Work isn’t working, it’s killing us

We mistake the nature of work and our purpose within it.

Cameron Wiltshire-Plant

Cameron is training to be a vicar in the city of Leicester.

Two people sit beside each other working on laptops, One looks askance to the other who frowns.

Resume Genius on Unsplash.

What is work for? In our individualist society we perhaps might zoom in on the minutiae of the specific role that we fulfil. Work is for the success of the company I work for, work is for building up my CV, work is to earn money enough to live, work is for seeing people I don’t have to live with. But what about work? The burden that humans have always had to gather enough resources to provide for themselves. We are mistaking the nature of work and our purpose within it, and it is beginning to kill us.

Each of the recent generations have had different, and askew, attitudes to their work. Baby boomers- those who got a job and a sensible haircut in the 60s, conceived work as a contract. They worked well at almost anything and the reward was home ownership, resources to provide for a family, and saving for leisure. The purpose of their work is the lifestyle it creates. To some extent, their successors in Gen X had the same perception and the same contract- stick at any industry and the reward will be generous enough to make the graft worth it.

But what happens when that contract is broken? When work no longer leads to those rewards? The Millennial answer is to seek out work that gives purpose, to accept the reward will not be fulfilling and so to find the purpose in the end of the work itself. Even if that means a lifetime of renting and scrimping, because the reward is not to be found in the payment.

A slow generational drift from the true purpose and boundaries of work has left us confused about its point and struggling to engage.

The Gen Z answer to this broken contract is the most fascinating of all; a reluctance to work at all. There is ‘quiet quitting’ whereby you do as little as possible whilst remaining employed, ‘bare minimum Mondays,’ and, of course, ‘lazy girl jobs.’ The purported aim of this generation is to find jobs where they can work from home, do almost nothing, and still receive a generous salary. Others are living the ‘soft life.’ They move in with mum and dad (usually boomers who have run the rat race and received the benefits of the contract) and do something creative part-time, earning little but doing little. It's a bit of the old baby boomer attitude seeking pleasure outside work but without the corresponding work ethic or career mindset.

On top of this is the mental health crisis, which prevents many of Gen Z from working, with one in three non-graduates out of work with mental health conditions. Bosses receive calls from parents of those in their 20s explaining that their children are too unwell to work.

I suggest that these things are linked, and a slow generational drift from the true purpose and boundaries of work has left us confused about its point and struggling to engage. We must look outside ourselves to understand what work was created for. In Genesis, the Christian origin story, God conceives work as a place of dignity and purpose. What Adam and Eve did in the garden mattered- they were the leaders of creation, and God even gave them the responsibility of naming other creatures. Humans were made to have responsibility, made to express this in their work. Even in the drudgery of repeated physical, administrative, or household tasks, we have the freedom to find purpose. We can take pleasure and pride in making things, fixing things, restoring things, even if just to the state they were in when we cleaned last week.

Find the purpose in the making, fixing, restoring, the very task itself.

The ‘quiet quitting’ of Gen Z or the dry contract of the boomers will not cut it. Even in jobs we don’t like, or tasks we find overwhelming, the same reframing is needed, perhaps even more so. Work itself brings purpose, and that is worth giving our whole selves to, otherwise listlessness and sadness will get us. We were made to find purpose and joy in the task of whatever is in front of us, no matter how simple.

Millennials have swung the pendulum too far in the other direction. Yes, this generation have found the importance of purpose in their work. But only in work that has an end outside of itself. Work has been created with an internal, permanent purpose. Suggesting that meaning only comes from employment with obvious altruistic ends means that any other kind of work, domestic or employed, is devoid of this meaning. The same listlessness ensues in any role not found to have such an end.

St Paul elevates work explicitly even beyond this created place of purpose. In his letter to a church in Colossae, he writes, ‘Whatever you do, work at it with all your heart, as working for the Lord, not for human masters.’ In other words, work is an act of worship, acting as if the task we are completing is for God, and putting the requisite effort in.

Of course, this is a massive challenge. How many of us put as much work in to satisfy our bosses as we would if they were the ultimate director of our eternal destiny? But it does redeem those moments where we wonder what the point of what we’re doing is, who will see it, and if it is really worth doing properly at all. God sees. God knows. And that makes it worth doing properly.

Paul also makes it clear here that work is not just what we get paid for. Work is everything we do that is not rest. Whatever we do - employed, at home, inrelation to our families. And this allows those who cannot work, in an employment sense, to take part in God’s purpose for humanity by working in a way in which they can. Whether it’s caring for a relative, nurturing a tiny veg patch, creating a piece of art, or hoovering the carpet. Find the purpose in the making, fixing, restoring, the very task itself. Do it as if God were watching. And feel yourself become more human.

Article

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.