How do I handle the tension between patient care and money?

Every day you hold two things that pull against each other: what patients need and what the budget allows. Starting to feel the moral weight of that is not a problem to solve away. It is a sign you are doing the job with your conscience switched on. The weight comes because both sides are real. Care matters, and money matters, because without it there is no care next month. Pretending either one does not count is how people go numb or go broke. Holding the tension honestly, feeling the cost of each tradeoff, is harder than picking a side and ignoring the rest. Let the weight guide you rather than paralyze you. Make each call as clearly and fairly as you can, keep the patient real in your mind, and then accept that no answer will be clean. You are not failing because it is hard. It is hard because it matters. Keep feeling that, and you will keep making these choices like they deserve to be made.