I had known since 8:30 that they were coming at 11 o'clock, but when they walked in the door dressed in blue and pushing an ambulance gurney, I stated to sob uncontrollably.
The resident standing next to me placed a comforting hand on my shoulder, "Mom is having a flashback," she explained to the transport crew. "Let's give her a few more minutes with the baby and take everything very slowly."
We were moving Nathaniel to a new hospital - a pediatric rehabilitation hospital.
Waves of guilt poured over the flashback of our first night - drowning me. "He doesn't belong in a hospital," pounded in my head repeatedly.
Early that morning physicians, nurse practitioners, and residents - nine of us total - had convened outside his room. It was Monday. The insurance company was insisting on a discharge before noon. No home nursing agency could promise staff for his case for at least a week. The admitting doctor turned to me, "Kim, you have to take him home. We have no medical reason to keep him at this level of inpatient care."
Deep in my heart I knew Nathaniel wasn't safe in our home.
Our family was still reeling from the crises - struggling to eat and sleep with any regularity - thrown into further chaos by having a child in the hospital for six days. I knew I couldn't be his sole care provider for a week while nursing staff was secured. I knew once the doctors and insurance company were no longer pushing the nursing agencies, their week promise for staffing could become two or three weeks. My phone calls alone would yield little pressure. But regardless of what I knew that morning, I was caught between the giants of our health care industry who seemed to be pushing me back and forth like a cat tosses a bug from paw to paw.
I swallowed hard and looked the attending physician in the eye. If I diverted my gaze, I would lose my determination.
"I don't know if there is any other option, but I will not take this baby home today. I can not stay awake for seven days until the agency finds nurses. My husband has not been fully trained to care for him. I very much want to be his mom, but if you insist on a discharge to my home this morning, I will call his Children's Division case manager and let her know I am walking away from him. Then he will have to stay here - safe - until they identify another family trained for his medical needs. I love him too much to put his life in danger by taking him..."
My voice caught. My chest heaved. I couldn't say the word home because more than anything that was where I wanted to be with my baby. I turned to the wall and cried. No one spoke; they waited.
When I turned back, the doctor smiled. "You are going to stay his mom. I will try to get him a bed at a pediatric rehabilitation hospital. I can't promise they will take him; they only have room for thirty-four patients at a time. But if we can get Nathaniel settled there, they will make sure both you and your husband are fully trained as his primary caregivers and that nursing support is in place before they discharge him. Would that be ok?"
I nodded, not fully understanding where we were headed or what I was agreeing to or if I had the authority just six days into being his pre-adoptive foster mom to agree to any plan. I was simply relieved there was an new option for today. "Give me your cell phone number, I will call you as soon as I know if they have a bed available for Nathaniel."
She called at eight thirty. He had been accepted as a patient. The insurance company had agreed. Transport was coming at eleven. He needed his car seat. I would drive in my car.
When his car seat was strapped on the gurney, I kissed his reddish yellow head good-bye unsure if I could let him out of my sight for the duration of the transport. I gave the paramedic his airway bag and suction machine. I gathered his things. I said good-bye to the hospital staff. I found myself in my van, head on the steering wheel, sobbing again. I had no idea where the new hospital was located.