What most nurses never think about early in their careers is: "What will I require when I retire?" We usually think about the bottom line in income as we raise our families, buy our first homes, etc. But I am absolutely amazed when I realize how little nurses are compensated in retirement benefits. Yes, today most companies offer 401(k) plans instead of actual retirement benefits and those that do seldom match an employee's own contribution to the plan. As more nurses retire, this benefit becomes crucial.

Because nursing is a predominantly female profession and there usually is a husband who receives retirement benefits, this component has not been seen as such an important factor for nurses. But we now know that anticipated spending in retirement usually is underestimated, and no one can live on Social Security and minimal retirement plans unless there is considerable cost cutting in one's golden years. A calculation of what these expenses might be will easily remind you that you need to consider how you will plan for your future.

I recently met a nurse who spent 20 years with the same hospital and had no retirement benefits. Another much-needed benefit is employee assistance programs to help nurses who develop addiction problems, such as alcohol or drugs, which I believe are occupational hazards for today's nurse.

The stresses of the work environment are so demanding that some nurses seek relief through substance abuse. When this is the case, it is wrong for an employer to do nothing to support these nurses in their rehabilitation. Most states have programs to support nurses who have a problem and help them to return to a work environment. But each employer has a responsibility to participate in caring for the nurse.

I know of nurses who either have been passed off to another employer or simply been discharged with no help or benefits. Why should nurses keep practicing when there is such a lack of support for the nurse who falters? Co-workers usually know when a nurse has a problem, and often no one tells as there is concern that the nurse will lose his or her job, creating further stress and exacerbating the problem.

I have had such nurses on my staff when I was a nurse executive and always made sure there was a support system in place. One of my longtime saved letters is from a nurse who had serious home and financial difficulties and a substance abuse problem. Her fellow staff did not want to aggravate the problem and so did not let me know, but when it became obvious and help was given, all were relieved to know she could return to their unit. We absolutely must have employee assistance programs as part of our benefits.

Other essential benefits to keep a solid workforce should include day care for children and the elderly, as many nurses have care responsibilities for their parents. Safe parking and transportation also are needed, especially in inner-city hospitals or clinics in unsafe neighborhoods.

Sure, sign-on bonuses and salaries may attract nurses, but education benefits, rewards for excellence in clinical practice and salary increases for certification in a specialty area and participation in the improvement of patient care also are important. Pay nurses what they are worth in more than salaries, but with multiple benefits, and nurses will continue to work and know with certainty that they are appreciated, recognized and rewarded.

Discuss this and other topics with your colleagues at www.nurseweek.com/rnvillage.