"Chausse, you're assigned to Ward 2.", my supervisor informed me without the slightest regret.
But to me, it sounded like a death sentence.
Staffing was seasonally low at my new place of employment, Wrentham State School, a state run institution for the mentally retarded, a sprawling campus of mid-19th century brick buildings discreetly hidden away amidst the wooded countryside of southeastern Massachusetts. So this meant that our normally static placements would be disrupted for a while as we each were assigned temporary "floater" placements. This meant mandatory service in an unfamiliar ward with unfamiliar "clients" (the newer, more PC term for the people formally referred to as "patients", but since mental retardation was not an illness, that label was deemed inappropriate.)
I was normally assigned to Ward 1.
Ward 1 was populated by about 8 men ranging in age from 20 or so to 50. All were diagnosed as DSM-II classification : Profound. Which meant that they were on a scale of 1 to 10 of retarded-ness, with 10 being the smartest and 1 being the dumbest, roughly a 2. Some of the staff disliked assignments with these types because it meant a lot of really menial things like toilet training, cleaning up bed-wetting and "number 2" accidents, spoon-feeding, and virtually no interaction with the non-verbal clients. This was considered demeaning by many of the male staff. But for some of us, myself included, we much preferred this to the alternative in our building...Ward 2, the other male ward.
The problem was that they were smarter in Ward 2, and, being mainly dual-diagnosed, more mentally ill than mentally retarded. And they were prone to much more violent outbursts of aggression.
Ward 2 also housed D Buildings most aggressive resident...Arthur Ancanachio.
The stories were plentiful:
"Did you hear about the time he put that guy in the hospital?"
"I heard he ripped a guy's arm off with his bare hands!"
"Don't you know he killed three guys with a hidden plastic knife? Slashed their throats!"
"I heard it was six guys! All at once!"
So it was with these obvious, yet still disturbing hyperboles on my mind that I nervously entered through the heavy steel, double-locked doors of Wrentham's most notorious ward for what would no doubt be a long shift.
The ward currently housed only one man, Arthur, but his staff ratio was 4:1. That's right, 4 trained adult men supervising one client. But what a client he was.
To say Arthur was huge would be an understatement. He towered above even my 6 foot 1 inch height by about 8 more inches, and due to a combination of genetics and constantly recurring states of physical agitation brought on by severe schizo-affected disorder, he was solid as a brick house.
He sat in the corner of the spartan ward, furnished with only a couple of chairs made of solid foam rubber, specially made for psych wards, and watched cartoons playing on a TV housed in a steel mesh cage bolted high up on the wall. Arthur didn't interact with anyone unless it was going to be bad for you. His similarly soft-sided bed was on the other side of the large room behind a couple of portable partitions. Staff were instructed to not look him in the eyes as this could set him off. We were supposed to stand the entire shift and maintain a distance of about 5 feet from him unless we had to move in for a PMAB maneuver...basically a multi-man hold to immobilize him. This would be used the second any staff recognized an antecedent. An antecedent was any known behavior that had been recorded in his records to have been a precursor to injurious behavior to himself. The antecedent could be as seemingly benign and almost undetectable as a simple eye-blinking pattern, or even a certain grin.
Since Arthur was so frequently violent towards staff, and he had such strength and mass, the policy to do a 4 man restraint was ONLY if he were about to injure himself. Which, since there just wasn't anything available for him to use to do so, was quite rare. The procedure that was followed if he bolt towards one of us was to evacuate the ward and monitor him on the closed circuit TV in another room, providing clear views of his actions from the two installed cameras high up near the ceiling.
I got through most of the shift including the tense mealtime and ADLs (showertime) when potentially dangerous implements such as plastic eating utensils and even bars of soap came into play.
But around 9:30 or so, as Arthur was about to get ready for bed, he decided to strike.
By this time of night, we staff had let our guard down since our charge had been so well-behaved all evening. Two of the other staff were out of the ward on cigarette breaks and the other guy and I were sitting not too far from Arthur, he watching TV (which we had by now ignored rules and switched to a program of our choosing) and I reading a book..."Noble House" by James Clavell.
Arthur jumped at me and caught me in his enormous hands. He grabbed but luckily I was wearing a loose sweater and despite my co-worker and I trying to free me, his grip was resolute. I had to wiggle out of the sweater to escape. We watched the on TV monitor from the other room. Arthur, frustrated at not having people to rip apart, proceeded to tear my sweater to shreds. He also picked up the book I'd dropped and ripped it to pieces.
Thankfully the next night I was not re-assigned to Ward 2. And from then on, I stayed with my bumbling and lovable drooling guys, never having to face the terrors of Arthur again.
