Had to code my best friends husband

[wannabeagreatRN, BSN, RN]

I don't normally post here but love learning from you all. I apologize as I ramble my story out. I am here tonight because on Wednesday night I had to code my best friend's husband who is also my friend and he did not make it. I cannot talk to her obviously because my heartache pales in comparison to hers. My husband was one of his best friends, I cannot keep unloading on him.

I've been an EMT for the last 13 years in our small community and a critical care nurse for the last 5. I have transported my own grandparents, found my father dead at 54 (which I thought was the worst pain ever at the time), and coded my friend's grandparents. But this has just left me feeling broken.

He was only 41 she is 33 and 18 weeks pregnant with their 3rd child. He has a long history of GI problems but for the last few months has been having exaggerated symptoms that I just knew was his heart. His mother passed at 38. He was a hardworking and otherwise healthy man though. I have spoke with him in great lengths the past couple of months about my worry. He has had me check his blood pressure which was normal but I insisted this did not mean his heart was healthy. 3 days prior to him arresting he brought it up to me. I could tell he was scared but he wanted me to rationalize it all away as stomach problems for him. I of course did not. He told me "I would know if it was my heart, my heart does not hurt. I just feel like there is car sitting on my chest" SMH. He had all the signs, textbook style. I explicitly and passionately educated him on atypical symptoms, on the A&P of the heart and why MI's occur, and other things such as cardiomyopathy etc. I had him pegged for MI or HF. Explained to him how "simple" it would be to go to the ER for a CXR, Enzymes, and EKG. Oh I bet his troponin was through the roof. He asked which hospital he should go to, I directed him to go 20 min. further to where I work which is a heart center. He then asked me if I thought he could wait till the weekend (5 days) so he didn't have to miss work. He knew what I would say, and I laughed and said "(his name) if you think I will give you a hall pass on this you are crazy I've wanted you to go for months. My husband watched as our phone conversation lasted an hour. After I asked my husband if there was anyway he thought I could make him get in the car and go... we all knew the answer. I spoke with his wife later, he did not go. He belched a few times and as usual felt better.

Well eerily I am one of those who has "thought" pop in my head. No I'm not psychic, just an anxious "what if" kinda girl who likes to be prepared for everything, including the probably never going to happen. And the other 999,000 thoughts/scenarios I've had have never came true, thankfully. I envisioned that afternoon having his wife call me screaming that he wasn't breathing, and me going down there (we live 2 miles apart) and having to do CPR and mouth to mouth (never done mouth to mouth before and yes it creeps me out)

Well 3 nights later it did. The local fire siren woke me at midnight. I only know what's going on by listening on my computer. I am also 13 weeks pregnant and sleeping horribly and that siren goes off all the time at midnight for our "frequent fliers" of the neighborhood. I sushed my dogs and got ready to go back to sleep when I decided I would just go ahead and see what was going on. When the scanner gave her address as a cardiac arrest. I rushed, She had CPR in progress from the moment he dropped, I arrived and another friend of our is fire chief and CPR/AED certified and I am so proud to say he had stopped at the firehouse and brought the AED and had already shocked him once when I came in. His CPR was tired at that point and I took over and began mouth to mouth and compressions. We shocked again. Then nothing. I ran it all through my mind. I wanted to get him out of that house so he was not pronounced in their bedroom. But I actually had hope given the events so I didn't want to waste any good cpr in that early time frame trying to get him out. I cussed him as I thumped on him. I was soooo angry with him for not listening to me, her, and his father (he was his father's only child heartbreakingly enough) Our local ambo is BLS only so I had to wait on a Medic unit for 20 min so I had nothing I needed for ACLS. But I already had a plan to get him back, start cooling measures for code ice by emptying her freezer goods around him and flying him to my heart center. I have a few successful of these in my career that came out at almost 100% even after an extended down time (over 10 minutes but with good CPR) I just knew he had to be one too. When the time passed that I knew that if I got him back that he would have brain damage and never forgive me I wanted to load him in that ambo and get him the hell out of there. Of course she would know he dropped in their bedroom but maybe just maybe being pronounced at the ER would take some of that away instead of in their bedroom. But I lost count of time and the ALS crews arrived and worked him, as professional and quietly as possible I pleaded with them to get him out of there. I know the protocol, they did what they are supposed to do, and they were very good, but we did ultimately pronounce him in their bedroom.

