Right now we live in Florida (put aside that I'm in school to be a PMHNP and that my wife currently works from home as one). If we went back to "bedside" why couldn't we live in Vacaville and commute to San Francisco (we each have about 10 years ICU experience) or live in Carson City Nevada and commute to Sacramento (or at least I could my wife could keep her current home based PMHNP, telemedicine job). In this way we could benefit from the high California pay (currently I make $45,00 no benefits working nights in the ICU) while minimizing the higher cost of living. Actually, I think living in Nevada and commuting to Sacramento might be the better bet even with relatively less pay in Sacramento than San. Fran. Currently, although I only live 32 miles from work in Orlando it takes me about an hour going one direction, but two hours with traffic going home.