Our Spotlight series highlights a new nurse from the SHIFT audience each month. We ask the same set of questions each time, but of course we get all kinds of answers. The individual stories and surprise twists in these conversations make us laugh and cry — and fill us with pride about nursing. Over time, we hope to discover both what makes each of us unique and what ties us all together as nurses.
Scharmaine L., a psychiatric mental health nurse practitioner from Louisiana, is not afraid to push the limits of entrepreneurship and nursing. Her nursing career spanned the ICU, ER, travel, Level 1 trauma nursing and home health fields before she became a nurse practitioner. From there, she launched her own community nursing business in the early 2000s to provide house calls to seniors and people with disabilities. It was the first nurse-practitioner-owned house call practice in the state of Louisiana, and a care model that many of her patients relied on during the devastation following Hurricane Katrina. Since, she’s earned her doctorate and developed her business into a teachable model, “The Housecall Course,” that has trained more than 3,000 clinicians to start their own house call practice. To reach even more people, she compiled her experiences and lessons into her first book: “House Calls 101.”
It wasn’t long before another need in Scharmaine’s community inspired her. The mother of two was unable to find minority representation in children’s books about healthcare or other STEM fields, so in 2015, the “Nola the Nurse” book series was born. It features Nola, a 7-year-old Black girl who starts her own nurse house call business caring for friends’ dolls, inspired by her mother’s day-to-day work as a nurse practitioner. From this nurse practitioner protagonist, the series has expanded to include multiple languages and characters like nurse anesthetists and midwives, as well as activity and coloring books. Nola and her friends model cultural sensitivity and relevance for young minds as they venture through different countries and explore a range of topics, from Hurricane Katrina to germs and cultural festivals. With Nola soon to become an animated series, Scharmaine has even taken her characters on tour, visiting local schools with a life-sized Nola character to share her stories.
With an eye for opportunity as an entrepreneur and community health advocate, Scharmaine realized the acute need for psychiatric nurse practitioners through her house call practice. So this year, she completed her certification to evolve her house call business to its next phase: virtual medication management and talk therapy. It’s a much-needed shift during a pandemic that required her to balance childcare, her patients’ needs, and her family’s health. Scharmaine came across our radar for her latest role, as she was asked to host a podcast about the monumental “Future of Nursing” report by the National Academy of Medicine. (You know we love podcasts!) It’s just one of the many ways that Scharmaine outlines alternative paths for the next generation of nurses to find answers to the needs they come across in their communities.
Why did you decide to go into nursing?
The thing is, I just really, really love science. And I think the fact that nurses are scientists is lost somehow in America. We get left out of all of the STEM conversations. They say, “Oh, it’s engineers, it’s mathematicians, it’s NASA.” Whoa, whoa, whoa, whoa, whoa. Nurses are scientists, and we have to know a lot about science — hello — so we won’t kill you, right? Especially as advanced practice nurses. I loved my biology and math classes. And while I wasn’t sure if I wanted to do nursing, I always knew I was going to go into something medical.
When I started, I got into a certified nursing assistant program in high school. It was just to get my feet wet and see if nursing was something I wanted to do. And it was. I loved it. I loved doing little things like filling up the pitcher of water, rolling the patient downstairs to go home, rocking the babies. Once I graduated from high school, and I actually got into the field and went to college to become a nurse, I learned that it’s more than that. Of course, that’s the backbone: caring. But then you get into other things like administration and other leadership roles, which is what I eventually did.
Tell us about a time when it was really hard to be a nurse or a time that made you question being a nurse.
Hurricane Katrina was really, really, tough. I was devastated. It was probably the worst thing I’ve experienced in my personal and professional life. Part of that was because I questioned what I was doing, and if I was supposed to come back. The storm hit in August of 2005, so I evacuated. But then I actually came back just two months later, and it was hell. The place was completely devastated. There was still standing water in lots of areas, all over town. And I questioned my sanity as far as wanting to come back so soon and render care to so many who didn’t have healthcare providers — and who definitely didn’t have healthcare providers going into their homes. So I questioned a lot of my judgment during that time, especially when I would go into dark areas that were especially hit hard. The National Guard was there, but nobody else. And trying to find someone’s home at night, in all that destruction, was challenging.
