Key Takeaways
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Wound Care Is Both an Art and a Science.
While evidence and physiology drive clinical decision-making, true wound healing requires individualized care plans that address comorbidities, psychosocial factors, pain, sleep, stress, and trust—treating the whole patient. -
Mentorship and Lifelong Learning Are Essential.
Early-career clinicians should “be a sponge,” seek multiple mentors across disciplines, attend conferences, engage in networking, and pursue structured education to build both knowledge and confidence in this complex specialty. -
Wound Bed Preparation Is Foundational.
Dot Weir’s “Wound to the Wise” reminds clinicians to “clean it like you mean it”—prioritizing thorough wound and periwound cleansing and optimization as the critical first step toward improved healing outcomes.
Transcript
Please note: This content is a direct transcript, capturing the authentic conversation without edits. Some language may reflect the flow of live discussion rather than polished text.
Catherine T. Milne, MSN, APRN:
Hi, I'm Cathy Milne and I'd like to welcome you to WoundConversations. I am so excited that we're going to be doing this. This podcast is all about where wound care professionals come together. We learn, we talk, we share, and we hope that you will enjoy this as much as we are going to enjoy this.
Jayesh Shah, MD:
All right. And I am Dr. Jay Shah and I am a wound care doctor, an internal medicine doctor, in San Antonio, Texas. And I am so excited about WoundConversations too, Cathy. And I know that each episode will bring you accessible insights from today's leading experts and emerging voices in wound healing; clinical practice management, emerging care models, and clinician wellness.
Catherine T. Milne, MSN, APRN:
And as we know from WoundCon, where we learn today and apply tomorrow, this podcast is very similar. Our conversations are really built around real world solutions and clinical situations. And what we want to do is to deliver better outcomes for your patients.
Jayesh Shah, MD:
Today we are kicking off a two episode series about starting your wound care journey with Dot Weir, the world famous wound care nurse and Dr. Lee Ruotsi. Whether you are just beginning your path in the field or have years of experience, this podcast is your space to connect.
Catherine T. Milne, MSN, APRN:
Now, WoundConversations is brought to you, of course, by WoundSource, the trusted resource for wound care professionals and WoundCon, of which Dr. Shah and I are co-chairs. And both of these are really a global connection to your education in wound care and wound management. So let's get started. So we want to listen today and apply tomorrow. So as we mentioned today, we are honored to have Dot Weir. She's a very good friend of mine. Welcome, Dot.
Dot Weir, RN:
Thank you. So nice to be here. I'm so excited to be on your first one.
Catherine T. Milne, MSN, APRN:
So Dot has been around for a long time. She's been practicing in wound and ostomy care for four decades. But what's really very near and dear to my heart is when I first started in wound care, I had to call Dot. I had no idea. I knew that she knew her stuff. I had a problem. I called her and she was so gracious and so helpful. And so I'm hoping that you will learn and see that graciousness from Dot. She is obviously board certified. She's a thought leader. She's a consultant. She's an educator. She is the co-chair for the Symposium for Advanced Wound Care. She was part of the founding faculty for the Wound Care Certification Prep Course. And she's joining us today from Holland, Michigan. She also has a special WoundCon connection, and she has been a very valued faculty member. And we look forward to having her on in the future.
Now, Dot has provided lots of webinar education, and she has done a lot for WoundSource hallmark, the Practice Accelerator, which you I'm sure will be getting emails, or if you haven't gotten emails, get yourself on the list. We'd love to have you. There's some great information there.
Jayesh Shah, MD:
All right, Cathy. One of my favorite parts that we will celebrate in every episode is hearing from such great people what really lights that spark in our guest and what's their wound care why?
Catherine T. Milne, MSN, APRN:
So now you've made Dot blush. Nobody else can see her on this podcast, but she's blushing. So actually, it is always inspiring to hear how people have gotten into this journey. So Dot, what's your wound care why?
