Carrie Williams is a patient at the Psychiatric Unit of Bayshores Treatment Facility. She is in a manic state, which is worsen by sleep deprivation and hyperactivity. Moreover, Ms. Williams is almost nine months pregnant, which makes her even more vulnerable. After a prolonged psychotic episode, a psychiatrist orders a nurse to inject medication into juice containers and ensure the patient drinks it. The main issue that this scenario poses is a medical dilemma between keeping the patient safe and obtaining their consent to treatment. If I were a nurse, I would follow the orders of the doctor and make sure that Ms. Williams drinks juice with Haldol.
In the presented scenario, the patient is clearly at high risk of causing injuries to herself and her fetus as a result of her manic episode. Principles of beneficence and non-maleficence would guide me as I would be trying to protect Ms. Williams, her unborn child, as well as other psychiatric patients on the premises. According to Rodriguez-Cabezas and Clark (2018), “if verbal de-escalation fails, pharmacotherapy intervention may be required to calm the patient” (p. 624). Haloperidol suggested by the doctor is a first-generation antipsychotic, which is commonly used in healthcare settings to address agitation. Administration of medication (although in disguise) is justified since “if a patient is agitated and it is obviously due to delusional thinking or hallucinations (…) then an antipsychotic will not only treat the agitation but the psychosis as well” (Rodriguez-Cabezas and Clark, 2018, p. 624). Agitated patients such as Ms. Williams are not likely to agree to medication even though Haldol can be crucial in calming and securing her and her fetus. The task of medical professionals is to do what is necessary and help Ms. Williams.
Rodriguez-Cabezas, L., & Clark, C. (2018). Psychiatric emergencies in pregnancy and postpartum. Clinical Obstetrics and Gynecology, 61(3), 615–627. Web.