Helping Nurses With Financial Wellbeing

By Rose O. Sherman, Ed.D, RN, NEA-BC, FAAN

Many nurse leaders are frustrated with how transactional nursing has become. In a pulse study done by the American Nursing Association in July 2022, 68% of nurses indicated that the one thing hospitals could do to make the environment more satisfying is to increase wages or give bonuses. They look at what travel nurses are paid and wonder why organizations don’t offer comparable incentives to their staff. Healthcare leaders review their current benefit packages, which could be worth 30%+ of the current salary paid, and ask why nurses are moving to new positions, often restarting the vesting process.

One thing I appreciate about the Gallup Model of Staff Wellbeing is that it includes financial well-being. Gallup researchers make the point that what matters in terms of financial well-being is money is not an end itself, but if directed at the right outcomes and managed well – it provides people with more choices and more freedom. These choices determine the quality of a staff member’s life. Gallup found that 45% of employees live paycheck to paycheck. Those who do are less engaged, report lower levels of well-being, and are more likely to leave organizations. Their advice to organizations who want to become employers of choice is to provide financial planning as a benefit, talk about financial investing, and how a benefits package can contribute to long-term financial stability.

I think Gallup makes a great point in their work, one I observed for years working with nursing graduate students. The average BSN graduate today enters practice with $37,000 in student loan debt, and some have much more – they feel behind before they start. When interviewing nurse leader graduate students for our state-supported university program, I always asked the question – How will you pay for this? Some students who earned excellent salaries with employer reimbursement plans told me they planned to take out student loans. I told them that the goal should be that they exit the program with no debt. To some, this seemed like a foreign concept. They were entering the program with undergraduate student loan debt and now planned to borrow more. I had copies of Dave Ramsey’s book, The Total Money Makeover, on my bookshelf and gave it to any number of students, advising them that they would never get out of debt unless they could get their financial life under control. So many of my students have told me they appreciated my straight talk about money.

I learned throughout my leadership career that most nurses lacked the financial knowledge that I had. I grew up in an immigrant household, and my parents were both money-savvy. As a young kid, my father explained the concept of net worth to me when I asked why we did not live in a bigger house or have luxury cars. When it came time to go to college – I had a choice of two state universities and turned down all private school admissions. Look at the return on investment; my Dad would say, and always ask yourself whether it is there.

I took these lessons to heart when the VA redeployed me from a leadership position into nurse recruitment (twice because of nursing shortages). I knew that, as an organization, we could not compete on salary but had benefits few could compete with. I did a net present value calculation on the VA retirement plan and lifelong health insurance entitlement. Some nurses I spoke with did not care, but many more did (even many young nurses) and were stunned by the differences in pay packages they were considering.

Younger nurses need our help with this. Most are unfamiliar with how to approach their student loan debt or the Public Student Loan Forgiveness program, which is much more robust than even two years ago. They don’t understand the power of compounding (see the Wealth-Multiplier-for-Young-Savers_072022t) or how little it takes to reach millionaire status if you start early, saving and investing in your retirement plan.

Those that do are working full-time and see the value in participating in a 401K plan. Many of this group are avid followers (he has interviewed several nurses on his podcast) of Dr. Jim Dahle at the White Coat Investor, the most widely-read, physician-specific (but certainly not limited to MDs) personal finance and investing website worldwide. He started his website and work because he observed that many physicians were terrible investors with little to show for their high incomes.

Recent research indicates that half of the millennials said they regularly run out of money and have to rely on credit cards or family for financial support, and 65% of millennials and Gen Zers have received financial support in the past two years from parents, significant others, relatives, or grandparents. Younger generations feel acute challenges — and anxiety — about managing money, struggling to balance “living in the now” with saving for the long term. Absent a more proactive approach to managing their long-term financial security; their outlook is grim. These younger generations look to employers for help, with 58% of Gen Zers and 57% of millennials believing their employer has a responsibility to help them feel more financially empowered.

Becoming an employer of choice is tricky in today’s environment, but why not broaden how you look at how you can help nurses with their well-being? Talking about money differently might be a good place to start.