Recipients of ONS Foundation Funding

Meg Bourbonniere, PhD, GNP

Dr. Bourbonniere is currently completing an outcomes study funded by ONS Foundation through an unrestricted grant from Genentech,Inc., Interorganizational Relationships and Post Surgical Cancer Care, which she hopes will provide the data needed to promote seamless care for older post surgical cancer patients. A CNS in Adult Health with a post-master's certificate in gerontology advanced practice, she became interested in oncology care in her doctoral program when she worked as a research assistant for Dr. Sarah Kagan. During this time, she also worked with Dr. Karen Schumacher, who was studying family caregiving skills for cancer patients who were discharged from the hospital. In this work, Meg realized how unprepared families were for the care that they were expected to provide for their elderly loved ones who had been hospitalized for cancer. She explored this interest area further, looking at rehospitalization from skilled nursing facilities for colorectal cancer patients. Health services research studies, supported by the John A. Hartford Foundation "Building Academic Geriatric Nursing Capacity" Program and the Agency for Healthcare Research and Quality, were the focus of her postdoctoral program. After completion of Dr. Bourbonniere's current grant, she plans to get the picture from the "other side" and interview nursing home staff regarding the process of admitting cancer patients from hospitals and providing cancer care in the nursing home setting.

Dr. Bourbonniere has been an ONS member since 2001. She completed her PhD recently and is currently on the faculty at Yale University. She is shaping a research trajectory in an acutely needed and important area of care-the older patient with cancer and how to best provide services to this population. This fits very well within the ONS research priorities in that the cancer experience of older adults is focused on symptom management issues, and the need for evidence-based nursing interventions to improve patient outcomes.

However, it has been challenging to translate a research plan into reality. In the case of her ONS Foundation funded study, it meant combining federal and state data under very strict requirements from each agency and developing novel approaches to obtaining data from clinicians. Her original plan was to interview discharge planners regarding the older cancer patients who needed to be placed in nursing homes postoperatively to meet their rehabilitation and general care needs. Finding the discharge planners, and then gaining access to them for interviews proved to be much more of a challenge than she had anticipated. Fortunately, she had help from excellent research assistants, Nina Sutherland, MS, RN, a former nurse manager in GYN-oncology and Kristin Corey, an undergraduate nursing student who aspired to practice in oncology. She relates that the best advice she ever received was to "Find a mentor!" She describes her definition of the most effective mentor as the, ".best senior person in your area of interest who is available to you to bounce ideas off of, and help in disseminating the results of your work, such as preparing manuscripts and subsequent grants." When asked what she would do differently if she was beginning her career over again, she indicated that she would probably "do things the same" except she would have specialized earlier in gerontology, specifically in a gerontology focused master's program.

Dr. Bourbonniere's goal is to improve the care of cancer patients in nursing homes, and hopes that advanced practice and generalist oncology nurses will actually practice in nursing homes. She states that the care of the older cancer patient in skilled nursing facilities has lagged behind the care planning and intervention for older patients with more traditional rehabilitation needs, such as total joint replacement. Cancer care planning and intervention are needed to improve care for post surgical cancer patients in the nursing home, and her research into interorganizational relationships will contribute substantially to that knowledge base.