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This post is part six in a nine part continuing education series on Surviving Nursing. 

Part one - "I Hate Being a Nurse." I get it, and it doesn't have to be this way.

Part two - Surviving Nursing Part 1: Why Self-Care Is Not Enough

Part three - Surviving Nursing Part 2: The Financial Path

Part four - Money and the Nursing Exodus Part 1: Everyone’s Missing the Point 

Part five - Leap From Career Misery To Financial Clarity, Confidence, Space & Ease w/ Maureen, ARNP

Part six - Money And The Nursing Exodus Part 2: Finances In A Burnout Role

Part seven - The Truth About Toxic Nursing Culture–How to Escape the Death Spiral (Pt. 1) 

In this series, we’ve been talking a lot about the realities that nurses face in their modern work situations, and what’s required to survive nursing across your career. We’ve talked about how a lot of nurses are leaving the profession, and in the last post, we talked about why increasing nursing salaries - while important - is not a solution to the nursing exodus. 

The dilemma we find ourselves in is that we are working inside burnout roles, which presents us with a stark reality:

People say that nursing is a reliable career that guarantees financial stability. That’s wrong because even though there’s no shortage of job vacancies, nursing work itself is not sustainable. Our working conditions lead to burnout. Burnout leads to the nursing exodus. 

What this means for most nurses is that you WILL NOT stay in your career until 65 years old….or whatever traditional retirement age is when you get there. 

Because the nursing system is set up as if it’s a sustainable 40 year career, if you aren’t capable of working that long then you may find yourself at a financial dead end.

LET'S REVIEW THE STATISTICS ON THE NURSING EXODUS

We've talked about this in previous posts, but to start, I want to review some statistics about the situation nurses find themselves in today. If you skim this section, the point is that things look bad. A lot of us are burning out and leaving.

In 2018, researchers analyzed the responses of more than 253,000 registered nurses from almost 15,000 units (14,938) and found that retirement and intent to leave is very high across job locations, including ambulatory care. 

2018 Press Ganey

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Intent to retire early and leave is the highest in nurses younger than 30 and between 50 and 64 years old 

Intent to leave direct patient care in other age groups was also very high.

2018 Press Ganey

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Among Canadian nurses, the average retirement age in 2019 was 58 years old.

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In the National Nursing Workforce Survey released in 2020, more than 1 out of every 5 nurses currently working in the U.S. reported plans to either leave the field or retire within five years. 

In 2022 that number increased to 1 in 4 nurses planning to leave.

There’s been some early data coming out from private businesses this year that indicates these numbers are about the same. 

In February 2024, the staffing agency, Incredible Health, analyzed data from 1 million Incredible Health nurse profiles and surveyed more than 3,300 registered nurses. Their results indicate only 79% of nurses intend to remain in the field until retirement. These results are slightly more optimistic, but less academically rigorous.

Intent to leave nursing hasn’t changed when comparing pre-and post pandemic. 

The reasons nurses give for leaving the profession before traditional retirement age are clear. 

• Nursing is a hard job. 
• With a lot of stress
• Making it difficult to sustain. 

Of nurses who left their jobs in 2018, pre-pandemic, 30% said they did it because of burnout. 

 Data from June, 2023 out of Greece indicates that burnout and job dissatisfaction among nurses is higher NOW as the pandemic winds down. Also that nurses are more likely to experience burnout than other healthcare providers.

In the U.S. there are more than 5 million nurses, but somewhere between 500,000 and a million aren’t working in the field. 

The American healthcare system is down about a million nurses. 

Many blame the pandemic for this, but what you’ve just seen is that nursing burnout is driving the nursing exodus. And that’s a long-time reality for nurses…both burnout and the exodus existed before the pandemic and they still exist now.

PEOPLE HAVE BEEN TALKING ABOUT THE MOST IMPORTANT CHALLENGES IN THE AMERICAN HEALTHCARE SYSTEM FOR DECADES 

In the next posts in this series, we'll talk more about why nursing work is so often toxic and burnout-inducing. However, to state things briefly, people have been talking about the most important challenges in the American healthcare system for decades. In summary, these challenges include:

• Disorganization as a function of our decentralized private system. 
• Dissatisfaction among the workforce. 
• A general shortage of staff. 
• Social issues leading to distrust of the healthcare industry. 
• Increase in workplace violence against healthcare workers. 
• The pace of change and the difficulty for systems to integrate new technology. 
• Rising costs, administrative waste, and failures for patients.

Working in this sort of environment is exhausting physically and emotionally, and has been reliably producing the results we talked about in the last section: burnout, and early departure from the profession. 

This is the reality for nurses. Our career isn’t sustainable across a lifetime. And we need solutions that take this into consideration. In the last post we talked about why increasing nurse salaries, although justified, isn’t going to solve the problem of nursing burnout or the nursing exodus. And in a post before that, we talked about why self-care isn’t the solution either.

So what is?

