Patient develops steal syndrome, following commencement of haemodialysis, leading to a secondary diagnosis of gangrene. Fistula was ligated to resolve the steal syndrome, but despite involvement from plastics surgeons, patient was sent home with thick black eschar surrounding nail bed to ring finger, with nil intervention to resolve the issue other than a nitrile cream. Patient visited GP numerous times, and was ‘fobbed off’ (as per patient) from plastics medicos at the tertiary centre where first examined.  Patient’s mental status declined over this period. Patient was waiting to transition to peritoneal dialysis but was concerned they would not be able to manage it, due to the ongoing pain and limited movability of fingers and hand. Nurse Y, with extensive wound care experience, suggested a wound care treatment plan to remove the eschar, for the finger to heal. Following 2 weeks of applying a debridement gel, the wound bed was cleared of necrotic debris and the healing process began. Since considerable improvement in the patient’s finger and hand, they have now been able to transition to PD, is pain free and with full movement of hand again. This demonstrates the impact of sound wound care principles being applied, as well as engaging the patient, to support the patient to achieve an effective outcome. Haemodialysis nursing does not just constitute cannulation, connecting and disconnecting from dialysis machines but involves engaging and supporting the patient throughout their treatment journey to support a quality of life that best meets their wishes.