brandy1017

While that is usually true, I agree with the others not to tell people that I'm a nurse or suggest meds they should take, especially strangers on the internet. To think he needs antipsychotic meds because he thinks calvinists are satanic is unwise, most likely wrong and not nursing scope. People have lots of "crazy" ideas about religion and politics, but to label them as mentally ill for that and then say I'm a nurse and you need meds is very stupid and leaving yourself open for a slap from the BON if he does find her and file a complaint. I agree to make her facebook private now. Or have one with a pseudo pen name, but I heard they are making you prove you are who you say you are now. Don't know if that is true though. Either way I would advise not to volunteer that you are a nurse and not to recommend med treatments to strangers on the internet.

I believe Indiana is one of the states that reports to BON when they fire nurses which I think is ridiculous when most work "at will" and can be fired at any time for any or no reason without union protection and hospitals do that especially if you are older and cost them more money!.

I agree and the tax cuts in 2017 may have caused a temporary economic boost but at the effect of worsening the debt by trillions at a time when the economy was good and they should have been conserving in case of an economic downturn like what is happening now and what happened during the covid "emergency" lockdowns! Those lockdowns harmed a lot of small businesses and restaurants and largely benefited the big corporations while worsening our deficit! We've been in a recession since Biden, but he changed the definition to try to hide it and now I would say we are in a stagflation and on the cusp of a great depression. This is the worst time to lay off federal workers, government programs and social benefits. Made even more egregious by the reality that it is to give tax cuts to the rich especially the millionaires and billionaires! They are the ones who already have plenty of money and will come out of this depression fine! That Musk was put in as an unelected oligarch to destroy our government and its social benefit, economic and political programs to enrich himself is disgusting! He is reaping billions in government contracts that he hasn't earned. Personally, I'm glad to see Tesla suffering from the boycott!

Right, it is very alarming that Musk is trying to cut SS staff, when they are already at a historic 50 year low of employees and having trouble with retention! They need more staff and investment in new computer systems, not less! Also I read the other day Congress wanted to raise SS age to 69 for everyone 59 or older! That is insane! A lot of people don't live that long. On top of that the last SS Commissioner said he figures about 30K people die waiting for disability! They make the process very hard, deny most on the first try and you can literally wait years to get approved. This will lead to even more people dying!

Wow! Three call ins a year are allowed! How generous, NOT! My best advice to the OP worrying about losing her job is find a non-bedside job where you aren't as stressed and exposed to as many bugs and you will probably be much happier and less prone to illness!

Sorry he is a PhD. He has his own YouTube site. For some reason the link didn't work, but if you search it on YouTube or Google you should be able to find the video where he explains the process in depth and has many other informative videos as well. Former SSA Insider EXPLAINS: How YOUR Social Security benefits are CALCULATED - YouTube - Search

My understanding is SS is based off a formula of the average best 35 years of your working career. So, if you worked more than 35 years, the lower paid ones drop off. Here is an explanation of the formula from a SS expert, Dr ED Weir. Former SSA Insider EXPLAINS: How YOUR Social Security benefits are CALCULATED - YouTube

Where I worked, they had female urinals that worked wonderful especially for someone with a hip fracture. If your place doesn't stock them, I would advocate for them to be added. They also helped for men that were swollen from CHF, for instance. I agree I think the purewiks are a stupid gimmick and suspect patients still get UTI's for all the reason you mentioned. Having the sponge against your skin is going to harbor bacteria and with women's short urethra's it doesn't take much for it to travel to the bladder and start a UTI. A true silver foley would be much preferred for an incontinent patient to keep them clean, dry and infection free!

Think you would have heard already. My God they sent the notice out to the air traffic controllers encouraging them to resign in the midst of that nationwide crisis with air crashes happening all around! But crickets for nurses. Once again you are probably too valuable to get an early retirement incentive! Consider the irony in that. During the Ascension takeover of my hospital, they were laying off people in droves, but not nurses. Sometimes they would play musical chairs with management they could reapply and see who was left standing. When they closed hospitals, they would reassign nurses to other area hospitals, and we were told if you didn't accept their choice for you than it was no severance and just goodbye to the unemployment line! Hope you get the chance for early retirement, but I would be surprised. Good luck!

