Alumna Marshirl Locklear serving the Lumbee Tribe one patient at a time

By Mark Ray

Robeson County, North Carolina, ranks dead last among the Tar Heel State’s 100 counties for health outcomes and health factors like smoking and obesity. Diabetes, cancer, poverty and a lack of local medical specialists make it hard for the rural county’s residents to maintain and improve their health.

But the situation is slowly improving, thanks to Marshirl Locklear, BU ’15 & ’18. A family nurse practitioner, Locklear opened a clinic in the Robeson County city of Lumberton in April 2019, just three months after the physician she’d been working for, Dr. Ben Hardin, died.

“We’re in a rural area, so I get to see a little bit of everything,” Locklear says. “We do have a hospital system here, but we lack a lot of specialists. I either have to send patients to Wilmington, UNC Chapel Hill or Duke (for specialized care). A lot of them don’t have transportation, so that’s a big issue.”

From factory floor to exam room

Locklear took a unique path to becoming a nurse practitioner and business owner. Married at 19, she was working in two factories and raising a child when she realized she would never get ahead without more education. She earned an associate degree in nursing in 1998 and a bachelor’s degree nine years later, but then took a break from nursing to help run the construction business she and her husband own.

“I was helping him with the intention of once I got this business up and running, I would go back into my nursing field,” she says.

Locklear wasn’t accepted to the graduate nursing programs she applied to, however, so she pursued a Master of Business Administration from Brenau, reasoning that the skills she would learn would benefit her in the construction business. She was right, but she wasn’t done with education — or with Brenau. After completing her MBA in 2015, she
began working simultaneously on two nursing degrees at the university: a Master of Science in Nursing and a Doctor
of Nursing Practice.

After graduating in 2018, Locklear began her short stint with Hardin before opening her own practice. Most of Hardin’s patients and staff followed her, which let her hit the ground running. She also received continual encouragement from classmates and faculty members — including Brenau Assistant Professor Jill Hayes, who made the six-hour trip to Lumberton for Locklear’s grand opening.

Navigating the pandemic

Less than a year later, the COVID-19 pandemic began. Locklear’s mostly elderly patients were scared to leave home for nonessential care, yet few had the technology or willingness to use telehealth services. Locklear managed to remain open, serving the few patients who still showed up and paying her staff — none of whom she had to lay off — through a Small Business Administration loan.

“Things were slow,” she says. “There were days we might not see two or three patients.”

Today, however, the practice is growing. Locklear now employs a second part-time nurse practitioner, two certified nursing assistants, a licensed practical nurse and two office staff members. She also has an in-house lab technician supplied by an outside vendor.

This success comes as no surprise to Troy Heidesch, director of Brenau’s Mary Inez Grindle School of Nursing.

“Dr. Locklear was one of the best students to graduate from our DNP and FNP programs,” Heidesch says. “She was driven, worked hard and believed in the importance of caring for others. In her work in school, her work with patients and her work as a business owner, she best embodies Brenau’s mission for students to live extraordinary lives of personal and professional fulfillment.”

Health disparities in Lumbee Tribe

Many of Locklear’s patients are, like her, members of the state-recognized Lumbee Tribe, which has territory in Robeson and three adjoining counties. Diabetes is prevalent, and patients struggle to control their conditions.

“In the Lumbee Tribe, we — including me — are apt to take medication,” she says. “We don’t want to change diet. We don’t want to change lifestyle.”

As a doctoral student at Brenau, Locklear studied perceived barriers to implementing needed lifestyle changes among diabetic and prediabetic Lumbees. As a nurse practitioner, she’s putting what she learned into action.

“If I have a new diabetic patient, I sit down with them for at least 45 minutes and we discuss diabetes and the effects it has on our body because nobody ever tells us that it affects every organ except the lungs,” she says.

Today, Locklear chairs the tribe’s Health and Human Services Committee, which approves research projects that involve the tribe, and she’s working on setting up an institutional review board to oversee such projects. She’s also involved in efforts by Community Organized Relief Effort, or CORE, a charity founded by actor Sean Penn, to educate Lumbees about the importance of receiving the COVID-19 vaccine.

But it’s apparent that Locklear’s real joy comes from helping her patients get essential medical care.

“That’s my giveback to the community,” she says. “There’s no reason everybody shouldn’t be able to see
somebody and get the care they need.”