What’s the point of purpose?

We need a wider understanding of our purpose – grand or small.

Emerson Csorba

Emerson writes on geopolitics. He is also a business executive and holds a doctorate in theology.

A white arrow on tarmac points towards a setting sun and people walking by a silhouetted lamp post.

Chris Loh on Unsplash.

In his 2009 book Start With Why, the leadership speaker and consultant Simon Sinek encourages leaders and businesses to think about their purpose. He encourages them to answer the question ‘Why?’ before moving to ‘How?’ Sinek’s book is part of an industry, with no shortage of self-help books, executive coaches and university programmes assisting individuals in finding purpose. Surely Sinek is right that a sense of mission (the ‘Why?’) needs to come before the development of a strategy (the ‘How?’ as well as ‘Who?’ ‘What?’ ‘When?’ and ‘Where?’). Yet working out our purpose is not easy. It takes time, effort, listening and crucially, an open mind.

In a ‘purpose economy’ (to use the term coined by writer Aaron Hurst), we risk arriving at fast, superficial, or inflated purposes disconnected from the unique vocations to which we are actually called. Several years ago, I undertook a project, of which elements were shared in the Harvard Business Review. One interviewee stated ‘We are a generation that is ruthlessly comparing ourselves with those around us and our role models at the same time. And if we are not doing something exceptional or don’t feel important and fulfilled for what we are doing, we have a hard time.’ In an age dominated by social media and its emphasis on presentation of superficial images inviting us to compare ourselves with others, these are words worth dwelling on.

This reflection struck me at the time, implying that many people believe that their purposes must be significant. Without grand purposes, we tend to struggle. That interviewee was right. Many of us value purposes involving high levels of excellence if not notoriety, whether pursuing elected political office, climbing the ranks in prestigious industries such as finance or consulting, or entering professions that are well-known and whose value can be readily explained to others (such as medicine, law or accounting).

The problem with an idea of purpose focused on excellence is that only some people will be seen to have worthy purposes. The consequence is more ‘ruthless comparison, in which we all look over our shoulders to what our peers are doing, wondering whether their respective purposes measure up or not. Of course, this issue could be dismissed as little more than a case of early-career angst, in which ambitious self-starters seek to outdo their peers in climbing the career ladder, but I doubt this is a good explanation.

Her calling is not as impressive in the world as the more publicly recognised calling of a profession, but surely the calling is of equal value.

After all, modern workplaces are full of people, across all generations, searching for purpose. More generally, rapid industrial transition over recent decades – whether the loss of the shipbuilding or coal mines (not to mention important parts of the steel industry in recent months) in the UK, or the recent loss of manufacturing jobs in the United States – and waves of technological change leave countless thousands of people feeling lost at sea. A sense of aimlessness is amplified when personal dignity is connected to work rooted in local communities. When this industrial work vanishes seemingly overnight amid shifts in government policy and technological change.

These examples suggest the need for a wider understanding of purpose, which makes room for many kinds of excellence, whether grand or small. Consider the example of a single mother. In comparison to the high-flying politician, business executive or university administrator, her purpose is anonymous. A paid job in the workplace is unlikely to be the source of the single mum’s purpose. Rather, the raising of a family is almost certainly the driving purpose in her life, a purpose which is nevertheless no less significant than those occupying more esteemed, high-status roles.

In the eyes of God, the single parent is called to the vocation of parent (I don’t think there is a difference here between a vocation or purpose), possibly through an unexpected event such as a divorce or passing of a spouse. Her calling is not as impressive in the world as the more publicly recognised calling of a profession, but surely the calling is of equal value. Indeed, from a Christian perspective, the lone parent fulfills a vital role of service in raising children who can help to approximate the Kingdom of God on Earth. Martin Luther pointed it out well: every person has a divine calling providing them with purpose, whether they are aware of this or not.

The idea is that a sense of what we are becoming matters more than the circumstances we find ourselves in.

How then can we define our purpose when elements of culture, technology and other forces tempt us to identify clear purposes as rapidly as possible? To start, it helps to resist the urge to form large and lengthy purposes. Our purposes are often revealed gradually. Even the most profound events altering the landscape of a person’s life must be digested slowly. Tom Wright, in his biography of Saint Paul, writes that after Paul’s encounter with Jesus while on the Road to Damascus, he returned to Tarsus for ten years to meditate on what he had learned. In all likelihood, Paul spent this time working as a tentmaker, working within a ‘small, cramped workshop,’ in which ‘he prayed, he studied, and he figured out all sorts of things.’

It is only ‘by the end of the Tarsus decade [that] Saul had worked out in considerable detail what it meant that the One God had revealed himself in and as the crucified and risen Jesus.’ Paul’s purpose was formed over many years, ‘hammering away’ at what he learned on the Road to Damascus. Had Paul wanted to make sense of his encounter with Jesus in a single go, then his purpose would surely have been truncated, thereby limiting the fulfilment of his unique calling that transformed the world we live in today.

Our circumstances may also limit the scope of our purposes. Our family, geography, gender, and socioeconomic situation all shape the people we become – at least in the short-term. The philosopher Robert Adams writes in Finite and Infinite Goods that ‘One’s actual circumstances condition and in various ways influence and limit one’s vocation. The vocation, however, is not the circumstances, but what one is called to do in them.’

The idea is that a sense of what we are becoming matters more than the circumstances we find ourselves in. The question of who we wish to become is a crucial one, involving personal vision, and Adams sees this question as outweighing extensive consideration given to existing circumstances. Another idea of vocation, proposed by the theologian Oliver O’Donovan, is more gradual. He says that we come to be a certain person over time, without too much planning. Our purposes develop one day at a time. Specific events give us chances to put our purposes into action, but we do not know when these events will occur.

With this approach, clear purposes are formed over time through constant practice, rather than revealed at the outset of an activity.

How then can we find our purposes when they are often ambiguous, intertwined with our personal circumstances, and without too much recourse to self-help books, life coaches or university programmes recommending quick answers?

Our purposes need to be worked out through consistent, small-scale practice of the things we enjoy. For some, this is the playing of a musical instrument, for instance the piano or guitar, two hours per day. For others, this is the constant practice of a given sport in the early hours of the morning. And for others, this is working away on a tricky mathematical problem that simply grips them.

With this approach, clear purposes are formed over time through constant practice, rather than revealed at the outset of an activity. It is then unexpected events – as Harold MacMillan said ‘Events, dear boy, events’ – which shape us. These events may change us, setting us in entirely new directions much like Paul’s encounter on the Damascus Road, or the lone parent following a divorce or death of a spouse. But it is not only the events that create purpose. The seeds of purpose are planted well ahead of time, through practice in relation to the things that bring us joy.

Our purposes, then, should be less a cause of anxiety requiring self-help industries – needing to figure everything out at once – than a reason for play, practice, and prayer, listening to the still small voice – perhaps the voice of God, gently leading us to a settled sense of purpose. This allows purposes we never imagined to reveal themselves to us over time, sometimes merging with – and sometimes out of – our circumstances and personal attributes that are more easily visible.

Rather than search for fast answers to our purposes, we can take comfort knowing that we do not need to do all the work ourselves. We may begin to work out our purpose through action, but trust that our purposes will come to fruition when the time is right.

Article

Care

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.