Had to code my best friends husband

[wannabeagreatRN]

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.

[wannabeagreatRN, BSN, RN]

Thank you all. Knowledge really stinks sometimes. I hadn't thought about the EAP program I will check into it. One day at a time right now. We just had his services. I feel like I'm letting go of some of the anger. I thought more about the amount of damage I believe he had already done and some of the patients I've had that stroked out in the lab and realize I will never know what may have happened. I get to go see the baby tomorrow for my NT scan so that's something to look forward too. You all really are a comfort. I know more questions and thoughts are to come. I have some time to take off work. I just don't feel I got it in me right now and want to be there for her. They have loaded her with ambien and Zoloft and she was so looped tonight I'm concerned about her falling. I feel he was very scared and told my husband that on the last day I pleaded with him and checked him out. I'm just worried now that the services are over cause busy serves us well but now it's time to get on to the "New normal"

[wannabeagreatRN, BSN, RN]

And many hugs to everyone else with this type of awful experience under their belts. I don't wish any of this on anyone. Its also a reason why I work over an hour away from home, I was tired of working on my neighbors day in and day out. Not only is it heartbreaking but no-one around here understands HIPPA

[jan286]

I teared up reading your post. I am so sorry you have to go through this and try to stay strong for the people around you. It sounds like you need someone to talk to-like a social worker. Is there anyone at your hospital you can meet with? A one time vent on AN is not going to fix this. You will continue to go through a roller-coaster of emotions.

[SnowballDVM]

I'm just so sorry that all of you are suffering so much. Denial is such a powerful thing. I know a lot of us tend to minimize our health problems, thinking, oh maybe it will go away on its own, or whatever, but in rereading your post I'm angry that he ignored some very obvious signs and now has left his wife a widow and his children fatherless and his father without his only child. How awful. I do wonder what the "extensive damage considering his age" was, and how it might have affected his prognosis had he gone in and had those arteries stented. But still...so sad that he was too scared and too much in denial to get checked out and at least find out what could be done to help him.

Does your friend have other people who can help her besides you and your husband? Friends, neighbors, church or social group who might be able to organize some meals, house-cleaning, outings for the kids, etc.?

I hope your appointment goes well tomorrow. You sound like a really thoughtful, caring person so I hope you will remember to take care of yourself too!

[Hancock330]

My heart goes out to you. It will take a LONG time for your pain to ease and you will have to use the coping mechanisms you know have worked for you in the past. I strongly support the suggestions regarding the EAP at work -- and, if desirable for you, individual counseling after that. You asked what you can do now. Remember that nursing provides a plethora of career paths. If this leaves you feeling burned out on ER/CC nursing, consider a different option for a while. Depending on your level of education and what's required where you work, could you do staff or patient education for a while? Could you do nursing supervisor either where you now work or at a different facility for a while? What about seeing if a community college needs a temporary clinical instructor -- if you think you'd enjoy working with students for a while. I don't particularly suggest trying to transfer to do patient care on a med/surg unit, only because the learning curve there and the level of physical effort required might be more difficult -- but depending on your mindset and preferences it is always an option. Would you enjoy some time in the cardiac cath lab where your work? Or the endoscopy unit? Would recovery room nursing appeal at all to you? Etc. etc. etc.

I know that I cope with tragedy by keeping busy -- but that doesn't work for everyone. Get some counseling. Take care of yourself so you can continue to take care of others. Try, most of all, to be gentle with yourself. If you usually participate in moderate levels of physical exercise, continue to do so. If you've never tried yoga, give it a try. Many yoga classes are conducted to gently stretch and exercise most of the big muscles in your body and to lead you to a state of relaxation. It might be very helpful for you now.

Best wishes and I hope that, in the fullness of time, you, your friend, and your husband can come to a place of peace in regard to what has happened. If any of you thinks that this can, will, or has happened quickly, you are definitely in denial and headed for future problems. Try to nurture each other.

I'll be thinking about you and yours.

[Diving]

That's a heavy load you're carrying. I can only imagine how huge it is. It really is an illness that health care professionals have(even more so for those of us drawn to emergency situations and life-threatening illnesses). We internalize the guilt to some degree each time our efforts aren't successful. Most of us deal with some way to detach ourselves enough that it isn't immediately hurtful. We tuck it away. You cannot detach because you are so close to them. He made his decision. You were a good friend and you are not the reason this happened or the reason he didn't make it. If you have ever in your life sought counseling, this is the time. The whole situation is tragic and permanent and so are the scars. Take care of yourself and seek counseling that can be objective. That's a lot to process and you shouldn't donit on your own and risk the health of your little one. I'm so sorry for your loss. You are not to blame so don't blame yourself. Best wishes to you, your friend and families.

