“How can I enact change on entire communities and bring about real outcomes? Things may be dark, but if you rely on hope, brightness is just around the corner.”
Dr. Scharmaine Lawson, DNP, RN, PMHNP(c), FAANP, FAAN (New Orleans, LA)
Some people see things in the world that they don’t like and they complain; exceptional people, like Dr. Scharmaine Lawson, make a change. Scharmaine grew up in the Magnolia housing project in New Orleans, which at the time was one of the most dangerous housing projects in the nation. She saw that the elderly and infirm in her community weren’t getting the medical care they needed due to limited mobility and resources to get to the doctor’s office. “When I graduated from high school, I was in a program where I also got my little certificate as a CNA, and that started the germ of me wanting to just go full-blown into nursing.” Scharmaine said when she started nursing, she wasn’t thinking about a doctorate; she just wanted to travel. She reached out to a travel nurse agency. “You just tell them where you wanna go, and they give you a house and give you a whole bunch of money, and you go and work in that environment for three to six months.” The best part for Scharmaine was choosing what specialty she wanted to work in. “Initially, I was in telemetry, step-down, cardiac,” and a Level 1 Trauma/ER/ICU nurse, and eventually she experienced almost every facet of patient care. Scharmaine used those travel opportunities to expand her nursing knowledge in different fields and earn her Master’s degree. As she gained more nursing experience, she was also enriched by her travels outside of the United States to Puerto Rico and the Dominican Republic. She witnessed firsthand that her talents were in great demand and significantly impacted those communities.
After over a decade of traveling, Scharmaine returned to New Orleans to be closer to her family. She says the travel nurse money is excellent, and a nurse can earn between $10,000 and $20,000 a week, but she needed to stay close to home for her children. Scharmaine is the proud mother of a 10-year-old daughter and an 8-year-old son who have also been thrown off track by the COVID rollercoaster, in and out of school with Mom traveling and cases rising. It’s been hard for them, but Scharmaine says it’s important for parents to set the tone with their children. “I just kind of downplay it. I don’t make a big old deal about it. You know, gotta roll with it.” She reminds them, “Anything that comes your way, you can handle it!”
In 2004, she took her decades of nursing talents to the streets and started making house calls. Dr. Lawson became the first nurse practitioner to own a house call practice in the State of Louisiana. Her practice had been in business in her community for a year when Hurricane Katrina hit and the levees broke, flooding her beloved city. Twenty-five thousand health care providers were evacuated after the storm, and four major hospitals were shut down. Dr. Lawson was one of the first medical health professionals to return. “I was one of if not the only one who was back in the city providing house calls and primary care to so many people who needed it at that time.” Her patients were predominantly geriatric and in desperate need of remote care. “These were my people, my patients. I grew up here.” Her practice was embraced by the community and eventually made over 100,000 home visits over three years after Hurricane Katrina. She wanted to expand her house call practice but didn’t have the bandwidth. To encourage and support other nurses, she wrote a book, Housecalls 101: The Only Book You Will Ever Need to Start Your Housecall Practice. In 2008, she started training other health care providers on how to open a house call practice in their region and developed The Housecall Course, which has trained over 1,000 clinicians on how to start and maintain a house call practice in their hometown.
Dr. Lawson felt the powerful effect she was having on her patients and that they were having on her, and she wanted to share her experience with her children. “I was trying to build my daughter a little children’s book library about what I did as a nurse practitioner (NP) or just trying to find any books about [a] Black nurse. But I couldn’t find any books.” So, of course, she wrote one. Nola the Nurse® is a children’s book series about a Black NP who makes house calls. Her daughter, Nola, becomes interested in becoming an NP too. So, she starts visiting her friends’ sick dolls to make them better and ultimately discovers new cultures with every home visit. Scharmaine wanted to educate children about nursing and STEM careers as well as identity and cultural sensitivity. “Whenever you go to someone’s home, you’re entering a different culture, and you need to recognize and respect that.” Each book explores a different culture as Nola visits different families, and each book features a recipe from that culture. Nola the Nurse® is an extremely popular title with 17 volumes and a coloring book, and it is being developed into an animated series. Dr. Lawson hopes her books will inspire children to explore nursing. “They can’t aspire to be something that they have no clue about.” Her books provide children an inside look into the medical field and the world of nursing.
While in-home visits are the cornerstone of Dr. Lawson’s practice, the pandemic has made them both imperative and difficult. Her patients are isolated and often high risk. “I think the greater risk is … me bringing something [COVID] to them.” Scharmaine is determined not to let the pandemic win. She’s finding alternative ways to provide care. “We have to adjust accordingly. And, you know, we have to get our minds accepting that it [the virus] is probably not gonna go anywhere. So what are we gonna do?” She has been seeing fewer patients in person and using telemedicine to provide care. “You can do house calls during COVID but have to be really cautious.” She says her patients are cautious about getting vaccinated but lean in when she explains the key scientist behind the development of one of the vaccines is a Black woman. “They get excited when I tell them about Dr. Kizzy [Corbett]. I realize that patients have a distrust of medicine, so I use myself as an example. I had both vaccinations, and I also get the flu shot each year.” The vaccinations are allowing her to provide hands-on care again.
“I really enjoy hearing about my patients getting vaccinated. It’s giving them a new lease on life!”
Dr. Lawson considers herself an ambassador of the voiceless. She is the Medical Director for Hope Community Clinic at the Family Justice Center, which provides primary care and trauma-informed care to domestic violence victims and victims who have experienced nonfatal strangulation. Dr. Lawson says she has seen an uptick in instances of domestic violence since the pandemic began. “I’d say the common denominator is stress. People are out of work. They’ve already been victims of domestic violence, and [the pandemic] has just exacerbated it. People can’t leave.” She feels there is an increased need across the board to expand services to behavioral health and mental health patients and identify those who exhibit symptoms. The medical community must be proactive to help solve these issues. Every day Dr. Lawson asks herself, “How can I enact change on entire communities and bring about real outcomes?” She wants to remind her fellow nurses that, “Things may be dark, but if you rely on hope, brightness is just around the corner.”
#FirstRespondersFirst Microstep
When you feel overwhelmed by a problem you face at work, identify the smallest possible step you can take to address it.
As you face incredibly complex challenges, practice breaking them down into small, manageable steps by asking yourself, “What’s the smallest step forward I can take in this moment?” This increases your sense of control and self-efficacy.
Scharmaine’s story is part of “Unmasked: Profiles of Humanity and Resiliency,” a collection of stories from the frontlines published by the National Black Nurses Association (NBNA) in partnership with #FirstRespondersFirst. The NBNA offers therapy and wellness services through RE:SET, a free mental wellness program developed for Black nurses to help them RE:SET, recharge and widen their circle of support. Visit nbnareset.com to learn more.