (Hele-On) is improving but limited.
Healthcare & Misc.	$300 - $500	Copays, personal items, etc.
Savings/Debt	$500 - $1,000	Highly variable based on student loans, etc.
TOTAL	$5,520 - $6,770	This budget is tight; discipline is required.

Can they afford to buy a home? The short answer is: it’s challenging but possible with careful planning. The median home price in Hilo CDP is well over $500,000. With a $110,083 salary, a standard 20% down payment ($100,000+) is a major hurdle. A single RN would likely need to budget for 5-7 years of aggressive saving or consider a FHA/VA loan with a lower down payment, which increases monthly obligations. Partnering with another professional is the most common path to homeownership in Hilo. Renting long-term is a very common and practical choice for many healthcare workers.

Insider Tip: Many local nurses live in areas like Hawaiian Paradise Park or Pāhoa and commute. While the commute can be 30-45 minutes, the lower rent (sometimes $2,800-$3,200/month for a larger space) can free up over $500 monthly, making homeownership savings more feasible.

Where the Jobs Are: Hilo CDP's Major Employers

Hilo is a medical hub for the Big Island. The job market isn't as fragmented as in larger cities; a few major players dominate, offering stability and clear career paths. Hiring is continuous, with the biggest waves occurring in spring and late summer as new graduates enter the market and nurses decide to relocate.

1. Hilo Medical Center (HMC): The flagship hospital of the Hawaii Pacific Health system and the state's second-largest hospital. It’s the primary trauma center for the eastern half of the island. HMC employs a vast number of RNs across all specialties—ER, ICU, Med/Surg, L&D, and rehab. It has a strong union (Hawaii Nurses' Association) and offers excellent benefits. Hiring trends are robust, especially for experienced nurses in critical care.

2. Life Care Center of Hilo / Avalon Care Center: These are major skilled nursing facilities (SNFs). They offer a different pace and are a great option for nurses who prefer long-term care over acute hospital settings. Demand here is very high due to the aging population; hiring is steady year-round.

3. Hilo Benioff Medical Center (formerly Hilo Memorial Medical Center): Part of the Kaiser Permanente system. While smaller than HMC, it offers a distinct corporate culture with strong benefits. Kaiser often hires for its integrated care model, requiring nurses comfortable with electronic health records and preventive care frameworks.

4. KTA Super Stores: This may surprise some, but KTA’s corporate office and in-store clinics (pharmacies, health screenings) employ RNs for occupational health, diabetes education, and community outreach. It’s a non-hospital setting with regular business hours—a great option for work-life balance.

5. State of Hawaii - Department of Health: Based in Hilo, this office employs Public Health Nurses for programs like maternal-child health, immunizations, and TB control. These jobs are competitive, require a BSN, and offer state benefits, including a pension.

6. Private Specialty Clinics: Hilo is home to a growing number of private practices in oncology, cardiology, and orthopedics. These clinics are often looking for ambulatory care nurses. Networking with providers at HMC is the key to finding these less-advertised roles.

Insider Tip: The “big island” rumor is that HMC is the only game in town. Not true. While it’s the largest, the other employers offer valuable alternatives. Check the Hawaii Nurses' Association job board and the State of Hawaii’s official careers website for public sector openings.

Getting Licensed in HI

If you’re already a licensed RN in another U.S. state, you’re in a good position. Hawaii is not a compact state, so you will need to apply for licensure by endorsement. The process is straightforward but requires patience.

Requirements & Costs (as per the Hawaii Board of Nursing):

1. Application: Submit an online application through the Hawaii Department of Commerce and Consumer Affairs (DCCA) website.
2. Fees: Application fee is $148 (non-refundable). There may be additional fees for background checks.
3. Education: Must be a graduate of an accredited nursing program. You’ll need official transcripts sent directly from your school.
4. NCLEX: If you passed the NCLEX in another state, you must request that your scores be sent to the Hawaii Board of Nursing.
5. Background Check: A fingerprint-based criminal history check is required.
6. Nurse Licensure Compact (NLC): Hawaii is NOT a member of the NLC. This means you cannot use a compact state license to work in Hawaii; a full Hawaii license is mandatory.

Timeline to Get Started:

• Weeks 1-2: Gather documents (transcripts, proof of licensure, passport photo). Start your application and fee payment online.
• Weeks 2-6: The board processes your application. They will send you instructions for fingerprints. Schedule this promptly.
• Weeks 6-12: Once all documents and fingerprints are received, processing can take 4-8 weeks. In total, plan for 2-4 months from start to finish. Do not wait until you move to start this process.

Insider Tip: The Hawaii Board of Nursing website is the definitive source. Bookmark it. Delays are common if documents are missing. Call their office for status updates if you haven't heard anything after 6 weeks. Once licensed, you must renew every two years, with a cost of about $88.

Best Neighborhoods for Registered Nurses

Choosing where to live in Hilo depends on your commute, lifestyle, and budget. Hilo is a spread-out town without a dense, walkable core like Honolulu. Most nurses drive.