Dot Weir, RN:
My wound care why. So I've been a nurse for 50 years this year. 1976, I started nursing, and then I went into wound care in 1980. So it's really all I've ever done. And so I don't know a life without wound care, but my wound care why is because every day is different, every patient is different. What we have to provide for them, the difference we can make in their life, every single patient is different. There is never a mundane day, as you guys know, when you're doing wound care. So I mean, I've worked with people in the past that said, "I'm just finding this a little boring." I'm like, "Well, this is not for you. " Because if you don't feel energized every time you step into your clinic or your hospital or whatever your practice setting is, then it's not for you. But that's my why is because it has just been such a passion for so long.
It has given me so many growth opportunities. And I mean, I'm sort of easing down because I'm getting up there in age and some people have, we have to retire at some point, but it has been 45 years in wound care and it has been, every day has been just a wonderful experience. And I'm excited for people who are just getting into it because the passion either grabs you or you realize maybe this isn't for you, but I certainly know that for 45 years, it has been certainly for me.
Jayesh Shah, MD:
Dot, what a right way to say that. And I think you create a legacy in wound care. Your work speaks for itself. You've been the greatest ever. We call you GOAT of wound care.
Catherine T. Milne, MSN, APRN:
Yeah, we do.
Jayesh Shah, MD:
You have done so much in the field and we are so honored to have you as our guest, but let's move into our main topic of conversation. We both know from our work that wound care is not just rooted in science. Although science and evidence clearly drives what we do, wound healing is also an art. Why do you think this is?
Dot Weir, RN:
It's funny. About, I would say at least 30 or so years ago, there used to be a meeting that was held in Florida every year, and it was called the Art and Science of Wound Care. So this is not brand new news. We have been talking about wound care as being art and science for a long time. And the science is a given. I can tell you that the science where the science has gone in the last 45 years in wound healing is amazing. In fact, it was about in the late '90s that I suddenly realized that there was a difference between wound care and wound healing. And when you really get into this and you really embrace it, you have to understand wound healing. But when you think about what art is, art is design, art is a specialized, something of beauty. I mean, there's a lot of ways you can define art.
And so science drives our practice. I think the art piece is really because each and every plan of care, each and every patient that we take care of has their own different needs. And it's kind of a cliche. You take care of the whole patient, not just the whole in the patient, but it really is true. And we have to connect with that patient. We have to gain their trust. We have to follow through on what we tell them that we're going to do for them. We have to make sure they realize that we are in this for them and that we are going to see them through this journey that they're on. Because I've never had a wound. I mean, I've had little boo-boos, but I've never had the kind of wound that these patients have. And so I think the art comes in taking the science and designing the right plan of care that's going to meet that patient's needs at every level with every disease process that they have going on, their Medicaid.
I mean, there's so many things that come into achieving wound healing in a patient. And so I think that's where the art comes in because we have to be creative in terms of how we're going to meet that patient's individual needs. And that's, again, that's why we want to show up every day because that's what drives us.
Catherine T. Milne, MSN, APRN:
What do you think are the challenges to the art piece? I mean, the science is coming and it comes in pieces at a time, but what kind of challenges do you have in that art piece?
Dot Weir, RN:
If you look at what we do, we're taking care of patients that have a host of disease processes going on. And Cathy, you go to all sites of care. So you see the diagnosis list that all these patients have. And I'm not diminishing other specialties on what they do, but if you're a cardiologist, they're looking at the heart. If you're an endocrinologist, especially in our world, you're dealing with their diabetes, we take that patient who has a hole in their body somewhere and we have to look at that heart. We have to look at the vascular flow. We have to look at the disease process. What drugs are they on? How is their diabetes being managed? Is it being managed? So we have to pull all of these pieces together to be able to fully understand how we're going to get this patient's healed. And again, it takes a team we talk about, we all talk about that all the time, how it takes a full team of providers to take care of these patients because we can't do it in a silo.
We have to make sure we know what's going on with their heart and their vascular, their blood sugar and any other disease that they have going on. And so many of these people are on these drugs that have made a huge difference, say, in their Crohn's disease, but it also is affecting their immune system. So there's so many things that we have to put together. And that's where we follow timelines and we say, okay, we're doing this now, but if we don't see a response in your wound, we're going to have to think further. And that's where we have so many wonderful advanced technologies these days that we can step up to. We always start with the basics, but we have now things that we can step up to in order to offer the patient continued hope that we're going to get that wound healed.