See my last post under the thread by Davey Do "What do you miss about nursing". Someone just like you was asking for help. Too long to rewrite it here. See your Dr and an ortho specialist about your back. I had serious back problems for years and only recently learned what they were when I finally went to the Dr and eventually got an MRI from ortho. There may be things to help starting with PT and depending on the situation the Dr may suggest other interventions such as an epidural, facet injection or ablation. It all starts with getting checked out and not just living with the pain! Also stop damaging your back by finding a job where you aren't lifting and moving people. or maybe after reading my prior reply to the OP 58Dontfeelgreat you will realize you can afford to retire early if you live frugally! I suggested a couple books on personal finance. Deal with your Debt by Liz Weston has an interesting take on it to use it as a strategy to reach your goals. She even used a HELOC for income temporarily while waiting for a new job to come to fruition! It is OK to have debt at times, not to be in a rush to pay off debt but consider flexibility to look at the big picture. I'm using this strategy to keep my taxable income low for Obamacare subsidies to make healthcare affordable and to help me make it to SS and Medicare. Maybe you will find you can retire earlier than you think! Best wishes to a more peaceful, healthy, pain free and stress-free New Year!

If you can't afford to retire, I would try clinics, Dr offices where they do things that they need nurses like urology, neurology for IV meds, cardiology or you could try an outpatient dialysis center. They will train you and the techs do a lot of the work. You could try to get an insurance job as a case manager. Or maybe you could get a PT job with health insurance if you can't afford to retire completely that could be the best of both worlds! I had been saving money for a long time, had a Roth IRA, HSA, 403b and had a small pension and used the Rule of 55 to retire early. It allows you to take money out of your 401k/403b without penalty as long as your employer allows this option. Most allow you to roll any IRA into it and some old 401k/403b's as well. But you would have to check with your 401k before you quit your job that they would allow for multiple distributions and you have to keep it at your employer. If they do, many do, you can take periodic withdrawals as needed to pay your bills but be forewarned they withhold 20% for taxes even if you are not in that tax bracket until you are 59 1/2. You get the excess back the next year when you file taxes. Downsides tend to be poor investment choices and high fees. I would use a bucket approach of several years' expenses in a cash account like treasury funds or annuity if that is not an option. I also had saved thru a Roth IRA where you can take the contributions out you put in before 59 1/2 without penalty and it helps keep my taxable income low to get affordable health insurance thru Obamacare. You need to keep your income at 400% of poverty or less for the best subsidies otherwise it is unaffordable. I have an HSA to help pay for medical/dental that is tax free and keeps my income low. You can do COBRA although it is unrealistic for health insurance so expensive but can use it just for dental and vision as I did for 18 months. I did a HELOC before I quit so I would have money in case of an emergency until I get Social Security. Have only touched it once to put on a new roof. It also would allow you to take money out to keep your taxable income low if need be if you didn't have a Roth IRA, but you would have to be very careful and frugal and not get over your head. Best rates usually thru a credit union in my opinion, the first ten years you can pay interest only, the last ten years you pay back the loan but it is adjustable, and it can climb to as high as 18%. Mine is currently 7% but we don't know what the future holds. It depends on inflation, the economy and the feds where the HELOC and other interest rates will go so if you get one you have to be very conservative as your house is on the line, unlike credit cards! I also have a lot of credit cards and use them for points. Get some credit cards if you don't have before you retire. More is better. You can always use them for balance transfers if you have debt as well. That is preferable to the HELOC as your house isn't on the line. Discover has 5% reward cycles and also frequent balance transfers. Chase and Bank of America also have continued the balance transfer options plus rewards. Some credit cards are not offering transfers or only one time like American Express. The credit cards also there for emergencies especially if you don't have a lot of savings. It's a hard mindset to accept debt as a strategy but that might be necessary to retire early. I pay my bills each month except I retired with some CC debt that I use the balance transfers. My pension pays my mortgage which will be paid off when I'm 63. I was lucky that I had time to plan and save and prepare vs a coworker who retired early unexpectedly after going manic. It turned out to be a disaster for her. Ascension cheated her out of almost 200 hours of PTO after working thru covid on the technicality that she called in even though they knew she was manic and had put her in charge vs taking care of patients! She panicked and sold her condo at a loss to one of those We buy ugly houses for cash places. Somehow went thru all of her. retirement in a year even though she was living in a cabin in the woods with her husband in the middle of nowhere. She filed for disability but of course was denied as I told her they would do. Disability is almost impossible to get these days unless you have a terminal situation. It took over a year for the first denial, she would have had to keep appealing waiting years for them to finally approve it but she had no money and her husband never worked she was the breadwinner. She had a small pension but it wasn't enough to live on. Eventually she pulled herself together and she is currently working at a nursing home. I'm also a strong believer in learning about personal finance. I know it's late in the game but some books that helped me were Deal with your Debt, Personal Finance for Dummies and Smart Women Finish Rich. I'm not an expert by any means, nor a financial advisor just sharing what I did to retire early. I decided not to get another job because I can't stand without pain 2nd to neuroforaminal spinal stenosis and spondy. Just had an ablation but doesn't appear to have worked. Anyway, I hope this info is of some help and hope for you and anyone else out there stuck in a bad job!

