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The Choluteca bridge: What’s wrong with this picture?


Have you ever heard of the Choluteca Bridge in Honduras? Designed to withstand even the strongest hurricane, it survived Hurricane Mitch, a category 5 storm that devastated the Caribbean in 1998. Every other bridge in Honduras was destroyed. The only problem: the powerful storm had changed the landscape and moved the river right out from underneath the Choluteca Bridge. Completely. Permanently. As this image shows, the bridge is now a bridge to nowhere.

The key theme in this story is change. Hurricane Mitch changed the course of the river, so the reason for the Choluteca Bridge changed. How do the words change and bridge connect to nursing? Whether I’m rounding, attending a meeting, or participating in a shared governance conversation, the word change always enters the discussion.

Why does this word make us wince or raise our blood pressure? It shouldn’t. Do you know how much change you experience every day? The change could be as simple as updating an app or driving to work by a new route due to a traffic detour—or it could be as complex as learning how to program the new I.V. pump just delivered to your unit.

We confront change many times in our daily lives and adapt to change every day. Yes, we’re changing all the time. Our continuous pursuit of high-quality patient care and nursing excellence requires us to change constantly. How do we readily adopt what’s new for us, our patients, and our organizations? And (what might be even harder) how do we stop doing the old and start doing the new?

Learning from each other is one way—building bridges to each other, sharing, discovering what’s working well for others. These are important aspects of dealing with change. A member of the faculty at the Institute for Healthcare Improvement described the need for change this way: “On finding what works, we need to standardize, simplify, and steal shamelessly from everyone who can contribute, because we’ve reached a point where no excuses are allowable.”

In nursing, standardizing practice based on highly reliable interventions is the key to surviving the current “hurricane of change” at the same time we’re creating innovations in nursing practice. The American Nurses Association (ANA) supports many learning opportunities—ANA’s Quality Conference and Staffing Conference, the American Nurses Credentialing Center (ANCC) National Magnet Conference®, to name just a few—where we share and learn, and where we build “innovation bridges” to our future and “connection bridges” for long-term networking.

From time to time, we have to look backward to see forward, and the story of the Choluteca Bridge gives the nursing profession a few lessons to ponder:

  • Change comes in many forms, some simple and some dramatic. Our ability to adapt to change is the important thing.
  • Learning happens through many forms—print, video, in-person presentations. Many of these forms are bridges and connections that help us understand what’s new and what’s working. We need to seek those opportunities often.
  • Major shifts are happening all around us, through technology and cultural changes as well as patient and care demands. Nursing—and nurses—change and shift every day. I see it constantly. It’s nothing new.

Think about the next bridge you’ll build—to a patient, a team member, a family in need. Your bridge has a purpose beyond what you can see. Keep reading and keep discovering, because the challenge is to learn faster than the world is changing.

Lillee Gelinas, MSN, RN, FAAN

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