So again, it goes really back to that art and science. We're having to design something that's very individualized based on the things that are going on in the patient's healthcare as well as in their lives. I mean, just in their lives, we talk about pain. You go into a patient's room and you say, "Okay, do you have pain?" On a scale of one to 10, what's your pain? What's the least? What's the worst? And the other question that we have to be asking them is, how is it affecting your sleep? How do any of us feel if we don't sleep well? Horrible. And so we have to think about the other pieces in their lives, what's going on personally that could be causing them stress. And we know stress is something that can definitely impact when healing. So we just have to be so much to these folks.
And I think that goes back to the trust where they trust that they can tell us what's going on in their life and help us to guide them. We can't solve their problems, for sure, solve all their problems, but we can certainly think how that might be impacting their ability to heal. So it's huge. And just talking about this gets me excited because these are the kind of things that make a difference in these people's lives.
Jayesh Shah, MD:
I agree with you that every wound is so unique. And every day when I practice wound care and I see wound care nurses kind of come up with a artistic way of doing the dressing, artistic way of creative way, I can say, to make patients comfortable and come up with solutions that are unimaginable because you're right, every wound patient is unique and they are complex. They are multidimensional and you really need both art and science to really help these patients who have kind of lost the hope and they're coming to all of us with that little bit of a hope left and say, "Can this guy take away my pain? Can this people help me heal the wound?" And that's what I find when a passionate wound care nurse is helping these wound patients. And sometimes it may be very intimidating to the clinicians interested in the field or those early in their careers.
However, this is also very dynamic and a collaborative community. Can you share from your experience some common early experiences or even missteps they might expect to encounter?
Dot Weir, RN:
Well, I think when you're first entering into any kind of specialty, you're going to have those moments of, do I really know what I'm doing? Am I really capable of doing this of insecurities via you say knowledge is power? Well, I think knowledge is confidence and the more you do it, you're going to wrap a leg sometime and it's going to rough on the patient. We don't do everything perfect every single time. With experience though, you learn how to wrap the misshapen leg. When you're first starting out, you just, I think the best thing to do is to have a mentor, someone that you can call someone. Kathy, I don't remember this phone conversation that we had, but you need to have someone that you can call and it can be someone that you have heard speak. And I think anyone who's on the circuit, kind of like we all are, are so open to having people call us and say, "I've got this problem," or, "How do I accomplish this?"
Being open to not only being a mentor, but a mentor, someone that wants to be mentor, a mentee, I guess it is. It's definitely not something you get out of, say, a course and say, "Okay, now I can do wound care." It does something that has to grow on you, but it comes with confidence and it comes with practice. I think being able to go shadow with someone, I think the best thing is when you can go to work somewhere where there is a seasoned wound care provider, and this is whether you're a nurse, any kind of provider that you can sit with and bounce ideas off of. And I think that the people who do wound healing and practice wound healing are that kind of person that are always going to be willing to share experiences, give you advice.
I mean, I think we have to be careful with some of the advice that's given, especially over the internet and in chat rooms, these Facebook pages and stuff, but find someone that you can trust and find someone who that you can be mentored by and it will make a big difference in your career.
Catherine T. Milne, MSN, APRN:
So you've done a lot of education throughout your career. And how do you think people early in their career, what kind of educational steps should they take? I mean, there's no substitute for a mentor. And I think actually people have a tendency to limit themselves to one mentor and really the more mentors you have, the better wound care person you will be and your patients will be much better for that. So I mean, if you're a nurse, you should find a physician and a physical therapist and a dietician. And if you're a physician, you should find a nurse and a dietician and a physical therapist. So I've learned tons from my patients and I also learned tons like at the SAWC and people come and talk to me and we start bouncing ideas. I love that. But when somebody's really starting out, what kind of educational steps do you think they need to do?
Should they take a certification course? Should they have formal education? What are your thoughts on that?
Dot Weir, RN:
I think you need to make yourself into a sponge and bring it in everywhere you can. And I think, of course, I'm very biased because I have been teaching the Wound Certification Prep Course since 2004. And while it's mostly for people who are already practicing and are ready to sit for an exam, we actually have a lot of people who come to the course that are brand new in wound care and just want that initial exposure to two days, 17 hours of wound care information. Because to really sit for any certification exam, you have to have a few years of experience. But I think becoming a sponge, and I'm probably the worst at reading journal papers. I personally learn better when I hear it from someone. And then when I see their references, then I'll go to that. But I learn better in a more didactic sort of a setting.
