Balancing shiftwork, sleep, and meeting together

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From Luke’s Journal 2022 | Rest | Vol.27 No.1

“Sorry guys. I’m pretty exhausted tonight.” 
These were the words that would regularly come out of my mouth at Bible study.

I was exhausted. Working overtime, after hours, evenings, nights, double shifts, 20 days straight. This was my new life. Not only was I struggling with long hours, but also the new weight of responsibility that comes with transitioning from a care-free medical student to a responsible-for-people’s-lives junior doctor. I had only once before stayed awake a whole night. Now, I not only had to stay awake during the night, but also function in emergency situations as if it was daytime. Driving home safely was a challenge. 

I went to church and Bible study when I could, but I was barely able to serve or contribute in any way. Still, when I wasn’t working, I turned up. Sometimes I fell asleep. Sometimes I had energy. Sometimes I didn’t. Sometimes I was able to concentrate. Often, I couldn’t stop thinking about whether I’d done the right thing for a patient that day. Either way, I was overwhelmed and exhausted and I often didn’t feel up to being there.

This is a typical story for junior doctors, doctors-in-training, and doctors in general. Devotion to our profession is expected and, particularly during training years, demanded. How do we prioritise God when we frequently miss church or fellowship gatherings because of our inflexible and exhausting work schedule?

The medical profession is not alone when it comes to shiftwork.¹ In fact, the Australian Bureau of Statistics reports that 16% of Australian employees work shift work. But how do people do it? How do you work in a job that is so demanding of your time that you feel constantly exhausted and have no mental or physical energy for living out your faith?

Practically, it is wise to develop good habits early if at all possible. In the sleep world we talk about sleep hygiene – creating good sleep habits that encourage restful sleep, and thus more energy during the day.

This is difficult to maintain as a shiftworker, but some things are worth considering:

Maintain a good sleep environment. Invest in blockout blinds, good quality well-fitting earplugs, an eyemask. Consider temperature control. Put the dog out.

Minimise screen-time before sleep. Light on the back of the retina provides a negative feedback loop to the production of melatonin, a hormone that drives sleep. Phones with blue light filters are not adequate if you are struggling to initiate sleep. Read a book (not online), or listen to a podcast. Don’t have a TV in your bedroom or watch Netflix on your laptop in bed. People often use screens as a distraction particularly when you have significant stressors during the day. Whilst it may help distract you from trying to remember if you prescribed the right warfarin dose for your patient, the light from the screens and constant flickering subconsciously wakes your brain up. This leads to difficulty initiating and maintaining sleep.

Maximise light exposure at the appropriate time. Good light exposure on waking helps keep melatonin levels at bay and increase alertness. If you are doing an evening shift, go for a brief walk in the sun before you start your shift. If you are coming home from a night shift, don your aviator sunglasses as you walk out of the hospital and drive straight home, minimising bright light exposure before your day-sleep.

Avoid caffeine close to bedtime. As a junior doctor you may have become addicted to the glorious smell and taste of coffee, even believing yourself to have developed tolerance to its alerting effects. But this is best avoided prior to sleep.

Don’t exercise too close to bedtime. You may want to keep up with your buddies on Strava, but exercise at an appropriate time, for example before your shift, or at least 1-2 hours before going to bed. Exercise wakes the body up.

Become a creature of habit. When not doing irregular shifts, go to bed at the same time and get up at the same time. If you are on a run of nights or evenings, habits can still be maintained that are appropriate for those shifts: go home, eat, read, shower, sleep. Turn your phone off whilst asleep, if possible. At least put it on silent to minimise waking from those frustrating scammers with seemingly normal phone numbers; or even just your mum checking to see if you have slept well today!

See your doctor if you are struggling with sleep and/or shiftwork. Check in with your local general practitioner, who has been there before and can exclude pathological causes, as well as access appropriate aids.

And how do you live out your faith when you are too busy and exhausted?
Consider factors that you cannot control and factors that you can. 

Things you might struggle to control may include your roster and your overtime, particularly when you are on a training program. Talk to your colleagues about how they manage, what they have put in place to be able to make it to regular church events and serve at church. If you are a trainee, consider what the job looks like at the end of all that training and how you might be able to prioritise Jesus in your life.

“Talk to your colleagues about how they manage, what they have put in place to be able to make it to regular church events and serve at church.”

My husband has been a shiftworker in an emergency department for eleven years. It is only now, after completing his training, that he has had the ability to take a regular weekday off work. This allows him to spend quality time with our youngest daughter who is not yet at school, and attend Bible study each week. He has always attended where possible before, however now he not only attends regularly, but also leads and encourages his brothers in Christ. Similarly, I have arranged my work so that I don’t work a full week – I usually have Tuesdays off and that has allowed me to lead a women’s Bible study group for the last couple of years. This wasn’t possible during training time, but now I can attend regularly and also commit to leadership. 

One factor that you may be able to control is turning up to church or Bible study when you are not rostered on shift. 

“And let us consider how we may spur one another on toward love and good deeds,not giving up meeting together, as some are in the habit of doing, but encouraging one another—and all the more as you see the Day approaching.” (Hebrews 10:24-25). 

Whilst you may not feel your best, it is encouraging for others when you turn up. By being there you too will be reminded of and encouraged by God’s love, peace and hope.

It might feel like you don’t have time for church or Bible study, or that you can’t commit due to unpredictable hours or study demands. However, not turning up means you miss out on the
encouragement from your fellow brothers and sisters to stay strong in your faith. With all the other stress of life around you, you need all the support you can get. Going to church in itself does not bring salvation, but God knows we need fellowship and mutual encouragement to help keep our faith strong. Do not be like the seed that “fell among thorns, which grew up and choked the plants” (Matthew 13:7), but continue to be part of Jesus’ body who, being “joined and held together by every supporting ligament, grows and builds itself up in love, as each part does its work.” (Ephesians 4:16)

“With all the other stress of life around you, you need all the support you can get.”

Finally, with all I’ve said, remember God’s grace. It may feel like you have been drawn away for a time by the world around you. Maybe you feel lost and struggle to get to church on Sunday or your Bible study group. Attendance doesn’t make you a Christian or guarantee your salvation. Rather, I encourage you to attend to build your knowledge of and love for God through the teaching of God’s Word and through mutual encouragement with your Christian brothers and sisters.

If you’re struggling to attend for whatever reason, turn to God, who listens to our prayers. Always remember His character: 

“The LORD, the LORD, the compassionate and gracious God, slow to anger, abounding in love and faithfulness.” (Exodus 34:6) 

Despite the shifts, the stress, and the exhaustion, God is still always faithful and offers peace, love, joy and a hope that lasts for eternity (without shiftwork!!).

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