[sissiesmama, ASN, RN]

OP, just want to check on u- u have been on my mind since reading your post - sending positive thoughts your way. Hope you're doing ok.

Hugs!

Anne

[kdkout, BSN, RN]

That is one of the worst stories I've ever heard. I thought I had experienced some stuff but nothing compared to this. I am so, so sorry. This has 'PTSD' written all over it. If ever anybody needed counseling right now, you do. This is very traumatic and I dont know why or how you can even consider going back to work right now. You NEED A BREAK. I know you probably need the money, but seriously?! This is too much. It's delayed grief - one thing on top of another on top of another. I am so so sorry. No one but medical people in the same boat (I've done all areas of nursing) with the same situations would understand. For myself, I moved away from family so I'd never have to work on someone I know. (Or at least the odds would be in my favor). I know it would be too hard for me - I'd much rather care for strangers. Dont you realize that you went far above and beyond?? You cant save everybody. You cant. He was a grown adult who made bad decisions. Think about it - would most people have friends with as much training as you BEG them to go to the Dr? You did more than enough!!!!! I am angry at him too and I dont even know him. You cannot save the world. For whatever reason, (fear? Denial?) He KNEW he was sick, yet he made the decision to ignore it. Please please please talk to somebody. And for crying out loud, consider a different job or at least one in a different place. You are pregnant and this is the last thing you need. Put yourself first for once. Good luck and God bless you, I am so sorry. Wishing I could give you the biggest hug ever.

[wellcoachRN]

I am so sorry that you had to go through this. I highly recommend contacting your EAP to see if you can get a few counseling sessions to help you through your grief. The other thing I want you to know is that we are never responsible to another adults actions. It is hard when we see the writing on the wall and someone is having a hard time accepting what may be happening. We can't force someone to do anything if they are in denial.

Please reach out for support. I wish you all the best!

[kdkout, BSN, RN]

More thoughts for you - I posted above and would like to add to what I was saying because I literally woke up at 4 am thinking about you. Before I forget, please consider reading either of these books, or both: "Boundaries" by Townsend and Cloud. "Codependent No More" by M Beattie. They can be life-changing reads for those in care-taking roles.

I hope you can "hear" me OK, sometimes email doesnt convey "tone" well. A couple of things in your OP are haunting me. For one, your statement about being an "anxious, what if girl." That is classic anxiety.

For background on me, I have been a cardiac med/surg tele nurse, a cardiac adult ICU nurse, a hospice nurse and am currently a level III NICU nurse. Not to mention some other areas.

Everything I read from you sounds like something I could've written in the past. I need, and get, counseling intermittently throughout the last 20 years in nursing. I tried meds once but they made me feel worse, so CBT and self-care and occasionally counseling are all I've got. With my family history of addiction issues, I wont touch alcohol or drugs. I know better.

Now, I may be wrong but you sound like you have GAD. Have you spent your life trying to control all of the what-ifs? Trying to control everything, period? Are you a perfectionist? Even your name "wannabeagreatRN" is "telling" about your personality. My counselor (a psychologist) would say that I'm also this way - I am "hypervigilant." I plan for the what-ifs, but the problem is that sometimes while you are planning for the what-ifs, you are missing something that is right in front of your face. This is what I see is right in front of your face: You are pregnant, presumably with your first child by what you've said about leaving your house at a moment's notice. You are concentrated on your career. You sound more young and idealistic, like I used to be. What are you thinking? I KNOW you want a healthy child, so what are you doing enveloping yourself in all of this stress, willingly? Why are you listening to your computer at night instead of doing healthy things to promote the sleep you need? Why are you not ignoring the scanner? Why are you even working as an EMT anymore knowing the situations you are going to be put in - by your own admission - finding your father dead, transporting your grandparents and now this? Why are you doing this to yourself? I'm not trying to "yell" at you, I'm hoping that you will ask yourself these questions. Only YOU know the answers and they are probably buried deep down. Did you grow up 'saving' family members in some way, and now you are getting paid to do the same? Were you the peacemaker in your house? - The one who took care of everything so everybody would be OK? OR, did you get this training because you dont trust anybody else, and you thought "If I were there, maybe they'd be OK." The thing is, you're not God. I'm sure you're a terrific nurse, but you arent meant to be at every code, & every bad situation. Nobody is. You are going to burn yourself out so fast your head is going to spin. You cannot do that now that you are going to be a mother. I'm sure your husband wants to see you take better care of yourself too. I dont need to tell you about women and stress and how that can affect your heart - you already know this. So when are you going to start taking care of yourself and treating yourself like you are your own patient? Because it needs to start now. Consider this your wake up call. Create a new life for yourself. Create boundaries for yourself. Do what you can and then let go. There will always be codes/MIs/emergencies but you have your own family and they need you.