Haven't seen you in a while, how have you been? Hope everything is well with you! I'm guessing the choice to wear scrubs is a nudge for you to be more helpful on the floor. Is that part of your job duties? Obviously if you wear scrubs it will be easier for you to jump in and be hands on with patient care vs business casual. I guess it would depend on the culture of that place and your job duties. Obviously business casual helps you stand out as management vs staff. It also depends on your own self confidence as we've had some supervisors that wear scrubs and don't mind helping out in a pinch vs others that prefer to wear more formal attire and are more standoffish. They make it clear they are not available to help out in a hands-on way! This is a hospital, but I think the same rules would apply.

I didn't mean for you to quit on the spot, although I found my best job when I did that myself. It was not nursing, but it led me into it as I was doing secretarial work, word processing for an insurance company. When I couldn't please them re speed no matter what I did, long story, I quit and gave my 2 weeks' notice and got a job as an ER admitting clerk. The manager that hired me was really wonderful and kind, a true Christian who prayed for her people back when I was not close to God, but I guess she helped nudge me back. It was my favorite job because it was enjoyable, low key and not stressful. I learned how much nurses did and gained a lot of respect for them though I didn't think I could be a nurse back then. After working 5 years there I went back to school to my dream university and that is where I had the aha moment that I should go back to school for nursing. But while school came easy, clinicals not as much due to my anxiety although I had very nice instructors and friends. Then got the nursing job I stayed with over my career, but it wasn't easy at all. Dealt with a bully out of the gate, an insane LPN who was jealous of new grads RN's just because she wasn't! I persevered thru that and other issues till I finally took early retirement end of 2020. They used to send me job offers in the mail from hospitals, nursing homes and home care etc. I considered them but most didn't come with a pension so that is one of the main reasons I stayed as well as free parking and I was close to work. But the important thing for you is that with this nursing shortage you should have no problem getting another job. Just take your time and find one that you will enjoy. You can always do agency nursing to fill in the gap in the meantime.

Right! The few times I was fired by a patient it was a relief! One time I was perplexed as I didn't know anything was wrong and I thought we had a good interaction. My supervisor understood these things sometimes happened so just put me on another wing the next day.