Neighborhood	Vibe & Commute	Estimated Rent (1BR)	Best For
Hilo Town (Downtown/Waiākea)	Urban, walkable to shops, restaurants, and the Farmers' Market. Close to HMC (~5-15 min). Older buildings, some with charm, some dated.	$1,600 - $2,200	Nurses who want to be in the heart of the action with a minimal commute.
Waiakea / Puueo	Residential, family-oriented, quiet. Close to beaches and parks. Commute to HMC is easy (~10 min). Good mix of older and newer homes.	$1,700 - $2,400	Those seeking a peaceful, established community feel close to town.
Hilo Banyans / Panaʻewa	Located on the west side of Hilo, closer to the airport and HMC (10-15 min). Features newer apartment complexes and subdivision homes.	$1,800 - $2,600	Nurses who prioritize a modern living space and a shorter commute to major hospitals.
Hawaiian Paradise Park (HPP)	A large, unincorporated subdivision east of Hilo. More rural, with larger lots and lower rents. Commute is 25-45 minutes depending on traffic.	$2,800 - $3,500	Those seeking space, a quieter lifestyle, and lower housing costs, willing to drive.
Pāhoa	A small, laid-back town on the eastern Puna coast. Very affordable rents but a significant commute to Hilo (45-60 min).	$2,000 - $2,800	Budget-conscious nurses who don’t mind a long, scenic drive and a tight-knit community.

Personal Insight: Many nurses in their 30s and 40s live in HPP or Pāhoa. The trade-off is the commute, but the savings are real and allow for a better quality of life (more space, gardening, less financial stress). If you work night shift, the commute is less congested and a non-issue.

The Long Game: Career Growth

A nursing career in Hilo is not a dead end, but it requires strategic planning. The 10-year job growth of 6% indicates stability, not a boom. To advance, you need to specialize and network locally.

Specialty Premiums:

• Critical Care (ICU/ER): Adds a $5,000 - $15,000 annual premium. HMC’s ER is the only Level II trauma center on the island, making it a high-demand, high-stress environment with excellent experience.
• Labor & Delivery: Highly sought-after. HMC and KTA’s women’s health services are the main employers. Pay is competitive, and the community is small.
• Oncology: Hilo is developing its oncology services. With KTA’s upcoming cancer center and HMC’s infusion center, specialty oncology nurses are becoming more valuable.
• Nurse Practitioner (APRN): This is the most significant advancement. A Family Nurse Practitioner (FNP) in Hilo can earn $130,000 - $160,000. The demand is high in primary care, especially in rural clinics and the VA. You’ll need a Master’s or Doctorate, which can be done online from a mainland school.

Advancement Paths:
The traditional path is from Staff Nurse → Charge Nurse → Nurse Manager. These roles are available but competition is fierce, as senior nurses often stay in these positions for 10+ years. A more promising path is Clinical Ladder programs at HMC, where you can advance as a clinical expert/educator without moving into management, earning extra pay and prestige.

10-Year Outlook: The core need for RNs will remain strong due to Hawaii’s aging population. However, the cost of living may push younger nurses to seek opportunities in the mainland after a few years, creating turnover and openings for those who commit. The rise of telehealth and outpatient care will create new roles outside the traditional hospital setting.

The Verdict: Is Hilo CDP Right for You?

Hilo offers a unique proposition: a strong salary for RNs in a stunning, natural environment, but it comes with a very high cost of living and a specific, island-style culture.

Pros	Cons
Competitive Salary ($110,083 median) that outpaces the national average.	Extremely High Cost of Living (Rent $3,570, Cost of Living Index 193.0).
Stable, High Demand Job Market with major employers like HMC.	Limited Housing Stock; competitive rental market.
Unique Clinical Experience (tropical diseases, trauma, community health).	Isolation from mainland; travel is expensive and time-consuming.
Unmatched Natural Beauty & Outdoor Lifestyle (volcanoes, rainforests, beaches).	"Island Time" Culture; pace of life is slow, which can be frustrating for some.
Strong Sense of Community; you’ll know your colleagues and patients.	Limited Specialties; you may need to travel to Honolulu for highly niche training.

Final Recommendation:
Hilo CDP is an excellent choice for a Registered Nurse who:

• Is financially prepared for the high cost of living (has savings, a partner, or a high-value specialty).
• Values work-life balance and access to nature over urban amenities.
• Is adaptable, patient, and interested in a close-knit medical community.
• Is looking for a long-term home rather than a short-term job.

It is not recommended for a nurse just starting out with significant student debt, or for someone who craves a fast-paced, anonymous city life. Do the math, visit if possible, and secure a job before you move. If the numbers and the lifestyle align, Hilo can offer a deeply rewarding career and a life that feels like a constant vacation, balanced by the realities of island living.

FAQs

Q: Is it hard for a new grad RN to find a job in Hilo?
A: Yes, it can be competitive. Hospitals like HMC have new grad residency programs but limited spots. Your best chance is to apply widely (including SNFs and clinics), be flexible with shifts, and consider working as a CNA or tech locally first to network. The 6% job growth helps, but local candidates often have an edge.

Q: What’s the nursing union like in Hilo?
A: The Hawaii Nurses' Association (HNA) is the primary union for nurses at Hilo Medical Center and other Hawaii Pacific Health facilities. It negotiates salaries, benefits, and working conditions. Membership is common, and the union provides a strong support network. It's a key factor in the competitive pay structure.

Q: How do nurses manage on-call or rotating schedules in Hilo?
A: It's challenging due to the cost of living. Many nurses, especially those in the ER or ICU, work 12-hour