Nancy Brook, NP, has succeeded in helping hundreds of people discover hope and eventually achieve peace of mind after being told the ultimate in devastating news: they have cancer. One of the secrets in her NP Bag; Nancy began her working career at Walt Disney World. The experiences she had there gave her a firm foundation on how to elicit the very best from people and create a sense of well-being and organization.
Awards & Achievements
Board certified AANP and AANC
Surgical Oncology Specialist Nurse Practitioner
Stanford Faculty Member (16 years)
Patient Guide and Advocate
Trainer and Mentor for Nurses & Coaches
Women's Life & Career Coach
Interview - Question & Answer
In your practice with oncology patients, what would you say are your strongest capabilities?
What I’m really good at is helping patients at the beginning, when they first receive the news. It’s when they first get that phone call and the doctor says: “You have cancer.” At that point, their world just kind of stops. They don’t know what to do next… they get a lot of advice, input. I’m really good at helping people collect the information, get themselves prepared, and organized so that they can take the next step with confidence.
Can you tell us some of the specific things you do to help your patients?
It can mean a number of things. It might be helping them to gather all the documentation from different places and putting it together. A lot of people see lots of different consultants – so they might see the radiation doctor and they don’t have the operative report and the pathology report, because that’s somewhere else. They may show up to see a surgeon and not have a copy of the MRI & they say, “I thought you had it!” So, what happens is, you don’t get the maximum benefit of the appointments you do have, there is confusion; there is a lack of communication between the providers—and that’s just not good. So, it can be as simple as starting with that.
Do you have other areas you work on with patients?
Yes. I do other things like helping the patient to understand when they need a second opinion or understanding a time frame. Sometimes people hear they have a tumor and think, “Oh no! I’ve got to have surgery tomorrow!” Well sometimes that tumor has been there for a while and until you have everything set up so that you are ready to go, and everything is in order—you need to take a step back. But how can a person do that if they’re in a panic?
This is about empowering the patient. If someone goes into a doctor’s office and is afraid to ask the hard questions or feel intimidated by the presence of your surgeon, or they don’t take a lot of time for you. The person can be very scared, but they really need and want answers. I am very helpful at helping people know how to have that discussion. For example, how to talk to that provider; how to create a list of questions; and know what questions you should ask.
Yes, and I would imagine the medical diagnosis could be confusing.
Exactly. Sometimes I help them understand what their cancer is, what does it mean. What do the reports mean? There can be a lot of jargon; some things are said because you have to say them for legal reasons. But people often don’t know what they really mean.
With patients do you usually know what lies ahead and do you help them deal with their options?
You can have a little bit of an inclination of what might happen. But it’s actually even touchier, because you want to be respectful of other people’s wishes. You might show up with a certain thought, or a personal history of something your friends or family have gone through. I can’t tell someone what to do but I can make some suggestions.
The rest of it is teaching them how to manage themselves. Creating a support system; knowing what you can and can’t do. Should you exercise? Should you stop exercising? Should you work? Discussing if this becomes their identity or is it just a feature of their life?
I do best at the beginning by helping people take those next steps with confidence. Being an advocate for them and supportive is where I am the most helpful. That beginning part is where I’ve had a lot of experience and that’s the time when the news can just throw the person’s head for a loop.
When a patient finds out he or she has cancer, it is hard not only on the patient, but the family as well. I understand that you have experienced this personally?
My mom died from cancer and even then, I was trying to be helpful, but I wasn’t very hopeful because I didn’t know what to do. So even if you’re bright or in the business, educated, savvy; when you are in those moments you are kind of paralyzed and it’s hard to take in what the options really are. It’s really hard to make good decisions because you see that big picture. You just have to put one foot in front of the other.
Impressively, you have two master's degrees and are working on your PhD. Did you get your Master's in Counseling to reduce professional vulnerability in working with the unavoidable emotional aspect of treating patients with cancer? Or, would it have been appropriate to address their significant perturbations under the hat of Nurse Practitioner?
