Patients of Selkirk’s dialysis program are speaking out about concerns related to costs, access to specialists and aspects of patient care.
The Kidney Health Manitoba Local Renal Health Centre (LRHC) program is coordinated through Kidney Health Manitoba, a Shared Health service, and operates out of the Selkirk Regional Health Centre.
Selkirk’s dialysis unit is one of six operating programs within the Interlake-Eastern Regional Health Authority (IERHA). It includes doctors and nurses with specialized training in dialysis who have daily access to a nephrologist, a Shared Health spokesperson said on behalf of Shared Health and IERHA. The unit is able to treat up to 48 patients.
Several patients and family members currently receiving care through the LRHC at Selkirk Regional Health Centre have shared their concerns with the Selkirk Record, calling for improvements to services provided by both healthcare teams and the facility. The Record has verified the identities of those interviewed but agreed to withhold their names due to privacy concerns related to their ongoing medical care.
They described financial pressures and medical concerns they say affect those relying on the life-sustaining treatment.
Dialysis is a life-sustaining treatment required several times per week for people whose kidneys can no longer function properly. Patients typically spend several hours connected to dialysis machines during each visit.
Among the most common concerns raised was the cost of parking associated with frequent medical appointments.
“In our opinion parking for life saving health should not be paid for by patient,” one patient wrote.
Patients say they often attend dialysis three times per week in addition to other medical appointments, creating ongoing expenses that can be difficult to manage, particularly for those living on fixed incomes.
The parking fees offset costs associated with parking lot maintenance and services, the Shared Health spokesperson explained, adding that “the region has initiated a review of parking fees, recognizing the potential financial burden for dialysis patients, and is exploring options to reduce this impact.”
Transportation costs were also mentioned. While transportation options exist in larger centres, patients say rural residents often have fewer alternatives and must cover fuel costs themselves. Patients noted that financial assistance programs for travel typically apply only to those who live more than 35 kilometres from a dialysis unit, leaving some patients responsible for fuel costs despite frequent travel to treatments.
Access to specialists was another issue raised by several patients. Some reported they have not seen a kidney specialist in person since beginning dialysis at the unit, saying nephrologists rarely attend the facility directly.
The Shared Health spokesperson said nephrologists maintain weekly communication and reviews with the Selkirk dialysis team involved in each patient’s care.
“Patients receive comprehensive annual assessments, either virtually or in person, involving the nephrologist, dietitian, social worker, pharmacist and the HSC (Health Sciences Centre) Local Centre nurse,” the spokesperson said. “In addition, the HSC Local Centre team completes in-person site visits to the unit twice annually to assess patients directly. Family physicians from the local community also attend the unit on a regular basis and liaise with nephrologists to address patient care concerns as needed.”
Patients also described experiencing a range of medical issues during treatments, including severe reactions, high blood pressure, headaches and other symptoms. Some said they believed certain issues could have been addressed sooner if their concerns had been acted on earlier.
In one case, a family member said repeated reactions during dialysis improved only after a filter on the machine was changed.
One patient said they sometimes feel reluctant to attend dialysis sessions because of how unwell they feel during treatments.
“I want to be there for my family,” the patient said. “But since starting dialysis I feel like my health has gone downhill.”
The Shared Health spokesperson noted that protocols for adverse reactions vary depending on the severity and may include the local medical team assessing patients while consulting with the nephrologist covering the unit. In some cases, patients may also be transferred to the Selkirk emergency department or to Health Sciences Centre in Winnipeg for more serious matters.
Nurses working in dialysis are required to complete specialized nephrology training, which includes the Manitoba Nephrology Nursing Course (MNNC) with 10 weeks of dedicated dialysis training in addition to acute care experience. Ongoing onsite training is also provided as practices and technologies evolve.
Patients also raised concerns about communication regarding treatment decisions. Some reported instances where medications prescribed by other physicians were cancelled by renal specialists without prior discussion.
According to the Shared Health spokesperson, “nephrologists will only make medication changes in relation to appropriate dosing for a patient with end-stage renal disease. Treatments prescribed by other physicians would not be changed unless determined to be an unsafe dose.”
They added that any medication changes are reviewed by HSC Local Centre pharmacy staff and communicated between Selkirk and HSC teams. When a new prescription is issued, the patient is verbally notified of the change.
Some patients also reported concerns about treatment settings during dialysis sessions, including occasions where they believed dialysis machines were set to remove more fluid than their bodies could tolerate.
A number of accounts also described procedural difficulties during treatments, including repeated needle insertions or treatment adjustments they believed were uncomfortable or difficult to tolerate.
One patient said they were poked 14 times during a single session.
In addition to medical concerns, patients pointed to environmental factors within the unit, including cold temperatures and a lack of reclining chairs for those who struggle to lie in beds for extended periods.
Some patients also expressed discomfort about being asked to leave the unit during a smudging ceremony.
“We come to a health facility for health issues not to be forced to leave for a smudging ceremony,” one patient wrote.
Shared Health said IERHA supports smudging ceremonies in hospitals and care homes in accordance with its policies in an effort to respect cultural practices and advance reconciliation. Staff work with patients and their families to accommodate requests and provide safe spiritual care spaces when available and appropriate. The Indigenous Health team, Waabishki Bineshiins, also supports Indigenous patients in navigating care and accessing cultural supports.
While patients voiced frustration about certain experiences, many emphasized their appreciation for the majority of nursing staff.
Several said some nurses provide compassionate and attentive care despite what they believe are system-level challenges.
Patients say they are sharing their experiences in the hope that improvements can be made to the program and that their concerns will be acknowledged.
They say dialysis patients depend on the treatment to survive and want to ensure the care environment supports their health and well-being.
Shared Health and IERHA encourage patients with concerns to speak with the unit manager or contact patient relations for further escalation.
“Concerns are reviewed through established processes, and feedback is used to support continuous improvement in care,” the spokesperson said, adding incidents are reviewed by IERHA staff and shared with Shared Health as required.
Since October 2023, four formal complaints have been made regarding the Selkirk dialysis unit.
