May 17, 2020

4 Ways to Finish Your Medical Residency Without Falling Further into Debt

3 min
Although 25 percent of residents have no debt, over a third (36 percent) still owe more than $200,000 after five years in residency, according to Medscape.
Upon graduating from medical school, most students have already accrued a significant amount of student loan debt. Entering into residency, one of the p...

Upon graduating from medical school, most students have already accrued a significant amount of student loan debt. Entering into residency, one of the primary concerns students have is incurring even more debt.

“What I see at the end of residency is just a need for cash – almost always,” said Chris Long, who specializes in financial planning for physicians. “Whether it’s preparing for boards, wanting to take a little time off before practice, relocation, all sorts of things … If you don’t have a plan to accumulate some savings or have a savings target by the end of residency, you’ll probably go further into debt.”

In order to combat this, Long established four ways residents can avoid accruing more debt who also don’t have the time to micromanage a complicated budget.

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1. Understand your cash flow using a monthly budget.

Instead of using online budgeting tools or apps, Long recommends a simple spreadsheet program such as Excel. Three things to list are your monthly take-home pay, fixed expenses and savings. BE sure to budget for things such as car, home maintenance and clothing. Always aim for a slight surplus at the end of each month.

2. Establish separate accounts to keep track of your spending and saving.

Long advises setting up two checking accounts and one savings account. From your budget worksheet, subtotal amounts for savings, discretionary and fixed expenses. When you get paid, pay yourself first by putting an allocated amount of money into savings. Then transfer your allocated discretionary amount into your discretionary checking account. Leave the rest in the other checking account. Many residency programs will allow you to split your direct deposit into multiple accounts.

The discretionary account should be your variable expense account, or what you use for groceries and the “fun expenses,” says Long. It is helpful to use a debit card linked to an online bank account so you can quickly see how much you have in this account, adds Long. Monitor your discretionary account balance and make spending decisions based on this balance until you get paid again. Don’t take from the surplus in your primary account or savings and avoid using credit cards.

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3. Use your other checking account for your “fixed” expenses and bills.

Surplus should build up in this account over time for things like car or house maintenance, clothing and seasonal variations in utility bills. According to Long, the idea is to avoid using credit cards and invading savings for these expenses when they occur.

4. Don’t rush to start investing.

If you don’t have a surplus at the end of each month without investments, then it is probably not wise to invest at this time. Start with managing your cash flow and then move into learning about investments.

“The first step always should be to create a budget that allows you to have some savings,” said Long. “People tend to underestimate how much they spend on eating out, groceries and these sorts of things. If they can actually save their target without dipping into their savings, then they can start discussing what they have access to in terms of IRAs and 401ks.”

Sourced from the American Medical Association.  

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Jul 22, 2021

COVID-19 "causing mass trauma among world’s nurses"

5 min
COVID-19 "causing mass trauma among world’s nurses"
Two nurses tell us about COVID-19, nurse burnout, and how to address it

Healthcare providers are facing ongoing nursing shortages, and hospitals are reporting high rates of staff turnover and burnout as a result of the COVID-19 pandemic. In June a report found that levels of burnout among staff in England had reached "emergency" levels

Registered nurses Molly Rindt and Erika Haywood are nurse mentors on US recruitment platform Incredible Health. In this joint Q&A they tell Healthcare Global about their own experiences of burnout and what can be done to tackle it. 

What does it mean to be suffering from burnout? 
Some of the most common reasons for nurse burnout include long work hours, sleep deprivation, a high-stress work environment, lack of support, and emotional strain from patient care. 

While every profession has its stressors, the nursing industry has some of the highest burnout rates. The massive influence on patients’ lives, the long hours, and many other factors put nurses at risk of severe burnout. And with the rise of COVID-19, many healthcare professionals feel the strain more than ever.