But to me, it sounded like a death sentence.
Staffing was seasonally low at my new place of employment, Wrentham State School, a state run institution for the mentally retarded, a sprawling campus of mid-19th century brick buildings discreetly hidden away amidst the wooded countryside of southeastern Massachusetts. So this meant that our normally static placements would be disrupted for a while as we each were assigned temporary "floater" placements. This meant mandatory service in an unfamiliar ward with unfamiliar "clients" (the newer, more PC term for the people formally referred to as "patients", but since mental retardation was not an illness, that label was deemed inappropriate.)
I was normally assigned to Ward 1.
Ward 1 was populated by about 8 men ranging in age from 20 or so to 50. All were diagnosed as DSM-II classification : Profound. Which meant that they were on a scale of 1 to 10 of retarded-ness, with 10 being the smartest and 1 being the dumbest, roughly a 2. Some of the staff disliked assignments with these types because it meant a lot of really menial things like toilet training, cleaning up bed-wetting and "number 2" accidents, spoon-feeding, and virtually no interaction with the non-verbal clients. This was considered demeaning by many of the male staff. But for some of us, myself included, we much preferred this to the alternative in our building...Ward 2, the other male ward.
The problem was that they were smarter in Ward 2, and, being mainly dual-diagnosed, more mentally ill than mentally retarded. And they were prone to much more violent outbursts of aggression.
Ward 2 also housed D Buildings most aggressive resident...Arthur Ancanachio.
The stories were plentiful:
"Did you hear about the time he put that guy in the hospital?"
"I heard he ripped a guy's arm off with his bare hands!"
"Don't you know he killed three guys with a hidden plastic knife? Slashed their throats!"
"I heard it was six guys! All at once!"
So it was with these obvious, yet still disturbing hyperboles on my mind that I nervously entered through the heavy steel, double-locked doors of Wrentham's most notorious ward for what would no doubt be a long shift.
The ward currently housed only one man, Arthur, but his staff ratio was 4:1. That's right, 4 trained adult men supervising one client. But what a client he was.
To say Arthur was huge would be an understatement. He towered above even my 6 foot 1 inch height by about 8 more inches, and due to a combination of genetics and constantly recurring states of physical agitation brought on by severe schizo-affected disorder, he was solid as a brick house.
He sat in the corner of the spartan ward, furnished with only a couple of chairs made of solid foam rubber, specially made for psych wards, and watched cartoons playing on a TV housed in a steel mesh cage bolted high up on the wall. Arthur didn't interact with anyone unless it was going to be bad for you. His similarly soft-sided bed was on the other side of the large room behind a couple of portable partitions. Staff were instructed to not look him in the eyes as this could set him off. We were supposed to stand the entire shift and maintain a distance of about 5 feet from him unless we had to move in for a PMAB maneuver...basically a multi-man hold to immobilize him. This would be used the second any staff recognized an antecedent. An antecedent was any known behavior that had been recorded in his records to have been a precursor to injurious behavior to himself. The antecedent could be as seemingly benign and almost undetectable as a simple eye-blinking pattern, or even a certain grin.
Since Arthur was so frequently violent towards staff, and he had such strength and mass, the policy to do a 4 man restraint was ONLY if he were about to injure himself. Which, since there just wasn't anything available for him to use to do so, was quite rare. The procedure that was followed if he bolt towards one of us was to evacuate the ward and monitor him on the closed circuit TV in another room, providing clear views of his actions from the two installed cameras high up near the ceiling.
I got through most of the shift including the tense mealtime and ADLs (showertime) when potentially dangerous implements such as plastic eating utensils and even bars of soap came into play.
But around 9:30 or so, as Arthur was about to get ready for bed, he decided to strike.
By this time of night, we staff had let our guard down since our charge had been so well-behaved all evening. Two of the other staff were out of the ward on cigarette breaks and the other guy and I were sitting not too far from Arthur, he watching TV (which we had by now ignored rules and switched to a program of our choosing) and I reading a book..."Noble House" by James Clavell.
Arthur jumped at me and caught me in his enormous hands. He grabbed but luckily I was wearing a loose sweater and despite my co-worker and I trying to free me, his grip was resolute. I had to wiggle out of the sweater to escape. We watched the on TV monitor from the other room. Arthur, frustrated at not having people to rip apart, proceeded to tear my sweater to shreds. He also picked up the book I'd dropped and ripped it to pieces.
Thankfully the next night I was not re-assigned to Ward 2. And from then on, I stayed with my bumbling and lovable drooling guys, never having to face the terrors of Arthur again.