What I’ve Seen as a Nurse and Why It Matters More Than We Think
Updated: May 14
Written by Clifford Cartagena, CEO & Founder
Clifford Cartagena, RN, BSN, is a psychiatric nurse, safety trainer, and founder of Gentleway Systems LLC. Co-founder of Arizona Care Horizon Institute, he is completing his PMHNP degree at Walden University. Author of The Gentle Art of Crisis, he advances trauma-informed, dignified approaches to workplace safety.
In today’s world, mental health has finally become part of everyday conversation. We speak more openly about anxiety, depression, burnout, and emotional well-being. But in my years as a nurse, I’ve come to recognize a powerful and often overlooked contributor to mental distress, something rarely addressed in clinical discussions: Financial stress.
It doesn’t show up clearly in lab results. It’s not always written in progress notes. But it is there, quiet, persistent, and deeply affecting the people we care for.
What I’ve seen at the bedside
As a nurse, I’ve seen moments that go far beyond clinical care. I remember families sitting at the bedside, trying to process a diagnosis, while also quietly asking one another, “How are we going to pay for this?” These are not careless people. These are not families who don’t care. These are individuals already dealing with illness, suddenly overwhelmed by financial uncertainty.
I’ve seen hesitation in decision-making, not because they didn’t want the best care, but because they were unsure if they could afford it. I’ve seen stress compound grief, and uncertainty add weight to already difficult situations. In those moments, the emotional burden is not just medical, it is financial, psychological, and relational.
When tragedy happens and there’s no plan
Outside the hospital, I’ve seen the same reality unfold in my own circle. A friend lost a loved one unexpectedly. There was no preparation. No financial plan. No protection in place. Within days, the family was faced with something they never anticipated: "Funeral expenses. Immediate costs. Bills that did not stop."
They turned to GoFundMe, hoping the community would help carry the burden. People gave. Friends shared. Support came in. But the truth is something many do not talk about: "It was not enough." The support helped, but it did not fully cover the expenses. Now, the family had to grieve while still worrying about finances. Grief alone is heavy. Grief combined with financial stress is overwhelming.
When finances affect relationships
I have seen couples struggle, not because they lacked love, but because of financial pressure. What begins as small conversations like, “Why didn’t we plan for this?” or “What are we going to do now?” can slowly escalate. Over time, these initial worries can turn into blame, frustration, and emotional distance. Money is not just currency, it represents security, responsibility, and the future. When that foundation feels unstable, relationships feel it deeply. Research has consistently shown that financial conflict is one of the strongest predictors of relationship dissatisfaction and divorce.[1] [2]
When bills surpass income, the mind feels it first
Financial strain doesn’t just stay on paper, it permeates the mind. I’ve seen individuals who are medically stable but mentally overwhelmed by financial pressures. Thoughts like, “How will I pay this?” or “What happens if I can’t work?” frequently cross their minds. The constant worry of “What if something else goes wrong?” becomes overwhelming.
This stress takes a toll on several aspects of life. It affects sleep, mood, focus, and even decision-making. Financial distress transforms into mental distress, impacting one's overall well-being.
Financial stability is not about wealth, it’s about readiness
One of the most important lessons I’ve learned is that financial peace is not about having a lot of money. It’s about being prepared. I have witnessed individuals with modest incomes navigate difficult situations with calm and clarity simply because they had some level of planning and structure. On the other hand, individuals with higher incomes often struggle because there is no preparation in place. The difference is not the income. The difference lies in readiness.
Why financial literacy matters
The good news is that you don’t need to become an expert. Financial literacy starts with small, manageable steps. Understanding your income and expenses, creating a basic budget, preparing for emergencies, and learning about financial protection, including insurance, are all essential.
It’s not about knowing everything, it’s about knowing enough to make better decisions. Even taking small steps can create meaningful change and put you on the path to better financial health.
Start with a conversation
One of the most powerful steps anyone can take is often the simplest: starting a conversation. There are professionals who can guide individuals and families through financial challenges. Financial educators, insurance professionals, and financial advisors can provide valuable insights and support.
You don’t have to commit immediately, nor do you need to have all the answers. The key is to be open to learning. Every informed decision reduces uncertainty and uncertainty is what fuels stress.
Mental health and financial health are connected
In healthcare, we often treat mental health and financial health as separate entities. However, they are deeply connected. When finances are unstable, the mind becomes restless. Stress levels increase, and emotional resilience decreases.
Conversely, when finances are managed, the mind becomes calmer, decisions become clearer, and confidence improves. Improving one area often leads to improvement in the other, creating a cycle of positive change.
A perspective from experience
As a nurse, I’ve seen firsthand what happens when people are unprepared. I’ve watched families become overwhelmed after a loss. Couples have been strained by financial pressures, and patients have been burdened by not just illness but uncertainty.
I’ve also witnessed what happens when people are prepared. While there is still grief and challenges, there is also peace, clarity, and dignity.
A simple but important truth
This is not about selling anything or applying pressure. This is about awareness. Financial stress is real. It affects mental health, relationships, and outcomes, but it is something we can improve—step by step.
You don’t need to change everything overnight. You need to begin. Because being unprepared is not something we plan for, it is something we often realize too late.
Disclaimer
This article is provided for educational and awareness purposes only. It is not intended to promote or sell any specific product, service, or business. The goal is to share insights on the relationship between financial well-being and mental health, and to encourage informed, thoughtful conversations.
Read more from Clifford Cartagena
Clifford Cartagena, CEO & Founder
Clifford Cartagena, RN, BSN, is a psychiatric and medical-surgical nurse, hospice provider, safety trainer, and founder of Gentleway Systems LLC. He is also the co-founder of the Arizona Care Horizon Institute. He was authorized by the ADHS (Arizona Department of Health Services) to deliver the Memory Care Services Training in Arizona. Cliff is currently completing his Psychiatric Mental Health Nurse Practitioner (PMHNP) degree at Walden University. He is the author of The Gentle Art of Crisis. With more than 20 years of nursing and leadership experience, he developed the Gentleway System, a trauma-informed approach to preventing and managing assaultive behaviors across healthcare and beyond.
References (APA Style):
[1] Dew, J. (2020). Ten years of marriage and cohabitation research: Financial issues and relationship outcomes. Journal of Family and Economic Issues, 41(3), 451-463.
[2] Falconier, M. K., & Epstein, N. B. (2021). Relationship satisfaction in couples facing financial strain. Journal of Social and Personal Relationships, 38(2), 456-475.