Burnout in nurses affects everyone — individual nurses suffer, patients are impacted, and employers struggle with enormous turnover. This is why it’s crucial for healthcare systems and management to watch for signs of nurse burnout and take steps to provide a healthier workplace. Employers should be careful to watch for burnout symptoms in their healthcare staff — and not ignore them. 

Symptoms include constant tiredness, constant anxiety related to work, emotional detachment and unexplained sickness. 

How widespread is this problem?     
Unfortunately, burnout affects approximately 38% of nurses per year and even the WHO recently labelled burnout as an official medical diagnosis. To put this statistic into perspective, nearly 4 out of 10 nurses will drive to work dreading their shift. Burnout is a reason nurses leave their positions. 

Other top reasons for leaving included a stressful work environment, lack of good management or leadership, inadequate staffing, and finding better pay or benefits elsewhere.

Even before the pandemic, demanding workloads and aspects of the work environment such as poor staffing ratios, lack of communication between physicians and nurses, and lack of organisational leadership were known to be associated with burnout in nurses. 

Have either of you experienced burnout? 
Rindt: I have experienced burnout as an RN. I was constantly fatigued,  never felt like I was off work, and would frequently dream I was still at work taking care of patients. In my particular situation, I needed to take a step back and restructure my work schedule to allow for more time off. After doing this, I was able to reduce burnout by deciding to work two shifts back-to-back and then have 2-3 days off.

Haywood: I definitely experienced constant anxiety related to work - so much so it would impact the days I wasn’t at work. At one point, I was even on medication to help combat the anxiety and stress I was facing on the job. 

I had heart palpitations, chest pain, and wouldn’t be able to sleep before working the next day, which slowly started to impact other aspects of my life. I knew I couldn’t continue to live this way, it wasn’t sustainable. Because of this, I began to focus on my needs and prioritising self-care, especially during the beginning of the pandemic. Putting my needs first and not feeling guilty were necessary for me to overcome burnout.

What impact is COVID-19 having on nurses' wellbeing? 
Some nurses have suffered devastating health consequences. Many nurses have dealt with excessive on-the-job stress, fears of becoming infected, and grief over seeing patients succumb to COVID-19 while isolated from their families.

New evidence gathered by the International Council of Nurses (ICN) suggests COVID-19 is causing mass trauma among the world’s nurses. The number of confirmed nurse deaths now exceeds 2,200, and with high levels of infections in the nursing workforce continuing, overstretched staff are experiencing increasing psychological distress in the face of ever-increasing workloads, continued abuse and protests by anti-vaccinators. 

However, other small silver linings that came from the pandemic include increased professional autonomy, leadership opportunities and career growth potential.

How much of the cause of burnout is due to the hospitals or healthcare providers, and what can they do to address it?

Nurse fatigue poses serious problems for healthcare organisations, and a recent survey from Kronos found 63% of nurses say their job has caused burnout. The survey also found that more than 4 out of 5 nurses think hospitals today are losing good staff because other employers offer a better work/life balance.

Nurse burnout  not only contributes to staff turnover, but it can impact the facility’s quality of care, patient satisfaction, and even medical outcomes. 

Strategies to address burnout include training improving  nurse-to-patient ratios, include nurses in policy discussions, and prioritise fostering a healthy work culture in hospitals. 

What does your role mentoring nurses on the Incredible Health platform involve?
Rindt: My role can vary based on the needs of the nurses. The nurses love knowing they have someone in their corner who can give interview preparation advice or provide suggestions on how to improve their resume. Knowing that there is someone who is well-versed in the job process and can help set expectations on what to anticipate, really helps to remove a layer of uncertainty.

Haywood: When screening nurses, it is customised to what their individual RN or nurse practitioner needs, and at a time that is most convenient for them. Nurses are busy and often aren’t thought of first. Being able to provide support from the very beginning of their career advancement journey helps tremendously.  We also provide resources such as resume templates and tips that can help nurses be successful and feel supported.

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