I could have done it under the NP hat, but at the time when I went back to school, I had a large number of patients who had many needs. They were going through a lot. I also had 2 children who had needs. At the time, I was curious about having a small MFT practice as well. In the end, I didn’t really do that; I kept really focused on my nursing position and other things that I’ve been doing; writing, mentoring and teaching. That’s been really good too; you can help a lot of people.
Do you work with people long distance?
Absolutely. The technology is so good; obviously the telephone is great, we’ve got Skype and email. We can look at records together and together walk through the reports. And the good thing is, no matter where you are in the states, medicine is the same. I can also talk to doctors on people’s behalf. If you don’t understand something, or the family doesn’t understand. Educationally, sometimes people can’t understand on their own. There’s a connection you can make for them.
If you were speaking with a nurse who wanted to expand their career what would you advise?
For a nurse who is thinking about doing something different or changing their trajectory within the nursing profession, the career of an NP is fast-growing. There is a lot of opportunity and also a wealth of options in terms of what you want to do. You may want to work with kids, in psychiatry, or counseling. You may want to work within the nursing industry to help employees, or at summer camps, schools, or in surgery. There are so many opportunities for which you are well compensated.
It gives them a chance to learn new skills; they are not the same skills you would use at the bedside as a hospital nurse. These careers really allow you to expand. The other nice thing, is that you can really recreate yourself. So as a NP you might start in internal medicine or pediatrics and then down the road say, this really isn’t for me; I really want to work in orthopedic surgery or any other specialty. You are able to do that. Doctors have to go through another residency program.
As an NP you can change your specialty area without going back to school. Typically, you’ll need additional on the job training and mentoring by your new team because they understand that your education is a strong foundation for whatever field you might like to explore. Another benefit is that you get to have geographic mobility if you need to move because you got married or other reasons. Basically, wherever you go where there are people with medical needs there will be a need for you. It’s a highly employable profession.
Any more advice?
Yes, for those who are interested who are college students or students who have a hunch they might have an interest in this kind of work; you can go more directly than becoming an RN with a bachelor’s degree and then works in a hospital. There are programs that move you directly through. There is a handful of them – I think Yale, Vanderbilt and Case Western Reserve University.
Two of the fastest growing careers in the nation are Nurse Practitioners and Physician Assistants. If someone were trying to decide between the two, what might you tell them?
At the end of the day we are somewhat interchangeable professionally. Say for example, at Stanford they may list a position as an NP or a PA in terms of work. The differences are in education. Physician Assistant can do a certificate program for 18 months or they can choose to do some kind of degree program. Nurses need a minimum of a master’s degree in nursing to become a nurse practitioner; moving toward a doctorate. They are certainly highly educated. Physician Assistant works under a physician at all times. A Nurse Practitioner can work independently in almost every state. We can write prescriptions for narcotics, we have DEA licensure; we can put a shingle out and run our own practice if we wanted to. So there is an independence there.
But a lot of it is that we have “nurse” in our name; so by that alone means we are looking at the whole person; we have a holistic approach. We’re not going to come in and look at your scraped knee and just address your knee. We’re going to talk to you about school, your marriage. We are going to try to give you some comprehensive care in a holistic kind of way.
You have written a book; "The Nurse Practitioner's Bag: A guide to creating a meaningful career that makes a difference." Could you tell us a bit about the book?
The book is written for college students, nurses, even mid-life professionals, who want to recreate their career and make a difference. And this is one way that they can, by becoming an NP. I tell some stories that are inspiring; there is a section on classes. But it’s really about what it is like to have a career like this. This is what it looks like; this is what your day looks like; this is what is exciting. It’s the “NP’s” bag so I explain tools like compassion, listening skills, technology; just the kinds of things to help people find out if they identify with it. On my website there’s a page where I wrote what is in the book.
Are you still active as a life and career coach for women?
Part of being a nurse and a coach is that I basically work with a handful of women; sometimes it’s about health issues like how to create a healthier lifestyle; not just managing high blood pressure or a sore knee. It’s about working with the whole lifestyle; work, balance, the spiritual part and the mindful part. It’s kinda nice to see people move from feeling good to feeling great as well being able to tackle bigger issues. At the end of the day, we’re all trying to do the same thing, right? To live a happier, healthier life.
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