So knowing what kind of a learner you are, some people can read and immediately remember what they've read. So it's pulling all of those pieces together, but I think the best advice is just be a sponge, learn everything you can. And of course, WoundCon is a good place to start, but there's such a good variety. And I mean, we've got a big fan club here because I'm the SAWC, you guys are the WoundCon, but there's a lot of education to be had out there. If you just look at, HMP Global has sites where you can go and see all kinds of archived presentations. Some of them are from industry, but we can learn from our industry partners because they have speakers like the three of us that are delivering their messages to utilize negative pressure or some kind of dressing better. So there's a lot of information out there if you just go looking for it.
So I think that being that sponge is the way to go.
Jayesh Shah, MD:
Doc, I think you said it so rightly. But for me, Doc, the main thing I like is networking. That's where I learn, learning from you when I meet you face to face and you talk about your difficult case. Sometimes the lectures are there, information is going to be there all over. Right now, we are in age of information. Information is handy. Everything is there, but getting that personal experience from someone like you, that only happens at SAWC.
Dot Weir, RN:
I think sometimes people look at this Symposium on Advanced Wound Care and think this is too high for me too, but you make such a good point about the networking. I love to see people's case studies. So just the poster hall and walking around and looking how people have solved problems in their own institution and so many, and we have the same philosophy, learn this weekend and take it home and start using it on Monday. All of our presentations are geared so that they have usable information that they can take back. So it's not just for the advanced wound care practitioner. You know what? Some of it's going to be over somebody's head. I mean, if I go into some of these Wound Healing Society sessions, I'm lost, but there's something there for everyone.
Jayesh Shah, MD:
Dot, like anything good, everything comes to an end and we are going to be wrapping up this episode, but let's focus on a Wound to the Wise. We coined this term as part of WoundCon. It's basically Kathy's brain child. So thank you, Kathy. I love Wound to the Wise and because it's a practical tips that we can give to our wound care nurses who are working, wound care doctors who are working, at the bedside. So it's really meant to hone in on top tips and pulse we hope the audience will take to the heart. What is your wound to the wise for the audience?
Dot Weir, RN:
It's my phrase that I love to use, and that is "clean it like you mean it." One of my most recent passions I would say since about 2019 has been on wound bed optimization and wound cleansing. The International Wound Infection Institute published our guidelines last March in 2025, and they're free for download. You just go to International Wound Infection Institute, but everything that we do for people's wounds, it has to start with a well-prepared wound. And so if I could get a message out, that would be for people to do better wound cleansing, periwound cleansing. So many things, you can't really see what's there where we have newer technologies where we can fluoresce and see where bacteria is. But I would say focus on wound bed preparation, wound bed cleansing, and a lot of times that's what makes the difference in somebody's ability to heal.
Catherine T. Milne, MSN, APRN:
Thank you so much, Dot, for joining us today.
Dot Weir, RN:
So happy, Cathy. This went so fast. It was fun. Yeah,
Catherine T. Milne, MSN, APRN:
I know. And the audience, I thank the audience for joining us on our inaugural podcast. Our next episode will be getting started in wound care, and we're going to have a conversation with Dr. Lee Ruotsi, and we're going to talk about career building tips and connection in the field. So until then, make sure you browse the content available on WoundSource.com and the accredited educational opportunities available from WoundCon. And don't forget about the SAWC. If you want to go in person and network like we've all talked about, a great conference. Thank you so much.
Jayesh Shah, MD:
It looks like that's all we have for this episode on wound conversation. What a great episode. What a great conversation with the GOAT. Make sure that if you like this, if you found this episode inspiring, if you found this conversation insightful, make sure you share this conversation on your social media page and send it to your friends and make sure that you know that future episodes are going to be available on WoundCon.com, SoundCloud, Apple Podcasts or Spotify. So be sure to follow us on your favorite platform. We look forward to providing even more opportunities to listen today and apply tomorrow.