Dialysis service in Nelson discussed at regional hospital district board meeting

The West Kootenay Boundary Regional Hospital District board has heard the pleas of its constituents. It will be requesting that Interior Health provide a report on the feasibility of offering dialysis treatment at Kootenay Lake Hospital in Nelson.

Donna Jansons, Regional Director of Renal Services with Interior Health, spoke at the recent WKBRHD board meeting on October 25, answering questions and hearing concerns.

“I want to emphasize that we are aware,” she said, “and we are working hard to see how we can limit the burden when people are already dealing with a chronic disease.”

Currently, hemodialysis patients in the Kootenay Boundary region have to travel to Kootenay Boundary Regional Hospital in Trail. This can put considerable strain on quality of life, especially for patients who must travel over two hours, one way, multiple days per week. There are also very few or no public transportation options for patients to get to and from Trail. Nelson patients used to make use of the Kootenay Seniors Transportation Program, but it ended its services in May 2023.

Since 2018, a group of dialysis patients living in Area D and the Nelson area have been advocating for a community dialysis unit (CDU) to be established at Kootenay Lake Hospital. Councillor Erika Bird of the Village of Kaslo received a letter earlier this year from a patient who lives in Nelson.

“When I go for dialysis on Saturdays,” the patient writes, “out of nine dialysis stations in Trail, six of them are patients from Nelson and beyond (Six Mile, Ainsworth, Woodbury Creek).”

Councillor Bird, a member of the Village of Kaslo’s Health Advisory Committee, was moved by the letter. She made a motion (which passed) at the October 10 Kaslo council meeting for the Village to send a letter to the WKBRHD board, seeking answers and explaining the need for dialysis services in Nelson.

“What does it take? How many people? What is the cost?” Jansons echoed at the meeting. “There is no clearcut answer about that.”

There are many factors that complicate establishing a CDU, beyond counting the number of patients.

What does it take?

There are two kinds of dialysis units, in-centre hemodialysis units (ICHD), and CDUs. ICHDs are embedded within larger hospitals and offer the full suite of renal services. CDUs, on the other hand, do not.

“Community dialysis units are called such because they don’t have the wrap-around services, no matter the size of the centre,” said Jansons. CDUs can be large or small, part of a hospital or not, but either way they are better suited for patients who are more stable and need less care.

Counting the number of patients receiving dialysis in Trail does not necessarily distinguish between those who can use CDUs and those who cannot. Even if a CDU is established at Kootenay Lake Hospital, Jansons said, some patients would still need to travel to an ICHD.

Staffing is also a big issue. CDUs, while offering fewer services, still require a nephrologist on-site at least a few times a month. Nurses need extra training, and the Province is already struggling with recruitment, let alone recruitment of speciality nurses.

Housing comes in to play, as well.

“People step away from job offers because of their inability to find a house that suits them,” said Lannon de Best, Executive Director of Clinical Operations for the Kootenay-Boundary District of Interior Health. De Best also spoke at the WKBRHD meeting.

It’s also not as simple as pulling staff from Trail two days a week to work in Nelson.

“When we do something like that, we pull away from the core of where the centre of services is for each of those areas,” said Jansons.

There are only four ICHDs in the Interior Healthy region – Kamloops, Penticton, Kelowna, and Trail. ICHDs lose their sustainability as soon as staff is pulled elsewhere.

“People ask me, what if we raise funds and just purchase a chair? Because a chair doesn’t actually cost that much,” said Jansons. “But it’s not about one chair, it’s about providing all the services around that chair.”

The discussion at the meeting may have brought up more questions than answers. However, the issue is gaining traction. Jansons said that the day before the meeting, she reached out to BC Renal.

“I think BC Renal would be open to coming to talk to WKBRHD,” she said. “There’s always an opportunity to talk more collaboratively together.”

Talk may feel small, but Jansons said Interior Health needs to understand the needs of the population when thinking about where to establish new services. Hearing from the community is the first step to achieving that.

The WKBRHD board is pushing for a report from Interior Health on the feasibility of dialysis services at Kootenay Lake Hospital to be available for review at its next meeting in January 2024.

Rachael Lesosky, Local Journalism Initiative Reporter, Valley Voice