“Nurses work too hard to be broke.” This was the realization that Theresa Duffy, RN, had nearly four years ago, when she was climbing the career ladder as an ICU nurse but not getting any closer to her financial goals.

She was saddled with more than $100,000 in student loan debt and working overtime just to live paycheck to paycheck.

In other words, she was like a lot of other nurses. A 2017 survey by the American Association of Colleges of Nursing found that nearly a third of nurses take out $70,000 or more in school loans. Meanwhile, 60% of Americans say they feel anxiety when thinking about their personal finances and 50% feel stressed when discussing them.

Theresa used to identify with all of those sobering statistics. Not anymore.

Tiny financial win by tiny financial win, Theresa began to shed the stress and anxiety brought on by her money problems and started to see her life change for the better. She started treating her finances as the pillar of health that they are—and just as important as physical and mental health to her overall well-being.

Now, she’s financially secure enough that she could take a year off work. But she doesn’t want to. “Just knowing that makes this job more enjoyable,” she says. “I work because I want to, not because I have to.”

Sure, her timeline to financial security may have been extreme—she paid off her debt in under two years—but there wasn’t anything extreme or unusual about the underlying steps she took to achieve it.

Here are 5 things you can do to improve your financial health today:

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1. Make a debt plan

The first step in making a payoff plan is facing facts. “Force yourself to log into those accounts and look at what the balances are,” Theresa says. “Once you know those numbers, that’s going to make it crystal clear what your next steps are.”

From there, look at interest rates, says Matt Elliott, a certified financial planner who specializes in helping healthcare professionals. “I usually suggest focusing on loans that have interest rates above six percent. Pay those off or look into refinancing them.”

For Theresa, her strategy was a little different. “I wanted a small win under my belt, so I started by paying off a $1,000 loan,” she says. “It built momentum and made me realize that money is as much psychological and behavioral as it is financial.”

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2. Set a budget

You know how we calculate intakes and outputs all day long as nurses? We’d do well to carry that practice home, says Theresa.

The intake is how much—to a penny—is coming into your bank account every month. For now, exclude overtime in this calculation. Output is everything you spend in a month—emphasis on everything. This is the basic definition of a budget, and yet a recent Gallup Poll found that two-thirds of people don’t have one.

Financial coach Rick Zwelling says creating a budget is the first step to feeling less financial stress and more financial empowerment. Start by keeping track of everything you spend in a month, including the date and what you spent it on. If intake is less than output, you’ve definitely got work to do. “There are only two ways to improve cash flow,” Zwelling says. “Spend less or bring in more.” If output is less than intake, you still have work to do. “If you find you have a surplus each month, that means you get to be mindful about how to apply that,” he adds.

Zwelling stops short of recommending a “right way” to budget, whether with a smartphone, a spreadsheet or pen and paper. “There’s no perfect way to do it,” he says. “The one that’s going to work is the one you’re going to use.”

Theresa printed out bank statements and rainbow-colored highlighters to categorize her spending. “I realized I was spending $700 on food each month,” she says. “It made me aware of how many times I said, ‘Ugh, I’m too tired to make something so I’ll just buy lunch.’”

But budgeting doesn’t have to equal boring. In fact, Theresa never gave up her monthly massages or her artisan coffee from the coffee kiosk. “Those were important to me, so I knew I needed to find a way to make them fit,” she says. “Creating a budget that’s realistic means you’re creating one that’s sustainable.”

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3. Save for retirement

You might be asking, “If I have student loan debt, how can I even begin to think about saving for retirement?” You can and you should, Elliott says.

In fact, if you have an employer, the first financial move to make is to find out about the retirement benefits your workplace offers, like a 401(k) or a 403(b) and an employer matching contribution. (Pensions are less common these days.)

If there is a match, take advantage of it. “Contribute enough to get the match,” Elliott says. “I recommend doing that before anything else, like paying off loans or starting an emergency fund. It’s basically free money.”

If you work the travel or per diem circuit, you’re not out of luck. Individuals can open retirement accounts, too. The important thing is to know the difference between all the plans, like Roth IRAs and traditional IRAs, and what they do and don’t offer.

“Ignorance is not bliss,” Theresa says. “Google can get you pretty far, but don’t be afraid to go in and ask more specific questions. It might be a new topic for you, but you’re smart. If you passed the NCLEX, you can figure this out, too.”

Nearly half of nurses say they don’t have time to dedicate to their finances, according to a 2015 Fidelity Investments survey.  

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4. Get ready for a rainy day

Nurses make great breadwinners. But if you’re sidelined and can’t work, bread still needs to be put on the table. If you’re a staff nurse, check your benefits for both short-term and long-term disability insurance. You may decide this is enough, or you may want to supplement those benefits with your own coverage.

If you’re not someone’s employee, you’ll need to seek these benefits out on your own. When she became a travel nurse in January, Sybil Vinas Meza, BSN, RN, embarked on a crash course in coverage options. “I settled on short-term and long-term disability, accident insurance and critical illness insurance,” she says. “If you’re a travel nurse, it takes a little more initiative on your part, but the peace of mind and security make it worth the work.”

Or, what if it’s your trusty mode of transportation or home HVAC system that’s been sidelined? This is why it pays (literally) to have an emergency fund. But only 39% of Americans say they could afford a $1,000 unexpected expense. Typically, an emergency fund can cover 3-6 months of expenses, but even having a little something is better than nothing.

In the hierarchy of financial moves to make, Elliott says socking away money for a rainy day should come after scoring the company match and getting rid of high-interest debt.

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5. Reassess your earning power

If you’re a nurse, you know that the world’s your oyster in terms of the variety of jobs available to you. Whether it’s picking up shifts to help pay down debt or working part-time to fit people for life jackets (it’s one of the ways Theresa became debt free) or becoming a travel nurse after being at one hospital for years, nurses have options—and those options could be the key to financial peace.

Sybil’s problem wasn’t student loans; it was living beyond her means. One luxury apartment lease and new car payment later, and she found herself struggling to keep up.

“I made the mistake of seeing what everybody else is doing and saying to myself, ‘I should be doing that, too,’” she says.

Extra shifts helped, but when her mental health took a hit and she couldn’t work OT anymore, she knew something had to give. She gave up the apartment and traded in the car for something more practical, but it wasn’t until she became a travel nurse when she felt true financial empowerment.

“I used to think financial stress was something everyone had—and that I would just have it forever,” she says. “But it doesn’t have to be that way.”

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