I am so sorry for rambling, but I have to get this off my chest. I went on the first 2 days just feeling so angry at him, as his wife did too. Now I feel less angry and am crashing. I keep replaying it all in my head, while I work on his obituary and funeral plans for his wife as all she can say is "I don't care just do it" (I don't blame her, she just can't handle it right now). I feel like I don't even want to go to work. Like I said I have done hard things. I have worked who knows how many codes. This has left me feeling so many different things. I miss my friend. I miss my best friend as this will forever change her (I will be right beside her though, our happy times will never be as happy). I don't know if I ever want to be apart of such again even on a stranger I feel I will see him. I promise, I have always been hard. I've done 911, tech'd in the ER, and like I said am now a CC RN. What the hell do I do now??? I can't talk to our mutual friends about how I feel about coding him or talk to my husband or my best friend. Non medical people just don't understand, they sympathize but they don't get the responsibility. I know deep down I did everything, but it will never make me feel any better, on the prevention part or the code. Should I have went down there and made a horrible scene for him to go?? ofcourse if I knew what I know now, he could have only been made at me for a couple days if he didn't listen cause he dropped dead. And I did all but forcibly threaten him with a frying pan, and yes I considered it. I told him that he was my husband I would've knocked him out cold and called 911 along time ago for him to get checked out... He laughed.

Autopsy revealed 3 main arteries were each between 80-98% blocked among "extensive cardiac disease considering his age".....

Thank you to anyone who manages to read my mess of thoughts here.

[NurseKatie08, MSN]

OP, what a horrible thing to have to experience! My heart goes out to you and your best friend. Be well.

[RN403, BSN, RN]

I am so incredibly sorry for your and your best friend's loss. Your story leaves my heart broken for so many different reasons. I send nothing but good thoughts and positive vibes your way and hope that you and your friend find the strength to move through this difficult time.

[sissiesmama, ASN, RN]

Oh that is such a nightmare! I'm sorry u had to go through that. I just can't imagine the pain - not only losing him as a patient but losing a friend. Sending hugs!

[AmyRN303, BSN, RN]

I'm so incredibly sorry.

[Esme12, ASN, BSN, RN]

I am so sorry for your loss...((HUGS)) You did your very best. He knows you did your very best. Sometimes our jobs just SUCK! IN some instances...ignorance is bliss.

You have to grieve your loss. This will take time but I don't think your friend would want you to change your life because of him. You are going to experience the stages of grief...it will hurt less as time goes by...I promise.

[Been there,done that, ASN, RN]

You were a friend first, a nurse second. You went above and beyond in your efforts to break through his denial/avoidance.

Please talk to your obstetrician ... you and the little one need immediate stress relief. Pleases take care of both of you.

I experienced a similar situation with my mother. So I can say I've been there , done that. PM me if you think it'll help.

[kiszi, RN]

::HUGS:: My heart goes out to you and your friend. I am so sorry for your loss.

[CrunchRN, ADN, RN]

There is nothing you could have done differently for a better outcome. So you must let it go and know that some people just have a shorter time than others for whatever reason and no matter what we do.

[kbrn2002, ADN, RN]

I am so sorry for your loss, as well as your friends loss. I know you realize there is nothing more you could have done, or anything you could have done differently, but that does not minimize your grief. Please talk to somebody. At the very least, please know you have friends here that will listen.

[NoblePath]

Does your employer have an EAP program? I'm just suggesting this so you could talk it out with someone? This is a very tragic event, and you did everything you could do. I'm sorry this happened.

[EMSnut45, BSN, RN, EMT-P]

Hind sight is always 20/20. It's not easy to turn off the criticism, but it sounds like you did everything you could to get him to take care of himself. Please know that you were a loving friend to him. I can't imagine the pain that you are feeling right now.

I am also in EMS and a critical care nurse. I have coded the loved ones of close friends as well. It isn't an easy position to be in. From what you said, you did absolutely everything you could have with the supplies that you had available to you.

Are you affiliated with the fire department or EMS service as an EMT? If so, they should have a counselor available to you (CISM). If you are not affiliated, there is a great resource, Safe Call Now (safecallnow.org), which is an organization that provides support to first responders.

As as a nurse, you also have benefits through work. EAP is a wonderful benefit that many people forget that they have or are afraid to use. It provides (usually) 6 free therapy sessions per year.

PLEASE take advantage of one of the above resources. This is the type of call that will follow you for a long long time. You need to take care of yourself and your baby!

((Big hugs)) from one who can relate.

EMSnut