At 5:12am, the alarm goes off. The kettle clicks on. A lunchbox is packed, checked, then opened again because one more thing needs changing. A small hand appears at the edge of the table, as if the child has woken mid-dream and is checking whether the world is still there. The nurse, (we’ll use Renee as her name), does not sit down. Sitting down is how you lose minutes. Minutes are what she cannot afford.
Her roster says she starts at seven. Her childcare opens at seven. And anyone who has ever worked in a hospital knows that “start at seven” is a polite fiction. You start earlier. You arrive early enough to be presentable. There is the hunt for a park, then the walk from the staff car park that was never built for today’s staffing levels. By the time you swipe in and take handover with the kind of attention that prevents mistakes, the shift has already started in everything but name.
Hospitals run on momentum. They run on the accumulated moral pressure of things that cannot wait. Someone cannot breathe. Someone is losing blood. A family is crying in the corridor. An IV pump will not behave. And beneath all of it sits the steady, unglamorous truth that bodies, if not cared for, deteriorate. Childcare runs on the minute hand.
At 6:02, Renee texts the first person on her list. Then another. Then another.
“Any chance you can do drop-off?” The replies come back with the weary intimacy of modern family life. Sorry. Can’t. In a meeting. School run. Not today. Maybe next week. Eventually a neighbour agrees, again, because the neighbour is kind, and because the neighbour knows what it is to be trapped in a timetable you didn’t choose.
Renee exhales – it is the feeling of getting away with something that should not require getting away with anything. This is common. It is built into the design, not into some private failure of planning or resilience, and not into a woman’s supposed need to “lean in” harder.
We built a childcare system that mostly assumes ordinary business hours, and then we built a wider care workforce that runs twenty-four hours a day. We then act surprised when the people who keep the country alive cannot reliably find someone to mind their children while they do it. Renee has tried most of these fixes. She has become an expert in workaround. Workarounds are the hidden curriculum of Australian family life – a system of favours and constant negotiation, with quiet shame never far away, all sitting beneath the official architecture of “choice” and “flexibility”.
A roster arrives with short notice. A child gets sick. Someone must leave work. A manager rolls their eyes. The worker is marked, subtly, as unreliable. A daycare sends a message – staffing shortage, we are closing early today, please collect by 4pm. A shift ends at 3:30pm, but a patient deteriorates at 3:20pm and your colleague is in tears, and you don’t leave. You don’t leave because you are a nurse, and because the thing you still believe, deep down, is that abandoning people is worse than abandoning yourself. But then there is pickup time. There is always pickup time.
A childcare educator, already exhausted and underpaid, waits at the door with your child while trying to hold impossible ratios together. There is a polite smile that doesn’t quite conceal the policy. Late fees. Warnings. The sense, in the pit of your stomach, that you are failing some basic test of adulthood. When the nurse tries to explain, she often finds herself speaking a language that sounds like excuses. The system trains her into apology. And because she is competent, she makes it work, until she doesn’t.
We sometimes talk about shift work as though it were a quirky personal preference, or even a kind of lifestyle choice. But shift work is, for many people, the condition of having a job that society depends on. NSW WorkCover’s guide on shift work notes that research shows “significant health and safety issues” associated with it.
If shift work already strains the human body and mind, then combining it with unreliable childcare is corrosive. It raises the risk of mistakes and burnout, and it pushes people out of the workforce. That matters for everyone who will someday need a hospital bed or some other form of urgent care.
ABC Radio Melbourne once told it through the voice of a nurse and mother, Clare Stirling, whose standard shifts start at 7:00am, 1:00pm, or 9:30pm, and who described childcare options as almost impossible to align with those hours.
Those start times are the skeleton of hospital staffing. They mark handover, and they mark the point where the ward flips. After a while your body learns to dread them. Try mapping them onto the standard hours of most centre-based care. The problem hardens if you have more than one child. It hardens again if you are single, or if your family lives interstate. It hardens if your partner is also a shift worker, or if you live in a suburb where places are scarce.
You begin to see what Renee sees.
There is an option, in theory, for families who can’t access ordinary care – the Commonwealth’s In Home Care (IHC) program. The Department of Education describes IHC as for families shut out of other approved care, often because they work unusual hours or because their circumstances make standard options unrealistic. On paper, that sounds like Renee. In practice, it often feels like proving your desperation in triplicate.
The ABC story notes that this in-home program was introduced as a small scheme and was capped at 3,200 places, providing up to 100 hours of subsidised care per child per fortnight, and that barriers like cost and eligibility criteria can make it inaccessible for many.
Even when families do qualify, the labour market reality remains – you still need a real person to show up where you live, at the right hours, and do the work safely. Subsidy alone does not conjure a workforce out of thin air. When nurses talk honestly to each other about childcare, the mythical figure is always roughly the same: someone who can cover overnight care, or weekends, or both.