CAREER STABILITY IN NURSING REQUIRES FINANCIAL SAVVY 

For each of us as individuals, surviving during the nursing exodus requires the opposite of what you might expect - that is, the financial savvy to be able to leave your job when you need to. 

This works because what nurses need is control over how much they expose themselves to burnout-inducing job environments. The right financial strategy can provide that control, and can protect you from financial instability if (or when) you need to leave your job.

Here’s what that looks like in a nutshell:

Setting up an enduring money plan that will 

1. Give you work optional freedom ASAP so you can work part time or not at all if you want.
2. Allow you to take risks in your career - by changing your job and setting firm boundaries.
3. Allow you to save and invest for retirement independently from your employer.

When you have the financial savvy to figure out how much money you need, where to save it and invest it, and how to make sure you set enough aside, then you will always be in control of your career and your financial destiny.

We'll talk about this more below, but first here's a quick analogy to help illustrate what nurses should be aiming for.

A QUICK COMPARISON BETWEEN NURSING AND FIREFIGHTING 

In the 1950s and ‘60s, firefighters were facing a problem of working in a dangerous, high stress, high burnout career. Sound familiar? 

Firefighters were leaving their careers early –and even dying– as a result of their work. Surviving for 40 years in frontline firefighting work wasn’t happening. 

So…Firefighters fought for change. In the latter half of the 20th century, they started winning.

The changes created new career options for firefighters including

• Early retirement benefits kicking in after 20 - 25 years
• An option to work part time and draw a partial pension 
• And transition to non-frontline positions to balance out the stress of the job. 

In some places, firefighters even negotiated for career counseling to transition into other fields as a standard job benefit. 

These schemes are still common and popular among firefighters today, Now, they are key tools for recruitment and retention. 

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You might be thinking “Yeah, but it’s wrong to compare nursing to firefighting–it doesn’t carry the same level of risk. Nurses should be capable of working full-time in their careers for 40 years."

It's true, nurses are not running into actual burning houses.

However, I’m not a fan of playing the game of “who has it the worst.” EVERYONE deserves to have a safe working environment. NO ONE should be expected to endure unsafe, unsustainable conditions across a lifetime.

Here are a few statistics to demonstrate just how serious the problem is for nurses.

The CDC reported 207 deaths in the healthcare setting in the years between 2016-2020. (By the way - Firefighter deaths during those same years were 303. It's more, but it illustrates that nursing carries a very high level of risk.)

• 13 nurses out of every 100 are physically assaulted
• And 39 nurses out of every 100 are subject to non-physical violent threats

• 80% of nurses don’t feel safe at work
• 82% of ED nurses had been physically assaulted at work in one year 
• 25% of psychiatric nurses experienced disabling injuries from patient assaults

In my own career I have worked in a location that’s been held up by gunpoint

• I’ve been sexually assaulted… 
• I’ve been kicked, hit, spat on, scratched
• and even followed home by a disgruntled patient in the past.
• I’ve had needle stick injuries putting me at risk for HIV and Hepatitis

The point is, our job is risky. 

It’s true that nursing is not firefighting. It’s also not the military or police–two other careers that have inbuilt early retirement options. (You know what else nursing is not? A profession where the majority of the positions have been historically held by white men.) It doesn't matter. It's a dangerous, burnout role that we should be treating like other similar roles.

Nurses have similar job-related problems. But we lack the safety nets of firefighters.

Working for 40 years in nursing is like firefighting work was 75 years ago - unsustainable. For many of us, it’s just not happening. When financial and career safety nets are NOT available to you as a nurse, you’ll feel like your career is unreliable and unsustainable.

And that's exactly why creative financial strategy is an essential element for easing burnout and slowing the nursing exodus… just as firefighter’s new career options helped solve their problem.

NURSES NEED SAFETY NETS. NO ONE IS PROVIDING THEM FOR US. 

Workplace burnout in high stress roles is not new. Many industries have dealt with the problem proactively for decades. 

Nursing is a risky profession. The data shows it. Nurses need safety nets. Unfortunately the healthcare system does not provide this. Unlike in firefighting and other comparable professions, nurses do not have access to early pensions, early retirement schemes, and structured transitions into less taxing roles.

This is what I believe, which I haven't heard anyone else saying: if the system doesn't provide these types of things for us, then nurses need to build our own safety nets.

As nurses, we have to fend for ourselves. No one is looking out for us.

How can we do this? Through financial literacy.

WHAT DO NURSES NEED IN THE MIDST OF THE NURSING EXODUS? THE FINANCIAL LITERACY TO PLAN FOR OUR LIKELY FUTURE.

A first step to building our own safety net is broadening the money conversation. For nurses, the issue is not just about wages. We need to ask ourselves, how do we prepare ourselves financially for the likelihood that our job is going to burn us out?

Nurses need financial literacy and financial behaviors that are appropriate to our reality.

