The growing need for financial literacy in nursing to connect the bedside to the boardroom
One of the most important leadership lessons I’ve learned didn’t happen in graduate school or at a patient’s bedside. It happened during what I thought would be a routine meeting.
As a doctor of nursing practice (DNP) program director, I met with leaders from a local health system to discuss expanding our partnership. My goal was to create additional clinical placements for our graduate nursing students while developing a stronger pathway for the organization to recruit our graduates into practice. I wasn’t simply asking for more clinical placements. I was asking us to rethink the relationship between academia and practice.
As nurses, we believe in building a continuum of care. We recognize when patients need additional services and connect them with the right resources. I viewed this partnership the same way. Universities prepare highly qualified clinicians, and health systems need well-prepared nurse practitioners and nurse leaders. Together, we could create a seamless transition from education to practice that would benefit students, healthcare organizations, and ultimately patients.
I came prepared with what I believed was a compelling argument. I described workforce shortages, the demand for advanced practice providers, and the opportunity to recruit graduates who already understood the organization’s culture. I believed investing in education–practice partnerships was a long-term workforce strategy that could improve retention and reduce recruitment costs.
The administrator listened thoughtfully before responding with a statement I wasn’t expecting, “We lose money on all of our family nurse practitioners.”
The conversation ended there. Although disappointed, I was curious. I wondered whether the organization measured productivity differently than I understood or whether there was financial data I hadn’t considered. More importantly, I realized I didn’t know enough to ask the right follow-up questions.
The comment was specifically about family nurse practitioners, but I realized the larger issue extended far beyond one specialty. I had framed my proposal around workforce development and educational outcomes. The administrator was evaluating it through a financial lens.
We were speaking different languages.
That meeting changed me. It wasn’t that I lacked evidence or passion. I lacked the financial vocabulary to connect my ideas to the organization’s priorities. That realization led me to pursue a master of business administration (MBA). Not because I’m leaving nursing, but because I want to become a better nurse leader.
Throughout my career as a clinician, educator, researcher, and program director, I’ve focused on bridging gaps between evidence and practice, students and clinical settings. I realized there was one more gap I needed to bridge: nursing and business.
Evidence tells us what we should do. Financial literacy often determines whether we’re able to do it.
Speaking the language of business
The American Association of Colleges of Nursing (AACN) notes that healthcare organizations are driven by a commitment to patient care, but they also must navigate budgets, reimbursement, workforce challenges, and long-term sustainability. As healthcare evolves, nurse leaders are increasingly expected to understand both clinical and financial decision-making.
For years, I assumed good evidence would naturally lead to good decisions. Experience taught me otherwise. Today, I see financial literacy as another form of advocacy.
Advocacy has always been central to nursing. We advocate for patients, families, safer workplaces, and evidence-based care. Increasingly, we also must advocate in conference rooms and boardrooms. That means explaining not only why an initiative improves care, but also why it makes financial sense. National leadership competencies, according to the American Organization for Nursing Leadership, now recognize financial management and business skills as essential for nurse leaders.
Financial literacy doesn’t replace compassion. It strengthens it.
Preparing the next generation
As educators, we do an excellent job teaching evidence-based practice, quality improvement, leadership, and research. Perhaps we also should teach students the financial realities that determine whether innovative ideas are implemented and sustained.
Nurses don’t need to become accountants, but they do need to understand how financial decisions influence staffing, quality, workforce stability, and innovation. That need has never been greater. According to AACN, nursing programs continue to face faculty shortages while thousands of qualified applicants are turned away each year, reinforcing the importance of developing leaders who can advocate for both clinical excellence and sustainable investments in the nursing workforce. My MBA won’t change who I am as a nurse. It will make me a more effective advocate.
The lesson I learned wasn’t that nursing should become more like business. It was that nurse leaders must learn to speak the language of business if we want our evidence, ideas, and advocacy to translate into lasting change. Some of the most important conversations about patient care don’t happen at the bedside. They happen where budgets are built, priorities are set, and resources are allocated.
Nurses deserve a seat at those tables.
When we can speak with confidence about both clinical outcomes and financial stewardship, we’re no longer simply asking organizations to do the right thing; we’re also demonstrating why doing the right thing is a wise investment.
I often think back to that meeting. What I believed was a failed partnership became one of the most important leadership lessons of my career. If nurses want to shape the future of healthcare, we must be fluent in two languages: the language of compassionate care and the language of sustainable change.
Our patients deserve leaders who can speak both.
References
American Association of Colleges of Nursing. The Essentials: Core Competencies for Professional Nursing Education. 2021. aacnnursing.org/essentials
American Association of Colleges of Nursing. Nursing shortage fact sheet. May 2024. https://www.aacnnursing.org/news-data/fact-sheets/nursing-shortage
American Organization for Nursing Leadership. AONL nurse leader competencies. https://www.aonl.org/resources/nurse-leader-competencies