I think bedside nursing has gotten more difficult ever since administration refused to allow foleys. This was because Medicare refused to pay for adverse events like UTI's. Never mind the added stress and workload on nurses who are more short-staffed than ever, combined with the increased obesity of majority of patients along with multiple chronic illnesses. I'm sorry a purewick is a poor alternative for a foley as they tend to leak if the patient doesn't lay perfectly still or if it is a cheap brand which staff has no control over! I really think the foley free movement is overkill as there are silver antimicrobial foley's available that could be used as well as maintaining good peri care. As to the patient firing you well, I wouldn't take it personally, instead I would look at it as they did you a favor! As others have suggested plan for bathroom needs before Lasix in the future so you aren't rushing to deal with trying to convince a disgruntled patient to use a purewick or trying to find a commode and adequate staff or lift equipment to move them. Your symptoms sound like anxiety which is rife in nursing, especially ER and other high acuity fields. I would consider if a job change to something less stressful would improve your quality of life! You don't have to be a bedside nurse forever! It is not a badge of honor, nor does it make you a better nurse. I would consider finding a job that doesn't leave you feeling so stressed and anxious that you have to call out sick after a bad patient interaction because the truth is there will be plenty of difficult patients and situations in the future. I say this as someone who spent her career as a bedside nurse for almost 30 years in a high stress environment dealing with anxiety and many times dreaded coming in to work. I would take as many low censuses as possible to deal with the stress and take vacations even if staycations to try to have work life balance. The only thing I have to show for it is a small church pension, but now most places don't even offer a pension. I wish I had listened to my heart and quit and found a less stressful and more pleasant job years ago. I took early retirement rather than continue under the unsafe working conditions end of 2020. If things had been decent, I would have stayed. My back was wrecked so I can't stand without pain, so I didn't try to get a clinic job. I've had PT several times since I retired, and a few facet injections and now I just had an ablation which might help with the back pain, but even if it does it is only temporary. Don't let this happen to you! Don't stay where you are unhappy and where you will just end up injured and used up in the end. Your health both physical and mental is precious and a healthy back is vital to work and enjoy life! Don't make my mistake!

That's good that the SSDI and Medicare are approved. With SSDI you are getting the maximum social security payment as if you retired at 67 so I would think twice about going back to work and losing that benefit. Most people can't make it to 67 to get the max benefit, especially in nursing! My mom was fired from her job when she was 59 after she had a knee surgery and couldn't kneel for her job at a nursing home as a housekeeper. Her Dr helped her get disability, but that was many years ago and now the disability process is very difficult as most are denied on the first try. I briefly considered it as I was told I had spinal stenosis from my job as a nurse of almost 30 years, but didn't pursue it as I learned the deck is stacked against a person. I'm living on a small pension that pays my mortgage and my savings and using Obamacare but can't wait till I turn 62 to start my social security and 65 for real Medicare. Two more years to go for SS but taking at 62 they cut it by 30% which sucks! Also am so tired of dealing with insurance hassles and denials and I can't get Medicare till 65 where if you keep original Medicare then what the Dr says goes and the insurance isn't playing God and Dr without a license! I've been denied Tens treatments and lumbar traction and they even tried to deny my colonoscopy 100% free per federal law! Had to fight for months to get them just to pay the $6K colonoscopy it was a nightmare! I finally got an MRI this year after I injured my back gardening and was told I don't actually have spinal stenosis but have foraminal stenosis and spondylolisthesis where my vertebra is slipping on each other and pinching the nerves from arthritis. I've had a few facet injections and just had an ablation that they say will help with the back pain I've had standing and walking. I hope it helps!

Hope you are doing OK and feeling better. Were you able to get Social Security Disability? I've heard that it is very hard to get, and most people are denied the first time and can literally take years to finally get your backpay once you are approved. Hope that wasn't the case in your situation. Then after two years you get Medicare but some states you only can get a MA plan and sometimes, they even charge you as if you are 90 or 100 years old when you take it before 65. Anyway, that's what I've heard. I read you can switch to original Medicare once you are 65 even if you have a MA plan now. Nursing is not the same anymore, so I do think you got out in the nick of time! I retired end of 2020, and they weren't even testing everyone for covid and like you if they weren't tested as Covid + on admit you were caring for them with a simple mask. At the end, when I gave my notice there had been a code and a patient turned out to be covid+ who was never tested and a dozen people had to be on leave and get tested. Obviously before the CDC said it was OK to work with covid. SMH There solution is we were to wear a TB mask with all codes and do CPR that way and I was glad I gave my notice as someone with asthma I felt like I was breathing thru a straw and there was no way I could do CPR in a TB mask anyway! It's been four years now since I took early retirement, and I have no regrets! I'm enjoying my life. Finally able to have weekends and more important holidays off to be with family and friends. Able to put myself and my health first as the job was so stressful I felt it was killing me and I would die of a stroke if I didn't quit! I had uncontrolled HTN on 4 meds and went from 100% stress to virtually none. I've lost over 40 pounds since I quit probably from no longer being stressed and my BP is OK now!

