On the brain injury unit at a rehabilitation hospital where I work, our focus is behavioral, cognitive, and physical rehabilitation for those with traumatic brain injuries. It’s not glamorous or romantic work. Many patients are just out of comas—they’re confused, sometimes aggressive, cognitively impaired to various degrees and almost always physically impaired. Much of my work focuses on meeting their physical needs.
One evening, I was with an elderly woman who’d just been incontinent. We were in her bathroom, where, with my assistance, she held onto the wall bars after standing from her wheelchair. My attention was two-fold—keeping her from falling and cleaning her body. I listened to her ramble from one uncompleted thought to the next when I caught the words, toilet nurse. I asked what she meant.
She said, “You’re always bringing me in here and cleaning me.” It was pretty lucid and aptly explains what I do. She went on, “Is there a reward for this?”
“No, I don't think so,” I said. “Well, there should be,” she declared. Ever since, remembering her sweet spirit, I’ve thought of myself as the toilet nurse. It isn't a title I often share, but I find it rewarding and humbling. It makes me I smile.
I work with people whose lives, along with those of families and friends, have been changed in a moment by a medical condition or a horrible accident. Their experiences, their courage, their suffering, and their successes affect me. I know bad things happen to good people. I see tragedies in my life and on a global scale. But after my shift, I sit in my car and pound the steering wheel, crying and yelling at God. “Where, in all of this, is your mercy and your compassion?” “How can you do this?” “How can you let this happen?”
I see a college student brain-injured for life by a car accident, perhaps a paraplegic or a quadriplegic. I see the pain of those who love him. I see his despair, if and when he awakens and orients, realizing what he’s lost. Some days it’s too much for me, and I sit in my car and scream at God and cry.
Then I drive home, sit in a quiet place and pray, prostrating myself before my God because I don’t understand—I may never understand. And yet, I remember there is God, and he’s holy and in control. I remember, “Our Father in heaven, hallowed be your name. Your kingdom come. your will be done” (Matthew 6:9–13). The next day, I go to work.
A few days ago, while pounding the steering wheel again, I asked God yet one more time where his mercy and his compassion and his love were in the life of one of my patients. After my outburst, I sat, emotionally and physically exhausted, in the silence. I heard from the depths of my heart God’s answer: Why do you think I put you at that bedside?
As a toilet nurse, I perform many mundane tasks, like keeping a patient clean. These are the tasks I cherish most—providing a patient--a person--with the precious sound of his name and an awareness of the dignity of his or her own being each time I enter the room. Practicing nursing. Practicing my faith. Always practicing, remembering God in the midst of them.
Karen Cavaleri, RN, originally wrote this reflection for the Journal of Christian Nursing.
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