It is 4 am, and I have been awake for 22 hours. My shift started at 2.30 pm, and the surgeries have not stopped all night. On the drive home, a kangaroo jumps across the road. I hit the brakes and just miss it.
When I finally walk through the door, I realise I have not had a drink of water in hours. I gulp some down and crawl into bed, hoping I will not be called back before my shift officially ends at 8 am.
This is what shift work can look like in a regional hospital.
I have worked as a nurse for 40 years. Rosters have improved since the days when we worked 10 days straight, sometimes finishing late and returning early the next morning. But shift work still wears me down. I have never adapted to night shifts, no matter how hard I have tried.
For rural and regional health workers, the barriers can build on each other. Long and changing hours make it difficult to sleep, eat well, exercise, and attend appointments. Driving home may mean travelling dark roads while exhausted. In a smaller workforce, there can be less flexibility to swap a shift without placing the burden on somebody else.
Ordinary health advice often does not fit. “Eat regular meals”, “exercise after work” and “keep a consistent sleep routine” sound simple, but they can be almost impossible when your working hours change from week to week.
Over time, the effects have added up for me. My weight, blood pressure and blood sugar have all suffered. I have felt burnt out more than once. My social life has also taken a hit because it is hard to commit to sport, volunteering, family events or time with friends when I do not know when I will be working or sleeping.
Shift workers are not always recognised as a priority group in workplace health and safety initiatives, but our work patterns create distinctive health barriers. In rural communities, where health services depend on relatively small teams, supporting the wellbeing of healthcare workers also helps protect the services local people rely on.
That is why I became involved in Healthy Shiftwork (www.healthyshiftwork.com.au), a CQUniversity project developed with shift workers. The aim was not to tell people to try harder. It was to make health advice fit the reality of shiftwork.
The project turned research into practical, freely available resources on sleep, nutrition, physical activity and mental health.
For me, the most useful advice was simple: use caffeine strategically and avoid it too close to planned sleep, drink water regularly, and prepare filling food before a shift.
I now think about when I need to sleep before deciding when to have coffee, carry water with me, and pack a protein-rich snack instead of relying on whatever is available during the shift. The exact approach will differ depending on whether someone works early, late or overnight, but planning around the timing of the shift can make healthier choices much easier. I have also shared the resources with colleagues because many of us were never taught how to protect our health while working these hours.
Rural shift work is essential, but poor health should not be treated as part of the job. Giving workers practical support early can help them build healthier habits, stay connected to their communities and continue doing the work rural Australia depends on.
Note: Grace Vincent, Gabrielle Rigney, Madeline Sprajcer and Charlotte Gupta assisted in writing and editing this article.
It’s 4am, and I’ve been awake for 22 hours. My shift started at 2:30pm and the surgeries haven’t stopped all Read more
Rural mental health professionals face unique challenges – from professional isolation to high caseloads and limited peer support. But innovative Read more
Growing up in rural Queensland instilled in Dr Prue Wallin resilience, compassion, and a deep respect for community—values that shaped Read more
In the Murrumbidgee region, health professionals are doing remarkable work. Across vast distances and complex systems, they deliver person-centred care, Read more