I didn't even think of it that way! I thought of it as all the nurses are paid the same, by visit so your experience wouldn't count. Just looking for a warm nurse body to do the job at the cheapest possible rate like how assembly line factory workers were paid back in the day before minimum wage rules and unions! No way would I take such a job! On top of it all the wear and tear on your car and the cost of cars now and they don't make them like they used to, some brands are known to have major transmission and sometimes engine problems before even 100K! The hours of unpaid documentation after the fact is always a given with home health jobs, but didn't think that this would also include unpaid driving time too. There are just so many bad nursing jobs out there it is a shame. I think home health nurses should have company cars, but what do I know.

The problem is that most hospitals know what needs to be done or what could be done to improve things, but don't care and won't do it if it costs them any extra money! My experience and others with shared governance, part of Magnet hospitals, is that nurses would be interested and invested in improving things, but it would end up being a waste of time and energy when their ideas were discounted in the end. By us the manager and educator even set the tone and decided what would be worked on in the first place which from my understanding is not the way it is supposed to be. I don't know if you are doing this for a school project or for improving your own hospital unit, but this is the reality that I've encountered and others such as travelers who worked at other systems over the years have voiced as well. You appear upset that many of us have mentioned the need for better staffing and pay as you apparently didn't want that mentioned. I'll be honest I guess I didn't read the fine print, but instead of being upset it should tell you how important these issues are to nursing satisfaction and retention. To tell us to ignore two of the most important issues is to discount and disrespect your fellow nurses since these are some of the main problems, but certainly not all. If you are planning on working in the hospital setting as an educator or manager and want to improve things, I truly wish you luck. The problem comes down to the budget, will your hospital allow you to spend the money necessary to do things to improve nursing morale and retention and that is the luck of the draw. A good one will, but there are many bad ones out there and with all the corporate consolidations and takeovers it makes it harder to implement common sense improvements in my opinion. All the ideas you have mentioned sound great, and I hope you have success implementing them where you work!

I'd be curious what happened as she was just using an intimidation tactic and there is no way she could maintain agency nurses in place of staff nurses due to the budget cost! Curious how many of your coworkers stayed and if she is still there. Usually, these things backfire and after enough nurses vote with their feet, the patient staffing is brought back down as even agency or travel nurses have their limits of what they will put up with! Also wonder if the manager is still there. I keep track thru the union and thru linked in. Many times, these troublesome managers or CNO's find their next job harder to find or may even require more travel time or relocation. I admit to having schadenfreude toward these nasty types and enjoy hearing of their downfall as it is inevitable and only a matter of time! For instance, a group of managers including the CNO were bragging about their 400K houses back in the early 2000's around the sole nurse in the Clinical Ladder Committee right before voting to demote a nurse with a 4% pay cut! But karma came a coming as the CNO was fired and sent out of the building by security, crying no less. Then one of the managers took her job, only to be later fired in the same manner, crying as well! Both of them had trouble finding a job after, took over a year and one had to relocate to a rural area. I smiled when I thought of her having to sell her fancy house! They had no compassion or empathy toward the nurse they demoted with a pay cut and she was far from the only one they did this to! Also the nasty manager that tried to fire us during covid who looked and had a mean streak like Cruella de Ville complete with a long streak of silver in her hair ended up having to drive even farther from her house when she finally quit the hospital I worked at. She had to start over at a new system losing her seniority and benefits. She had already been laid off at her prior Ascension hospital and only given the job by us as a favor of being the friend of the CNO and was an L&D/OB nurse and really not qualified to be a Cardiac Manger. Ascension had cleaned house and laid off all our management and educators after they took over our hospital so they would only hire yes people! I felt sorry for the poor nurses who would have to deal with her as she acted like Jeckyl and Hyde, she would start off emails with Jesus and Mother Teresa and they would always end with I will write you up...threats over something or other. Made me feel good she had an even longer commute at least and the people left at my old place were finally rid of her and her nonsense! I had taken early retirement by then. She is one of those people that give Christians a bad name!

