Sandwich Therapy
Pat Risser

Years ago, I was working on an adult acute inpatient unit. While working night shift, I had one of the male patients come up to me every night and ask for a dab of Vaseline. I knew he was going to go off in private and “do his thing” but I had no problem with that so I’d grab the big jar of Vaseline from the nurses station and hold it out for him to help himself.

One night, one of the day shift nurses was filling in and she saw this and asked me what was going on. I explained the situation to her and she was apoplectic! I wasn’t sure what upset her. Perhaps, I thought, she was thinking that maybe he was going to go eat the Vaseline. In any case, I knew she was upset and she didn’t speak to me the rest of the night.

A few days later, I heard through the grapevine that I was in trouble. The nurse had reported me and word had spread like wildfire that there was going to be serious repercussions at the next staff meeting. Apparently, most of the other staff supported the nurse and felt that what I had done was wrong and inciting the patients to indulge in lewd and lascivious behavior inappropriate for patients on a psychiatric unit.

When time for the staff meeting arrived, I was prepared to defend my actions. The nurse who was head of the unit called the meeting to order and then she immediately raised the issue. She had done a bit of research in preparation for the meeting. In reviewing the records, it turns out that in over a year on the unit, I was the only staff person who hadn’t been assaulted on the unit.

She then reminded the staff that we were supposed to be helping ‘adults’ on this unit and that they are also sexual beings. She asserted that it was far better for the patients to “go off by themselves and do their own thing” than for them to “go off on staff.” With that, the other staff nodded thoughtfully and the matter was completely dropped.

Another time, one of the large men on the unit had raised a chair over his head and was threatening one of the nurses. The chair was one of those sort that are designed to be so heavy that the patients aren't supposed to be able to lift them. The other staff were in position to do a 'take down' and had the Thorazine injection ready. I approached the guy and while maintaining good eye contact, I said, "Do you want something to eat? Would you like a sandwich or a donut?" He looked amazingly startled and then he set the chair down and said, "yes." I unlocked the doors of the unit and walked with him across the street where I bought him a cup of coffee and a sandwich. While he was eating, I said, "You looked angry back there. Want to talk about what was going on?" Well, we had a good talk and he was considerably calmed down by the time we returned to the unit. From then on, I was teased by the other staff about practicing 'sandwich therapy.'