There are all kinds of things that I did during that time, trying to reach people, where I felt unsafe. So I definitely questioned not only whether or not I was sane, but also whether or not I was in the right profession for such a time as it was. Later on, I realized that I was in the right place at the right time, and I made the right decisions. But it certainly didn’t feel like it at the time, and I didn’t always feel safe doing this work. It was one of the toughest moments because both the personal and professional parts of my life were bad, since living there was so challenging, too. Usually, you have one part of your life that’s bad and the other part that’s good, but when they’re both bad, it’s a lot. But you’ve got to do it. You’ve got to get through it.
Who inspires you?
I have so many people who inspire me, but I’d say probably the one person who really inspires me is Nelson Mandela. Everything he went through — the fact that he was imprisoned for all those years and never gave up his faith or his belief in his countrymen — that’s inspiring. Mandela continued to believe that he would be released, and when he was, he was just so vibrant and still full of life and hopeful. To me, he’s the epitome of someone who never gives up and believes in freedom. He’s always just been one of my favorites. I wish that I would’ve had an opportunity to meet him before he passed. There are a few others, for sure, but he’s at the top of my list. His words are so inspiring, and there’s power in stories like his. … He went through all that he did and came out on the other side still victorious and encouraging the masses. That’s when I think to myself, “I could do so much more.”
Describe your SHIFT BFF. Why are they your best friend on the job?
Because I’m not on a traditional shift, I’d have to say other nurse entrepreneurs. We just give each other a call and say, “Hey, what do you think about this?” And most of them are not local. I live in New Orleans, Louisiana (hello, NOLA the Nurse!) so most of them are out of state, but it’s nice when I can just pick up the phone and call one of them or FaceTime and say, “Hey, today’s really tough. I wasn’t able to meet this deadline. What would you do?” Or I have some friends who will listen to some of the animation for NOLA the Nurse, because we’re doing the parts now where we add the voices to the motion, and some of it was just a little off. So it’s nice to be able to call other entrepreneurs who kind of get my style, if you will. And they’ll just say, “Oh no, it sounds good.” Or, “No, it needs something else.”
It’s nice to have those BFFs in the field. They’re not literally next door to me or in the chair next to me, but they’re a long-distance network of folks. Because I mean, when you get to certain career levels, you have to have people who are on the same level as you, who understand what you’re going through and what you’re doing. … So it’s nice to have other entrepreneurs to share your journey with, because they’re going through something similar as well. They’re talking about how they’re going to meet payroll, or stressed that they need to hire somebody today or they’re flying out tomorrow to Kenya to do a keynote. I mean, who are you going to tell that to — right? You have to have a network of people who are doing similar things as you and who can say, “Oh, yeah, yeah. You want to get this when you get there, do that.” It’s nice to have other people to bounce ideas off of. So, yeah, they would be my shift BFFs, albeit virtually.
Tell us something about your specialty in nursing that other nurses may not know.
My original specialty is family nurse practitioner. Then recently — actually, this year — I completed my psychiatric mental health nurse practitioner certification. And I did that because of having a private practice for so many years, just doing family practice, I realized the acute need for psychiatric nurse practitioners. I wanted to also have that other level of care given to my patients who are in marginalized communities. So that’s my day job, where I do virtual visits with my patients in psychiatry and help them out that way.
My other job is in the entrepreneurial space, where I get to teach other nurse practitioners how to start a house call practice. I have “The Housecall Course,” which I’ve been running now since 2008, and I teach other clinicians from all over the world how to start a house call practice in their areas, or if they want to just add it on to their original practice.