Financial literacy is the term used in the literature to describe the ability to manage your finances in a way that leads to wellbeing. From the Financial Educators Council: Financial literacy means “Possessing the financial knowledge, behaviors, systems, team, and plan to confidently take effective action that best fulfills an individual’s personal, family, and global community goals.” 

For nurses, because our jobs are unstable and our career length is likely going to be shorter than 40 years, financial literacy is particularly important. 

Nurses’ financial responsibilities are already complex. We are looked up to as the responsible one’s in our families and communities. We pay our bills. We support our families – parents, children, extended relatives overseas. We want to create generational wealth –  leave money behind. A lot of us give money to charity. Many of us are single parents, and most of us start our careers with student loans and other types of debt. Many of us come from socioeconomic disadvantage and are using nursing to lift ourselves out of poverty.

However, due to the nature of our career, we also need to plan for unusual contingencies.  

1. We need to have enough money in the bank to cover expenses if we leave our jobs abruptly. 
2. We need to have enough to plan for extended time away from work – to drop hours for long periods of time. 
3. We need to have enough to plan for early retirement - like police, firefighters, and members of the military, but without the built in benefits, pensions, and supports.

In order to survive nursing, and exist healthily in the middle of a nursing exodus, we need to adopt a money system that takes all of this into account.

I know, it’s a lot, but the good news is it’s totally doable.

If you’re a nurse who makes a nursing salary, you make enough to achieve all of these things if you manage your finances intentionally. All of these skills are well within your capabilities. I can say that confidently. You graduated nursing school. You have what it takes. It’s not your fault if you don’t know how yet, because these are skills you don’t learn in nursing school and in my experience are almost never a part of the discussion around nursing and money.

HOW CAN NURSES DEVELOP THE FINANCIAL LITERACY THEY NEED?

In the midst of a modern nursing exodus, the discussion around money is important. Nurses are right to push for higher wages, and employers are right to give them to us. 

But just as important is the issue of how to manage those wages in order to plan for the realities that our job presents us with. 

Learning about finances and (more importantly) implementing strategic behaviors around money that perfectly suit a nurse’s lifestyle are essential for nurses & APRNs in the current environment.  

Employers, unions, and educators should be helping us down this track, but that doesn't happen. This discussion is (in my experience) essentially non-existent in conversations around money and nursing.  

There are, of course, ways that nurses can develop these strategies themselves. There are dozens of books on financial strategy, and financial gurus (some good, some bad) who will coach you. But figuring out your own financial goals, and which tools and strategies to use is a process that can take years. I know - I did it myself! It took me more than a decade to really get things sorted out!

This is a big part of the reason why I decided to start sharing my personal money strategy with my nursing colleagues. I saw the writing on the wall the first year I was a nurse that this career was going to exhaust me. I began to set up a strategy to pay off my $200,000 in debt, and invest to prepare for my future.

I hoped like heck that my system would work. There was no roadmap for me to follow, and I was frustrated by how traditional financial advice didn’t match my needs as a nurse. I made some expensive mistakes along the way (the worst was losing out on $300,000 from working with a trustworthy financial advisor), and had to change my strategy multiple times. Across a decade or so I figured it out though, and put together a system that worked better than I ever could have imagined when I started my nursing career. I've used my nursing money to travel around the world, buy my home and cars in cash, and …eventually… step away from nursing at 35 years old to heal my extreme burnout. Now I'm able to work when I want, if I want, and I'm completely confident that I am set up for early retirement. Even now, decades before normal retirement age, my investment returns pay me more each year than my nursing salary ever did.

I think more nurses deserve to have this same safety net. I wish our industry provided it, but it doesn't, so I teach nurses to build it themselves.

You have to do the work - there's no way around it - but I know from experience working with dozens of other nurses that you can figure out an enduring strategy that will change your relationship to nursing in a matter of months, not years. Helping nurses achieve that is what Nurses Investing for Wealth is all about.

What’s most important is not what you know when it comes to finances, it’s what you do. Helping you change your financial behavior and therefore change your life isn’t something I can accomplish just on a blog, but it is what The Nurses Investing For Wealth Method™ does for nurses. If you want to see How to Become Work Optional in One Hour a Month–Without Burning Out, Wasting Time on One-Size-Fits All Finance Strategies, or Falling for Bogus Investment Ploys, click here.

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Bae, Sung-Heui. “Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review.” International Nursing Review vol. 69,3 (2022): 392-404. doi:10.1111/inr.12769

Bahlman-van Ooijen, W., Malfait, S., Huisman-de Waal, G., & Hafsteinsdóttir, T. B. (2023). “Nurses' motivations to leave the nursing profession: A qualitative meta-aggregation.” Journal of Advanced Nursing, 79, 4455–4471. https://doi.org/10.1111/jan.15696

Bimpong, Kweku Andrew Ampadu et al. “Relationship between labour force satisfaction, wages and retention within the UK National Health Service: a systematic review of the literature.” BMJ Open vol. 10,7 e034919. 21 Jul. 2020, doi:10.1136/bmjopen-2019-034919

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