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'She is going above and beyond': Dartmouth psychiatric nurse vaccinates local health providers
The Standard Times - 2/7/2021
Feb. 7—DARTMOUTH — With the scramble for COVID-19 vaccines as the state rolls out Phase 2, a local psychiatrist has gone above and beyond to make sure her staff is fully vaccinated to better serve patients of a vulnerable population.
Amanda Raposo, psychiatric nurse practitioner and owner of Brighter Side Wellness in North Dartmouth, recently received 200 doses of Moderna vaccine to vaccinate her staff and surrounding physicians. Brighter Side Wellness is an outpatient mental health facility with four nurse practitioners.
"Our practice is private," said director of operations and her father, Al Raposo. "We're geared toward those who are anxious and depressed. This is totally out of our scope, but we felt we needed to help out the community as mental health providers."
Amanda Raposo insisted on vaccinating her staff to keep them safe in order to keep patients safe. Al Raposo agreed and said this would help them see patients and make them better.
"TeleHealth is great, but a lot of clients miss that face-to-face interaction," he said.
According to Amanda Raposo, about 25% of her client base is dealing with substance abuse. She is a registered Suboxone provider and is able to treat patients with opioid addictions. Vivitrol is another injection she provides that can prevent the relapse into drug or alcohol abuse by blocking the ability to get high and reducing cravings. Patients must come into the office to receive these treatments, however, so vaccinating her staff was incredibly important as they interact with a high-risk population. Amanda Raposo said that while they receive treatment for addiction, the patients may have compromised immune systems or other worsening symptoms due to neglect.
"The staff may be healthy, but patients are in recovery and addressing other health conditions," she said.
Amanda Raposo said that once the vaccine was announced, she knew she wanted to extend that opportunity to her own practice and be as involved with the vaccine distribution process as possible, even volunteering when it became available to help the community in any way she could.
It isn't exactly a simple process, however. The Centers for Disease Control and Prevention has strict requirements to qualify as a vaccination site and can only ship in bulk depending on the vaccine. The minimum order size and increment for Moderna COVID-19 vaccine is 100 doses, which is one carton of 10 multi-dose vials with 10 doses per vial. Amanda Raposo did not have enough employees in her practice alone to qualify so she teamed up with Child and Family Services in New Bedford. After completing mountains of paperwork to become a registered vaccine site, she said it was a huge struggle to get the vaccines and took almost a month of phone calls and emails just to reach someone from the Department of Public Health. She said it felt amazing finally getting the confirmation of receiving 200 doses.
"For Amanda, her middle name is persistent," Al Raposo joked.
CFS was thrilled to partner with Brighter Side Wellness. Executive Director Anne Sampaio said CFS employees were considered essential but were categorized in the last group of Phase 1 distribution. Sampaio had been trying to find ways to vaccinate her staff and said the call from Amanda Raposo "was just a gift." Sampaio sent out emails to her staff with literature about Moderna vaccine and by the next Monday, more than 150 of her 460 employees were interested. They were scheduled to receive the vaccine later that week on Jan. 14 and 15.
"It went seamlessly for something that was pulled together in less than 48 hours," Sampaio said. "The staff is extremely appreciative. More staff came to me wishing they had signed up."
Once the shipment was received, the practice used the large waiting area as a distribution site with one-way traffic. The office even utilized the front office staff to make copies of cards and record necessary screening information to report back to the CDC. Amanda Raposo said supplies were sparse, and the shipment included only 105 syringes for the 200 doses. Luckily, Child and Family Services were able to chip in while Amanda Raposo purchased 20 syringes out of pocket.
"We're not a clinic where we're doing shots," Al Raposo said. "It's more a labor of love."
Amanda Raposo said that although the CDC supplied her practice with 200 doses, she was able to vaccinate others by using up every last drop of each vial to stretch it from 10 to 12 people.
"We didn't waste a single dose," she said. "We received emails from private practitioners in the area and invited them in."
Al recalled that after vaccinating those qualified for Phase 1 in the area, there were still some doses available and they offered them to an older RE/MAX real estate agent form the office upstairs, along with employees and even customers at Joe's Original restaurant across the parking lot.
After delivery, Moderna vaccines need to be stored in a freezer between -25 degrees Celsius and -15 degrees Celsius or in a refrigerator between 2 degrees Celsius and 8 degrees Celsius for up to 30 days and cannot refreeze. Once the first dose has been withdrawn, the vial must be discarded after six hours. With these guidelines, it was a race against the clock to make sure all doses were properly administered.
Al Raposo said that after the practice was done with scheduled vaccinations, there were three more doses available but no more people, so they called around the area to make sure they didn't go to waste.
"They didn't even think it was real at first, they thought we were joking," he said. "Our slogan is we make people happy, and we made a lot of providers happy who are making other people happy with the vaccine."
With only one dose left, Amanda Raposo offered it to a patient on a TeleHealth conference who had many comorbidities.
"It's been great to give back to the community," she said.
After the first successful round of vaccines, Amanda Raposo has been working tirelessly to get more doses to vaccinate more frontline workers, police and EMS as well as prepare for high-risk clients and teachers in Phase 2. She said she put in a request for the Pfizer-BioNTech vaccine which ships in quantities of 1,000 so she can vaccinate more people at a time.
Amanda Raposo said that it has been important to keep her staff healthy and safe during the pandemic because of the rise in mental health issues caused by the pandemic. She said she cannot wait for the day to vaccinate her clients because some are in a very dark place and they need to continue their medications. Since vaccinating her staff, she has spoken with her clients to let them know they are vaccinated to give them a sense of security. She emphasized the importance of educating the public about safe vaccinations to make her patients feel comfortable.
"If they trust us providing health care, they'll feel comfortable knowing they got vaccinated," she said.
Amanda and Al Raposo will continue to push for more doses to keep vaccinating providers until "they open the gate." Al Raposo said if they can stop one person from getting sick, they've done their job.
Sampaio said she is looking forward to partnering with Amanda Raposo for the second dose on Feb. 11 and 12 and will continue to team up when more quantities of the vaccine will be delivered for Phase 2.
"She is going above and beyond what she's expected to," Sampaio said. "Hats off to her for doing this for the community. It's a big responsibility and requires lots of planning."
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