In the last five years there has been many changes for the senior vascular ward nurse in the Waikato. Prior to 2019 there were few dressing choices available with most patients needing to go to theatre for debridement. The use of penthrox in the ward has meant more and more debridement is done on the ward by senior nurses who have been upskilled. They now use versajet and curettes to do debridement that previously would have required a trip to theatre and an anaesthetic. This has had enormous advantageous for patients who formerly would have had to be nil by mouth, often for several days, which interfered both with their glycaemic control and rehabilitation. Fiscally the advantage to the hospital is huge. A soft tissue debridement in theatre is costed at approximately $3200 whilst a versajet debridement on a ward can be done for less than $1000.00. With a ward bed being costed at about $1200 a night anything that enables a patient to be safely discharged earlier is valued. Waikato, like many other hospitals, is continually juggling admissions and discharges. Senior nurses now also routinely use and care for extra cellular matrixes such as BTM and endoform often discussing with registrars which is appropriate. In the Waikato vascular ward we now often utilise stimulan beads to provide targeted anti-biotic options for patients where infection is suspected based on clean tissue or bone often taken in theatre during initial amputation. More change is coming with our Intensive Care and High Dependency Units merging into a closed Critical Care Unit. This will mean that vascular patients who used to routinely be booked into HDU will now go into a unit on the ward through which senior nurses will rotate. Does this lead to more responsibility for the senior vascular nurse? Yes it does but it also makes it more interesting and satisfying.