Glad you found a new job with better work life balance where you can spend time with your puppy! It will be 4 years since I took early retirement in December and the best thing about it has been the extra time I've been able to spend with our family dog Buster. It is all the more bittersweet now as he has just been diagnosed with lymphoma, a devastating disease. I'm heartbroken, my only consolation is all the time I've had with him for these past 4 years. He just turned 9 this September and has struggled with bad allergies, atopic dermatitis, has been on various immunologics to treat it which sadly increase cancer risk along with his age. Atopica has worked the best, but he developed tumors that needed surgery twice in 4 months, plasmacytomas, a rare coincidence that has been noted with atopica. They were benign but due to recurrence we saw a chemo Dr who started him on melphalan. I swear they used to use that for organ transplants back in the day. Both meds can cause GI side effects nausea, vomiting, diarrhea so I thought his issues were from the meds and I would premedicate with compazine or cerenia. In reality it may have been the lymphoma hiding in plain sight and was discovered after he couldn't eat or stop vomiting 24 hours and an abdominal US found nodules in his spleen. We just got the results that he has Type T lymphoma called "terrible" worse than B called "bad" which is more common and started chemo the UW-Madison Chop protocol. In the interim he was off both meds, discovered he was allergic to chicken a mainstay of his diet and even ice cream so now his diet is restricted. I had assumed he just had environmental allergies all this time. We know roundup is linked to lymphoma and they believe some viruses may cause T-cell lymphoma. It was a shocking diagnosis I had no idea, yes looking back he had been slowly losing weight. Without treatment they say he could die within weeks! With just prednisone maybe live a month or two so CHOP is our best hope along with prayer. I'm spending my time researching medical articles and videos by Dr's and people who have been thru this with their beloved pets. So please say a prayer for Buster if you would, it would be much appreciated. He is beloved by the whole family! He is my baby!

Yes it is very common in healthcare in hospital and office settings. In hospitals it can be more often in ICU or day surgery where census fluctuates more, unless people are able or willing to float. There is usually voluntary low census so depending on the amount of staff it may not be an issue, but the twin problems are short staffing and having vacation requests denied over this followed by unplanned mandatory low census. Some units will even low census staff halfway during the shift and/or put them on call adding insult to injury. For offices staff can find themselves low censused when the Dr's take their vacations. The other issue which is ridiculous is some greedy unethical corporate employers will actually refuse to pay out your PTO when you leave unless it is mandated by the state or city you live in as there is no federal requirement for vacation or sick leave. There are only a handful of cities and states that mandate PTO payout so unless you have a union contract or decent employer they can legally steal your hard earned PTO when you leave. Check your policy handbook and HR as they have to tell you this upfront if they refuse to pay out unused PTO. But use your PTO before you go if you can. Take a staycation, use FMLA if possible or for low census, but don't let them steal your benefits!

You need to leave this hospital for the fact that they won't allow you to use your PTO! This is unacceptable! We deserve and need to take time off for our mental health! Sadly, unlike the rest of the civilized world, American workers are treated like third world citizens denied the basics of vacation, sick pay, healthcare, and paid time family medical leave. I can't even promise you they will pay out your 200 hours of PTO when you leave and that should be criminal, but because there is no federal law requiring vacation etc unlike Europe they can do it and some greedy corporations will pocket all that money and not pay you out even though you weren't allowed to use it! Read your handbook and check with HR, but regardless you need to find another hospital for that alone! The downside of ICU is many hospitals are cheap and feel if a nurse has only 1-2 or now 3 plus patients as they short staff, they don't deserve a CNA and can do the CNA's work too! They don't want to spend the money! That is the obvious opinion and culture of the hospital you are at so that is another reason you need to leave ASAP. When you leave I suggest you look for another type of nursing. If you still want to do ICU try CCU or CVICU for example. In the meantime, I'm surprised you guys aren't using rectal tubes with these patients if they have liquid stool. It would help make your job more bearable in the meantime as there would be less to clean up. It can still leak around the tube, but much less mess than without it. You might also want to consider different nursing options such as working at a surgery center or clinic or homecare. You don't have to stay in the hospital, nor the ICU setting. Avoid another liver unit and ask if they have CNA's, but even if they do you will still probably have to help them with the patients. Hope you are able to find a better job where you are allowed to take your PTO. Hope they reimburse your PTO, but read the policy if it requires two weeks do that and no callouts as they used that excuse to cheat a manic coworker out of her 200 hours of PTO in our unionized hospital after she worked tons of OT during covid! Many hospitals will use any technicality to deny your PTO payout. If you are so depressed and burnt out and find they won't pay out your PTO (they have to put that policy in the handbook), then I suggest taking some FMLA for your psych issues to help burn it down first. You can then take time off to refresh and deal with your mental health. Also, you can start the job search while using your PTO. Just make sure to come back and then give your two-week notice or they can retroactively deny your health insurance for the time you were gone on FMLA. I wish you the best of luck!

