When I worked at Borders in Downtown Crossing in Boston (remember Borders?!), I was once reprimanded for asking customers if they needed a bag for their purchase rather than giving them one automatically. I explained my reasoning to the manager (lots of people actually don’t— and never thought about it, and would be just as happy not to waste the plastic). He didn’t agree. I didn’t care, though, and I kept doing it. It’s not a grand gesture, or a thought-out action plan, but hey, stick it to the man, right? And so it begins.
On a more significant scale, my badass twin sister is an attorney— and she does things like support the defense of Mexican nationals facing death sentences in the U.S., and defend humanitarians charged with crimes for providing life-saving aid IN THE U.S., jeez. That’s values-based professional work writ large.
And me, now? I’m a nurse. My current work is as an educator (I teach in an APRN program), a nurse practitioner (I provide direct care in a college health center), and a researcher (I’m involved in a project looking at reducing barriers to timely care for people with acute coronary syndrome). I’ve also been an ICU nurse, a primary care provider on a mobile health unit, and a health policy teacher. In every role, there’s been some way that I’ve worked not merely fulfilling a job function (hanging IVs, assessing clinical competencies, writing prescriptions for blood pressure meds). I’ve also worked continuously to promote something I believe in: that health and health care are human rights, and structures that impede the access of marginalized groups to health must be challenged, and sometimes dismantled. Sometimes this work shows up in micro ways, as in directly providing health care services to an undocumented person who does not have other options. Sometimes it’s in a 40,000 foot way, teaching other nurses how to navigate the political system in the role of advocate. I haven’t always had a consistent theory of praxis that guides me along one specific manifestation of my ethical orientation, but it’s something I’ve thought about since I entered the profession (and in fact, it underlies my decision to become a nurse in the first place). In all of my work, though, am engaging in nursing through praxis. When I attend a protest in my lab coat. When I work to build a program expanding access to care in rural settings. When I sit in an exam room with a sexual assault survivor and bear witness. I think I can and should continue to develop an overall theory of impact for my work, but I know that what I am already doing is meaningful to some.
This attention to meaning— or praxis, the continual intersection of action and reflection— isn’t unique to nursing or to education, the field where the concept of praxis was developed and defined by Paolo Freire. Everyone who has a professional life and identity has the opportunity to engage in reflective action rather than functional action alone. At the heart of this approach is understanding why we do what we do.
Plenty of pop business books discuss the mission (objectives and approach) and vision (desired future) of an organization. Some personal development books (like that old chestnut, The Seven Habits of Highly Effective People) also include discussion of personal missions and visions. I suggest that, if you are a professional, you think about developing a professional vision and mission statement. Not for your job, but for your life’s work. Why are you in your field? What do you believe about it, what do you want to accomplish with your work? Developing this personal guidance can be helpful when you face decision points— should I take that job, do I want that promotion, is this project a good fit for me, should I hire this person? Answering questions like these requires a nuanced understanding of what success looks like. For a values-driven professional, success is more than meeting financial goals or career benchmarks. But if you lack clarity on what success looks like when you include values, it’s easy to default to these false and incomplete yardsticks. The outside world will not enact your values for you, you have to do it.
In an example from my own life: I graduated with a dual PhD/DNP, meaning I was prepared for both research and clinical practice. I was evaluating my next move and considered research postdoc positions— but I found that every one I considered wouldn’t leave me time to develop a robust clinical practice. And if I stayed on that road, it would likely be into a tenure-track position that would again rob clinic time to support research and publishing activities. Because my professional mission includes direct clinical service, I was able to evaluate my options with some clarity even when I was hearing a lot of outside advice to focus on research. Remember, the only one who can truly understand and promote your values is you.