You Don't Have to Start in Med-Surg as a new Grad nurse

In reflecting on my career, I'm reminded of something I heard a lot of as a student: start in Med-Surg. I got lots of reasons. In hindsight, It would've been better to do the thinking myself regarding what I wanted instead of listening to those telling me how it is supposed to go.  Do You Have to start in Med-Surg as a new graduate nurse? No. That is my opinion after working in different specialties of nursing. It is not a bad idea to start in medical-surgical nursing but it is not a requirement or an absolute necessity. If you get the opportunity to work in a specialty you would like to end up in, please go ahead and take that opportunity. Your body will thank you later.  When I was graduating from college, a professor I admired told me to start in med-surg. And back then, it wasn't uncommon to here people say "start in med/surg". One of the reasons I sort of recall was so you can learn the basics of nursing and what not. Another rationale was that because you ar...
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Open Enrollment: What to do with your Flexible Spending Account or FSA

  Yesterday, I discussed what to do at open enrollment in terms of your health plan. But your health plan isn't the only  thing available to change during open enrollment: your FSA election needs to be made. Even if you are not making any changes to your health plan, you still need to log in and elect how much you want deducted for your Flexible Spending Account or FSA. If you elected $600 last year and don't log in this year because you are not making any changes to your health plan, you will have $0 in your FSA account next year. This money doesn't just appear in your account; you have to make the election yearly. This is a good thing because you can adjust it as needed. For example, if you are going to have a baby and anticipate paying more for doctors visits, you can increase your election. 

If you are anticipating having a major surgery or procedure done, you can elect accordingly. For example, if you want to get LASIK, you can make the full election accordingly. If you are thinking of getting braces, that's something to keep in mind as well. If you have an elective procedure scheduled for December 27, and are out of funds, why not wait until the new year and pay with tax-exempt dollars? 

This is also a time to do some planning if needed. If you know you are going to resign in February, plan accordingly with your election. Keep in mind that your full FSA election is available for use at the beginning of January😉. Maybe you can take the opportunity to buy certain needed supplies - Stethoscope, AED, sanitary pads, OTC drugs and other eligible items. This goes for those who are retiring also. 


The FSA can help with Tax Planning

In some cases, the FSA can help with tax planning. If you anticipate your taxable income to be at the threshold that limits your tax deductible contribution to a traditional IRA, you can divert a little bit more into your FSA and so have the opportunity to contribute to the traditional IRA. The good news is that the threshold has gone up significantly. I recall two years ago when the threshold was about 68k and  and limited the deduction I could take. For 2024, a single person can take the full deduction is $77,000, you can take the full deduction. You can't take it if it's over $87,000. Keep in mind you can take a partial deduction if you fall within these numbers. Either way, the FSA can help.

Another tax planning example with the FSA is the extra medicare tax of 0.9% for single people making over $200,000 and married filing jointly over $250,000. If electing an extra $1000 will save you $1,800 in extra taxes because of how much you make, that's not a bad alternative. Considering you can use your FSA money to pay for a wide range of things. The money you elect into your FSA isn't taxed. So if you elect $3000 and you are in the 22% tax bracket, that's a savings of $660. And if you are in the 32% tax bracket, that's even bigger savings of about $960. That's almost $1000 of tax savings!

I recall a coworker who elected less because she didn't use the funds one time and lost it. Yet, she was having a baby. There are so many baby items you can buy with FSA dollars, it's not worth letting a past experience control the present. You can even buy Prenatal Vitamins with your FSA funds. Children are an added expense, why not use the opportunity to save money on your baby expenditures. 

The bottom line is that you are in charge of your FSA; save wisely!

The FIRE'd Nurse.


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