The Impact of Financial Stress on Performance

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

In healthcare, we are rightfully concerned about stress and burnout in our workforce. There are many strategies discussed to build resiliency including mindfulness, meditation, gratitude journals, exercise, sleep and a host of other interventions. Notably missing from every list that I have looked at are interventions to help staff deal with stress related to their personal finances. Yet, financial stress is the single greatest source of stress for over 60% of workers in the US today. I have seen this in my own work where I often have graduate students (working nurses) drop classes because they could not afford to prepay tuition in anticipation of tuition reimbursement from employers. Many acknowledged although they have a good income, they are living paycheck to paycheck.

We have data that suggests that roughly 20% of the nursing workforce has more than one employer often working full-time in two settings. Much of this work is driven by financial need. In a recent report about graduate student debt, the American Association of Colleges of Nursing reported that sixty-nine percent of graduate nursing students surveyed in 2016 took out federal student loans to finance their education. The median amount of student loan debt anticipated by graduate nursing students upon completion of
their program was between $40,000 and $54,999. Fifty percent of all graduate students within this sample who borrowed federal student loans stated that their largest
concern upon completion of their program will be their ability to repay loans. The second most pressing concern for students was the rise in interest rates on their student loans. These concerns are jointly connected, as the rise in interest rates makes student loan repayment more costly to the borrower.

Financial stress and debt can have a significant impact on work performance. Both health and productivity suffer according to the Society for Human Resource Management. Their research indicates that less than 50% of the workforce are savvy about their personal finances. Those reporting high levels of stress were more than four times as likely to suffer from symptoms of fatigue, headaches, depression or other ailments. They were also twice as likely to report poor health overall, leading to more sick days, increased absenteeism and decreased productivity. In nursing, there are also safety issues for patients when nurses work two jobs or a great deal of overtime to deal with debt. Many Baby Boomer nurses are working beyond where they thought they would because they cannot retire and be financially stable.

Best practice organizations have found that there are three key types of financial education that staff need. These include the following:

Benefits literacy education so staff are fully aware of benefit available to them and the cost benefits of different plans.
Retirement security education so staff are fully aware of the retirement plans available, investments within those plans and the power of money compounding in retirement plans.
Financial literacy education where staff are taught to manage personal budgets, repay debt quickly, avoid credit and assess any loans carefully that they do take out.

While one on one advisement is helpful, group classes have been found to be very powerful. Organizations can either organize their own sessions or use best practice programs such as the Dave Ramsey Smart Money Management. If we as leaders in nursing truly want a healthy and empowered workforce, then helping nurses to better manage their own finances has to be part of a resiliency program.