Toronto Rehab's Lourine Smith is seen here dressing a patient's wound. In one case, she advocated for a patient to try a new honey dressing (not the kind we eat) to clean the bacteria and debris from the wound, allowing it to heal completely (Photo: UHN)
Lourine Smith discovered her love for nursing later in life. She began as an in-home health-care aid for an elderly lady in Toronto and loved the caregiving role, but felt she could do more to help people with the right training.
She enrolled in the Registered Practical Nurse course and was hired on at Toronto Rehab's Bickle Centre in 1995. Smith's career development didn't end there. While she worked at Bickle, and raised two children, she went back to Humber College and earned her Diploma in Nursing. She then attended Ryerson University part time to earn her Bachelor of Science in Nursing Degree.
The Bickle Centre is where she realized her professional calling.
"At Bickle, many of my patients had some form of a wound and it is how I became passionate about wound care," explained Smith. "I could see how I would make a difference in their progress."
Sharing her wound care expertise
Seeking a new challenge, Smith transferred to Toronto Rehab's Musculoskeletal Rehab Program, bringing her specialized nursing care experience with her.
"There wasn't anybody on the MSK Rehab team with a speciality or expertise in wound care," said Smith. "It became my performance objective to develop formal, expert wound care knowledge."
Smith enrolled in a course to become an enterostomal nurse (ET) – a nurse with specialized skills in wound, ostomy and continence care.
"We are fortunate to have Lourine on our MSK Rehab team," said Mary-Grace Grossi, Program Manager, MSK Rehab, and Toronto Rehab. "She takes every opportunity to share her expert knowledge of skin health maintenance, wound care and the management of pain associated with wounds –necessary to optimize care for all of our patients, but particularly our trauma patients."
One patient's gratitude for the healing power of honey
Smith's expertise came along at the right time for MSK Rehab patient Alan Madras. After being struck by a truck, doctors didn't think Madras, 51 years old, would survive. If he did, they never thought he would walk again.
The challenge was that the skin on one of Madras' legs had been torn off the underlying tissue. The surgeons used his other leg as a donor site to repair his wound.
"I was in excruciating pain when anyone touched my legs," said Madras.
Madras' wound didn't heal easily. Smith tried different wound care dressings on his legs, but nothing worked. When he stood up to participate in rehab, blood would rush down his legs causing it to bleed—this limited his opportunity to recover physically.
"Lourine met the challenge of my wound care," said Madras. "The whole team paid a great deal of attention to my special needs."
"We recommended a trial of honey dressing to his plastic surgeon who was in agreement with the suggestion," said Smith. "It's not the kind of honey we eat - this honey cleaned the bacteria and debris from the wound and also decreased his wound pain, allowing it to heal completely."
The honey was messy and difficult to manage. Smith dedicated time to helping Madras shower--meticulously cleaning the area and scraping off any excess honey.
"It was worth it," said Smith. "Having in-house wound care expertise on the MSK Unit allows for patients like Alan to fully participate in the rehab they need."
After four months at Toronto Rehab, Madras completed his therapy—he was able to walk and returned home with his wife, Ruth.
"I'm so thrilled he's alive and able to walk," said Ruth. "We are so fortunate Toronto Rehab was there for us."
An unexpected calling
Smith has become a mentor to her colleagues in wound care.
"Lourine's passion for this work is contagious," said Grossi. "She effortlessly embraces her teacher role and sensing her passion, others are pulled to her in the learning journey."
Smith has no doubts her career has ended up how it was meant to be.
"It feels so good to help solve my patients' problems," said Smith.