Didn't you say you would need to commute 1.5 hours a day when you get your NP for a job? So keep in mind it isn't going to solve all your problems. You know some NP's that are doing remote making $150K and do they have benefits like health insurance? No guarantee you will also get that job at the end but will still have the student loans to pay back. Usually if a hospital is paying tuition you have to stay with them for so many years, but again that doesn't guarantee they will give you an NP job, only if one is available. As to a Roth IRA that is something you do yourself. You and your spouse can each open one say at Fidelity or Vanguard usually need $1-3K to start and the government tells you how much you can set aside each year. I'm retired so don't know what it is up to guessing maybe $6K. Usually advice is start by putting enough into your 403b/401k to the match limit, then fund your IRA, then go back and fund what you can in your 403b/401k. Reason being that you have control over that and can choose better funds than what is usually available in an employer plan. If you have a high deductible health insurance plan you should open an HSA if you don't already have one and sometimes the hospital will add to that. That is your money and you can take it with you when you leave, unlike an FSA where you have to guestimate, and they can keep it if you leave or you can only rollover $500 at the end of the year if you guessed wrong. Really you should learn about personal finance, take a class or read up on it. As to worrying about maxing out your retirement and a future divorce, well most people don't max out their retirement. If you got a divorce, you would probably have to leave the house and lose the childcare so would be able to move then and have more options for better pay. I wouldn't worry about the future. Make the most of the money you have now as a couple by learning about personal finance. It sounds like you have a lot going for you as a house on land given by family and free or low-cost childcare thru family! So instead of worrying about maxing out your retirement and making the most money possible, appreciate what you have and find ways to stretch your money and that's where knowledge is power. Most were never taught about money and so pay more than they should for everything. Going back to school could make you more money in the long term, but if you end up having to pay for your own health insurance as some NP's find themselves in you might not be happy. And grad school student loans, the interest rates are higher and starts capitalizing immediately there is no grace period, no bankruptcy options for student loans if you get sick, unemployed or things don't work out. Student loan debt is the worst debt out there. NP's usually work long hours on salary. You have a lot to consider. Especially since you want to enjoy your time with your children now while they are young.

Happy for you that you made good money, received bonuses and volunteered for OT. That is the way it should be. I'm all for that! I was happy for the travelers I worked with and glad to have them. But not everyone had fair pay, voluntary OT with bonuses some were forced with mandatory OT and floating. Some were denied hazard pay and raises and there was even a CNO of one hospital that had an attitude when called out about the lack of raises how dare they complain. My hospital got a 2.4% raise only because we were union the rest of the national system did not so they lost staff as they should. Plus many nurses quit for travel jobs for more money. People have bills and if they can travel and want to why not! The hospitals don't put us first so put yourself first! I've mentioned before a coworker of mine worked tons of OT during and after covid only to have a mental health crisis and take early retirement, call in sick and they used that to deny her 200 hr PTO! I believe this same system will take your PTO when you leave or are let go unless a state/city law prevents them. So once again I say use your PTO, even if to just take a staycation to relieve stress or look for a better job! Don't let them steal your PTO! Nursing pays a living wage. Many people are trying to become nurses because there are so few jobs out there now that pay a decent wage. Plus the few that do tend to also have constant layoffs! There are nurses on here who were engineers and teachers who after being laid off went back to school for nursing because they knew it was a more steady income. But lo and behold nurses were laid off during covid and are being laid off now! It is a common practice in non-union places to get rid of the older workers and then rehire new grads for half the pay! So even if you are a nurse you still need to plan for the possibility of losing your job or becoming sick or injured from the job. So build up an ER savings. I advocate a Roth IRA as you can take the contributions out in an emergency. Also an HSA if you have a high deductible health insurance plan.