In fact, a new WalletHub report sinks the islands to the bottom of the list when it comes to best and worst states for nurses.
Out of 51 spots, Hawaii came in (drum roll, please) 50th.
The study looked at dozens of factors for the nursing industry including the number of health care facilities per capita, nurse to patient ratio, job opportunities, and of course, annual salary.
Despite the increasing demand for quality healthcare in Hawaii along with the island's aging population, the study found Hawaii had among the worst amount of opportunities and competition for new nurses.
"More specific to nursing professionals are the various day-to-day demands placed on them, such as mandatory overtime, overstaffing, unionization and disrespectful behavior by patients," the WalletHub report said.
When it came to annual salary adjusted for the cost of living, Hawaii was dead last.
The study, released Wednesday, was compiled to help assist nursing graduates identify best and worse states to work.
Overall, the one place worse than Hawaii for nurses: Washington D.C.
On the other end of the spectrum, the best states for nurses included Maine, Montana and Washington.
And despite the critical outlook for Hawaii, the nursing industry as a whole looks promising.
"Nursing occupations are some of the most lucrative careers with the lowest unemployment rates in the U.S. In fact, the industry is expected to grow at more than double the rate of the average occupation through 2026," the report said.
But, this isn't the first time Hawaii has fallen towards the bottom of a national list.
On this study, out of a perfect score of 70, the state earned 38.49.