Paula Cortez is a 43-year-old multiracial female who is HIV positive, has Hepatitis C
Paula Cortez is a 43-year-old multiracial female who is HIV positive, has Hepatitis C, and was diagnosed with bipolar disorder 10 years ago.
In addition to HIV and hepatitis, Paula has multiple foot ulcers that can be debilitating at times. She currently lives alone in subsidized housing and reports no immediate or extended family in the area. She is a member of a local church, but her attendance has only been sporadic due to her physical pain and symptoms; therefore, she has not built relationships with other members. Paula is receiving disability benefits due to her multiple diagnoses and is supported by an interdisciplinary team of a physician, psychiatrist, obstetrical nurse, and social worker.
Paula has recently become pregnant, following a sexual encounter with a brief acquaintance. She has been unsure whether she wants to continue the pregnancy or terminate. Paula told her social worker she is fearful of the father of the baby, and she is convinced he will try to hurt her. In fact, the father of the baby has started to harass, stalk, and threaten her many hours of the day. Paula has begun to exhibit increased paranoia and has reported she started smoking again to calm her nerves. She also stated she stopped taking her psychiatric medications and has been skipping some of her HIV medications.
Paula disclosed to the social worker that she was neither eating nor taking her medication—and she had not gotten out of bed for days. The social worker observed that Paula appeared to be rapidly decompensating, potentially placing herself and her pregnancy at risk. Based on the social worker’s suicide risk assessment, Paula has been involuntarily hospitalized and placed on the psychiatric unit, for a minimum of 72 hours.
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