Many of us working in rural and remote health have experienced a particular kind of tired. It’s not just the end-of-shift exhaustion or the aches from a long drive back from an outreach clinic. It’s often a quieter fatigue that settles in; the work that once felt meaningful feels mundane. You know you’re doing a good job, but you can’t quite remember why it used to matter so much to you.
There’s often an unspoken expectation in health work (perhaps especially in rural and remote practice) that you should continuously feel grateful, motivated and even inspired. The expectation that choosing this vocational path, with all its demands, means you’ve signed up for it all, and that devotion shouldn’t waver. This expectation is neither accurate nor fair.
Feeling ‘purpose’ isn’t a permanent emotional state. You can make a distinction between felt purpose, that warm, energised sense of meaning, and held purpose, the commitments and values that remain even when that warm feeling has gone quiet. You can hold a purpose without feeling it every day, and for most people doing difficult work in under-resourced environments, the feeling goes quiet because the work is so demanding. This is not a reflection that something has gone wrong for you; it’s a sign you need rest, recognition or support.
Using your curious beginner’s mind, think back to why you chose health work. Why did you choose to do it in a rural or remote community? Perhaps it was a connection to place or country, or a pull towards communities where the work felt more tangible. It might have been the breadth of clinical work that’s not available in metropolitan settings. For many, it was the quiet conviction that people in these communities deserve excellent health care, and your willingness to be a part of making that happen. Even if those reasons feel distant right now, they haven’t expired. They can serve as an anchor, reminding you of what you already know about yourself.
When our needs, such as safety, autonomy, or adequate rest, go unmet over time, our capacity to access a sense of meaning narrows. Our nervous systems were never designed for sustained pressure. So, if you’re sitting with that inner voice that’s telling you “I should feel more grateful,” or “I used to love this work,” it might be worth asking that voice what you have been carrying lately, and how long it has been since the conditions actually supported you to do this work well.
Something we can do to help ourselves is take some small, low-pressure moments to notice and/or reflect. For example, at the end of your shift or perhaps during that long drive:
- Think of one patient/client or interaction this week. What did you bring to that moment?
- What would feel different about this work if you weren’t so depleted?
- What would you say to someone new to rural or remote work who asked you why this work matters?
It can help to verbalise this experience out loud with someone you trust, such as a colleague, supervisor, a peer support contact, or the Bush Support Line. Something shifts when we acknowledge out loud that we’re finding it difficult to connect with our purpose, rather than carrying this silently.
Brief mindfulness strategies have also been found to be effective in improving health provider wellbeing.¹ Some brief mindfulness strategies you can incorporate into your day to help you reconnect with your purpose and improve your sense of wellbeing include:
- Micro-reflection. At the start of the day or your shift, gently ask yourself, “What is one thing I can offer today?” or “Who might genuinely benefit from me being here?” This reflection should be brief, grounded, and non-demanding.
- Savouring small moments. Mindfulness research supports the practice of consciously pausing after positive micro-moments, such as a patient expressing thanks, a colleague laughing, or a problem well-solved. Stay with these moments for 15-20 seconds after they occur, rather than rushing onto the next thing, as this can help counteract the negativity bias that contributes to burnout.
- Values-based breath anchor. Choose one word that reflects a core value of yours, e.g. care, community, or presence. Pair it with a slow exhale during moments of stress. This is a subtle way of reconnecting with your held purpose in real time when the pressure is on.
- Body check-in. A brief body scan, noticing tension in the jaw, shoulders or chest without trying to fix it, builds your awareness of stress accumulating in your body before it becomes overwhelming. Check in, breathe into that spot, and release any tension where you can.
- End of shift acknowledgement. Undertake a brief closing ritual, mentally noting one thing that was hard, one thing that went ok, and one thing that mattered, no matter how small you may think it is. This practice is about self-awareness and reflection rather than forced gratitude or toxic positivity.
You don’t need to feel inspired every day to undertake meaningful work. For most people, the purpose is doing the work over time, and it isn’t a fire that burns constantly. Think of it like a thread running through the fabric of what you do; sometimes visible, sometimes not.
On difficult days, gently and without pressure, it’s worth asking yourself, “Why did I choose this?” This is not to make you feel guilty, but somewhere in that answer is a truth about who you are and what you value. That doesn’t go away; it just sometimes needs a little quiet to be heard.
Take care,
Dr Nicole Jeffery-Dawes (she/her)
Senior Psychologist, Mental Health & Wellbeing Service
- Gilmartin H, et. al (2017). Brief Mindfulness Practices for Healthcare Providers – A Systematic Literature Review. The American Journal of Medicine, 130 (10), 1219.e1-1219.e17