A lot of people, they say, “Oh, house calls, what’s that about?” And there may be a bit of apprehension about it, because when a patient visits you in the clinic, it’s a totally controlled environment. You get to control everything. They sit down, they have to take off their clothes and put on a gown for you to examine them. Whereas, when you go to their home, it flips. You’re no longer in control. Yes, you’re the provider, you have all the power, you can write prescriptions. But you’re in their home now, and they’re actually in control. So, you can ask them to stop smoking, you can ask them to put the chihuahua away, but when you get there, the reality is, there’s smoke in the room. Yeah, they’re not smoking, but the drapes are full of smoke, right? And the chihuahua is going crazy in the kitchen just behind a little gate. … There are things that you’re unable to control, but you still have to do your job.
A lot of people don’t realize the shift in control that happens (hey, there’s that word, SHIFT!) when you are doing house calls. Sometimes it’s a bit of a hurdle for clinicians to get over, because we’re used to working in controlled environments. But when you go into their home, you enter the patient’s culture and have to respect the culture that you’re walking into. Maybe you need to take off your shoes or other things, like some people insist you eat something before you can even touch them. They say, “No. We’ve got to have some beignets and coffee before you take my blood pressure.” And you just know this, right? So, it breaks your routine, and then on top of that you have to learn how to render care in a totally different environment that you don’t always learn about in nursing school. That’s the pretty cool part about house calls. I like doing things a little on the edge, if you can tell. House calls kind of put me out there. I’m free. I can take care of a patient on the swamp, on the bayou, on the rooftop, or wherever. It’s still care. Just the scenery has changed.
Describe your community’s health. What is your hope for your community’s health in the future?
Most of my patients live in a marginalized, impoverished community, so my hope is that all of them will be vaccinated, because a lot of them are not. There’s a stigma within the community around vaccines and not wanting to get one. Now we’re in the phase of getting boosters, but so many of them haven’t even had the first vaccine. So, my overall hope is that many of them will see the benefits of getting the COVID-19 vaccine and see that it does save lives. I’m trying, on a daily basis, to help chip away at the stigma that vaccines have in the community.
I hope that we’ll have more people on board who’ve decided to get both shots. Because some people in my community will get one shot, but they won’t go back to get the second one because they may have gotten sick in between or had strong side effects. So, part of convincing them is explaining to them what happens when you get a virus, versus when you get the vaccine. Yeah, you may not feel well after getting vaccinated, but the alternative is death. Are you afraid of those symptoms more than death? You have to explain it to them.
What is your vision for the future of nursing?
For me, it’s pretty simple. My vision for the future of nursing is that all children will know about the important roles of advanced practice nurses, and that we are viable members of the health care team. Something I’ve always said when I talk about launching “Nola the Nurse,” is how can children aspire to be a nurse practitioner if they’ve never heard those words? If they have no idea what a certified registered nurse anesthetist does? They don’t know what “CRNA” means. Or the word “midwife,” they don’t know! So how do we help them get to the point of acknowledging, and maybe experiencing those roles, once they’re more aware? We have to first teach them these words. Every child knows “lawyer,” “doctor,” even “basketball player,” right? But say “nurse practitioner,” and “Oh.” There’s always a pause. My goal is to end the pauses, erase the ambiguity about the role. We’re viable members of the health care team. Yes, we are nurses. Some of us have doctorates. But we still are, at the end of the day, a nurse.
So I’m going to keep writing and pushing until kids all over Malaysia, Kenya, Africa, Hawaii, Canada — everywhere — they know what a nurse practitioner is, what a midwife is and what a CRNA is. The books introduce them to the terminology and the words in a story format, and then I have the activity books where you see the characters come to life. It’s a process because there are four characters. So the push has been all about “Nola the Nurse,” but the last couple of books have mentioned “Maddi the Midwife.” We haven’t really talked about what midwives do, but now that we’ve introduced her, it will spark curiosity. The kids can say, “Oh, Mommy, what does a midwife do? She’s with Nola the Nurse.” It starts with a small introduction to the words, which hopefully can spark curiosity about what those characters are learning to do.
