Nathaniel and I achieved a milestone recently. I had been out grocery shopping and he was home with our private duty day nurse. As I walked through the front door I called my usual to him, “Nathaniel! Mommy is home!” He ran to me. Arms out stretched. Smiling broad. A first.

He has been running to greet Rich, Ben and Josiah’s returns for a very long time. If he sees one of them come up the sidewalk through our living room picture windows, he prances a happy dance around the room until they open the door. He is right there waiting. Hugs follow. Until recently, my returns have been received much more nonchalantly. There was usually a smile. Sometimes a wave from across the room. But not until lately was I welcomed with the same exuberance the men have almost always received. And in perfect honesty, not every return since this monumental one has been as joyous. Still sometimes he stays aloof.

I see this as evidence of loss in Nathaniel’s life. Loss of a birth mom whose voice and heartbeat he knew first. Loss of a foster mom whose arms and warmth he knew from the hospital. Both are consequential events in his little life. But I think his reluctance to fully attach to me yet is most significantly due to his loss of a healthy childhood. His need for private duty nursing and his lived experience of over two thousand female care givers’ shifts have made him immune to missing just one. A lot of women have come through the front door and left again. Who am I to deserve more emotion than the rest?

I do not intrinsically know how to heal this.

It is not mentioned in hospital provided literature on caring for a trach child. And while our preparation classes for foster and adoption explained loss and its effects, the placement of a child in a permanent home was suppose to end the cycle of new loss. Our instructors and licensing worker talked about permanency as the moment when healing can start.

We lost another night nurse earlier this month.

Perhaps similar to a young child who experiences transient workers at a day care facility, however the presence of nurses and mom at the same time makes the situation even more complicated for Nathaniel. Where does mothering end and nursing start or mothering start and nursing end when the professional has just one patient to attend?

“The agency told me that you are a very involved mother,” said the interviewing nurse at my kitchen table last week. “I’m fine with that.” Whew, I think. I have her permission to be his mom. Yet I know from experience that blending our roles is not as simple as uttering that four word sentence. I know the awkwardness of mom and nurse side-by-side sorting out a child’s need and deciding which provides what care. It has been one of the hardest things for our night nurses especially to understand – that I want to be awoken and involved if Nathaniel wakes in the night. It can be seen as a personal affront to the nurse’s skill or care giving abilities. At the very least is raises an unspoken question: What does the other woman do?

It seems logical at the kitchen table in the middle of the afternoon interview when we are both fresh and excited to begin. “I want nurses to attend to medical needs: suctioning, preparing g-tube feeds, administering medications and treatments, and offering insights from your assessments. I want to nurture Nathaniel, comfort him when he wakes, change his diaper, get him dressed.”  I rattle on. “You are not here so I can sleep. You are here so I can just be mom. I want to do all the things a mom normally does for her child...” She nods, but does not fully get it.

Because the three a.m. moment is still unbelievably awkward. If the mom provides the care, the nurse is delegated to sitting on the floor or a hard kitchen chair temporarily brought into the nursery so mom and son can have the comfortable rocker. She has to wait while her training prompts her to constantly be fixing and doing. If the nurse provides all the care, mom is delegated to the role of case manager or administrator who tosses and turns until daybreak when resentment is finally replaced by sleep. Nothing in my twenty-five years of mothering prepared me for this constant dilemma of sharing a patient-child in my own home. I long for the day when we will not need nursing help. I even relish the times when a nurse calls in sick, only to stumble head first into a chaos of exhaustion when our family alone has to meet all of Nathaniel’s needs.

So I try to provide a mother’s love as naturally as I can in our unnatural circumstances.

And I learn more intimately why my Heavenly Father is jealous of being my first love. Why His commands to my mistrusting heart begin with “I am your God. You shall have no other gods before me.” I more fully understand why He does not want me looking to other gods, or nurses we could call them, to meet my needs. And I see my own hesitation to run to His arms. I can list the losses that cause me to question if He is truly the one who will never leave me. In a childlike fear, I silently wonder when His shift will end. When will He tire of my brokenness and move on to a new case?

I am Nathaniel. Indifferently I migrate towards the door, zigging and zagging and distracted by the unimportant, yet aching to leap into the arms of the one who opens the door. Not a first leap, but a continual one. Because I must run daily to the one who has adopted me as His child. Daily accept His love. Trust that He is committed to bringing healing and redemption in my life. Daily I  too must set aside my orphan ways of living and rest in the welcome home embrace. 

Oh sweet Nathaniel. I know how hard your journey to the door.

I am staying, little one. Trust in this.