Family Day Care (FDC) is often more flexible than long day care, because it can be delivered from educators’ homes and often outside standard hours, with smaller groups. A submission to the ACCC’s childcare inquiry highlights this flexibility. It reports that 88.2% of family day care services offer care on weekdays before 7am or after 6pm. It also says 85.5% offer weekend care, while 47.5% offer overnight care; in that submission’s comparison, long day care offered no overnight care at all.
That sounds like the answer, until you confront the second truth – flexibility is not evenly distributed. Renee lives in an area where some family day care educators are already full, while others cannot do those hours. A few once offered overnight or late sessions, then stopped because it flattened their family life.
This matters morally. We cannot solve a public system failure by quietly demanding that individual educators become endlessly available. That simply moves the pressure from nurses to early childhood workers, another feminised workforce already stretched thin.
Australia’s early childhood education sector itself is under strain.
In 2024, ABC News reported on a workforce study finding that Australia’s early childhood education sector needed 21,000 more qualified professionals to meet sustainable staffing levels.
So, when we ask childcare to “just extend hours,” we are asking a workforce that is already short-staffed to do more with less. That is a recipe for more closures and more burnout, with quality slowly giving way. This is why the nurse’s problem and the educator’s problem are two ends of the same rope.
Even if you work ordinary hours, childcare is not equally available. Key findings from Victoria University’s Mitchell Institute report that almost 24% of Australians live in childcare “deserts” where there are more than three children vying for every childcare spot, and that 700,000 Australians live with no access to childcare.
Now add shift work on top of that.
If you live in an area where places are scarce, you negotiate for anything at all. You take the place you can get. Then you contort your life around it and try not to think about how fragile the arrangement is. You are grateful to have it. You are also waiting for it to collapse under the strain of staffing shortages.
Renee is morally exhausted. Moral exhaustion is what happens when your values pull in directions that cannot be reconciled. You want to be present for your children. You want to be safe for your patients and solid for your colleagues. The system makes it impossible to do all of that at once. You begin to feel like you are failing everywhere.
You leave your child crying at drop-off because you must make handover.
You leave your colleagues short because there is no one else to collect the kids.
And over time, something hard happens – you stop seeing these as political problems and start seeing them as personal flaws.
When enough nurses do this long enough, the hospital begins to bleed experience. The ABC story about shift workers notes that many colleagues, particularly single parents, end up leaving the hospital system because shift work with young children is “unmanageable,” and that this can mean experienced nurses leaving.
The Productivity Commission’s inquiry into ECEC examined the barriers of cost and availability and set out reforms aimed at widening access, improving affordability and quality, and moving over time toward a more universal system. https://www.pc.gov.au/inquiries-and-research/childhood/
But there is a specific question we keep skirting because it forces us to admit something uncomfortable – Do we want a society that runs 24/7, while parenting infrastructure runs 9–5? If the answer is no, and if we are serious about making paid work and family life fit together, and serious too about keeping hospitals staffed, then we need to stop treating “flexible care” as an afterthought. Not every family wants, or should need, care at midnight. The point is to build options for the families whose labour keeps essential services running.
One route would be co-located childcare near hospitals and major care hubs, designed around shift patterns rather than office hours. Another would be a simpler in-home care pathway for genuine shift-work needs, with less “prove there is no other care” bureaucracy and better support for actually matching carers to families. Flexible models such as family day care also need targeted support, because they already provide more non-standard-hours care than long day care but remain unevenly available. And some of the burden sits inside hospitals themselves: longer notice periods, fewer last-minute swaps, and more predictable rostering would matter, because even the best childcare system cannot respond to chaos.
And beneath all of this sits a deeper shift – treat childcare as care infrastructure. Treat it as one of the basic systems that lets ordinary life function.
At 6:41am, Renee walks into the ward. She smiles the smile you learn in nursing – calm and capable, with just enough cheerfulness to promise your colleagues that you are not going to collapse today. No one sees the morning she has already lived. That invisibility is part of how the problem persists. It is spoken about in break rooms. It is solved with grandparents or neighbours, usually threaded through with guilt.
But it doesn’t have to be that way. If we want a country where the people who care for us can also care for their own children without breaking, we need to build a world where a nurse’s roster fits the world.
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Assumption for anything, anywhere is the crux of the problem.
Wouldn’t one answer for hospital and aged care workers for hospitals and aged care facilities to provide on site child care.
And why is this not already provided? Hospitals and aged care facilities cry out for workers, nurses and aged carers need jobs and many of them are women of child bearing age, surely governments have enough information to be able to work this one out.
So often this shortfall is hidden because the family is able to fill gaps. My granddaughter, a nurse and university student with a shift working husband can only manage with the backing of both her mother and mother-in-law. Another family I know is fortunate to have an unemployed member who is able to back up the rest of the family – elderly parent, widowed brother with teenagers, two sisters with small children. He is on call for whatever comes up, which is daily. If he finds a job, the whole family system will collapse.
Such family support masks the gaps in the system, and does not recognise what a delicate balancing act lies behind many workers.