How can nurses be better to each other?
For you to be better to someone else, you have to first take care of yourself. It starts with you. It starts with self-care. When you feel good about yourself, that feeling is transferred to someone else, because you’re already happy. You’re already whole because you’ve taken care of yourself. If I’ve given myself the moments of self-care that I need and deserve, it’s easier for me to take care of someone else and to transfer that wholeness. … Every nurse needs to take moments for themselves. It could be something as small as taking a few moments to meditate quietly every day, 10 or 15 minutes. And then when you see your friend, it’s easy for you to have empathy for them because you know that you filled your vessel that morning when you got up. Then it’s easier for you to take care of your fellow nurses, your colleagues and your patients, because you’ve made yourself whole that morning.
But you have to put it on your calendar or set reminders and actually remember to do it. We’re always making time with our family or with our partner or with our patients or associates, and usually we get the short end of the stick. And yet we are the common denominator with all of those people. So I’ve learned it all starts with me, even if it’s just 10 minutes of meditation with an app. I try to do that every night. At least 5 or 10 minutes before bed, then 10 minutes when I wake up, that’s 20 minutes and, of course, if I get some exercise that’s great, so it adds up to an hour of self-care a day. Then we’ve got 23 hours for someone else. Aren’t you worth at least an hour out of the day? The more we focus on trying to fill our souls and fill our vessels and make ourselves better, then we can give more. We need to erase the stigma that self-care is selfish. Because when you’re being generous to yourself, you can actually give more to others.
Describe one of your best shifts ever.
I’ve had so many, but some of my best moments were in the baby unit. I got to rock babies to sleep and feed them. Those are some of my best moments. I’ve had so many other moments, but those were moments that really made me say, “Wow, this is the life.” It’s when I was called to nursing. I was working pool nurse shifts for a while, and even then, I went over to the wellbaby unit and would rock babies. It’s a time to slow everything down and pick up the baby, and just get in a rocking chair and rock them, have the little music flowing behind you. It’s just amazing to hold a sleeping baby and rock them. And you just think, “Wow, they have the whole world ahead of them, but I get to hold them, just for now, safe and sound.” There’s nothing like it. I wish I could do it now!
A highlight of my career outside of a traditional shift was hosting the “Future of Nursing” podcast. It was the first time I had hosted a full podcast. I learned so much about health equity and social determinants of health, the important roles nurses play in those issues and how nurses need to be supported. All the recommendations from the National Academy of Medicine’s Future of Nursing report actually came to life in the podcast. That was, among other things, one of the highest points of my career. I loved, loved doing the podcast. It was amazing. I actually had to evacuate from Hurricane Ida during the taping. I brought the equipment with me, so I had to get into some voiceover studios in different cities to do the work.
It was a fun, wild ride and made me feel like I wasn’t in the fight alone. A lot of times, when you’re fighting for something for so long — like health equity or the different types of social determinants of health that I deal with on a daily basis and in community work — it can feel that way. So it was just nice to see that an organization is saying, “Yes, these things matter.” And, “Yes, we’re going to make a slew of recommendations about how we can get behind you, and how America can get behind you and make sure that a lot of these social determinants of health are eradicated, so we can have more positive patient outcomes.” Participating in this project made me feel like I was on the right track, because a lot of times you do something and you’re facing the same issues for so long it becomes like, “Is anybody here? Is anybody listening?” So it was really gratifying to know that the National Academy of Medicine is on our side.
Learn more about Scharmaine:
She’s on Instagram @dr_lawson_np
Here’s her LinkedIn
Learn more about Scharmaine’s practice and house call course on her website.
Hear Scharmaine dig into health equity in “The Future of Nursing” podcast.
These links are not endorsed by SHIFT and the views expressed within are their own.