The talk today of evidence-based practice carries with it the assumption that there might be one method, one 'way' of doing things, which might be the 'best' way to work with all, or at least most people. However, common sense tells us that people vary greatly. What 'works' for one person will not work for another. Indeed, often what 'works' for one person, at one moment, will not 'work' for them even a short time later. People change!

Why do we need to refer to studies of 'samples' of 'anonymous people' to find out 'what works'? Why do we not simply ask the person what works for this person, now?

Some years ago, when we began talking about this in our workshops someone said, "its just common sense". I remember saying, "Oh, do you think so? I agree, it makes sense. But what is it not more common?"

Effective caring is about being sensitive to such subtle changes; building these tidal rhythms into the flexible care the person needs. Caring draws from a well of what might be called 'intuitive' or 'human sense' that taps into the evidence of what takes place between the nurse and the person in care. However, the practice of this form of care, especially today, is so rare, that it perhaps it should be called 'uncommon sense'. This uncommon sense is, at least, as powerful as the evidence of what 'works' for people in general. If you were the 'patient' who was being asked  - "what is working for you? What isn't working for you?" - you might feel that this 'uncommon sense' was far more important than the latest 'evidence-based guideline'. 

Poppy Buchanan-Barker