The Current

Holding up an iPad in the ICU, this social worker connects isolated COVID-19 patients with loved ones at home

Social worker Scott Graney is there for almost every conversation between critically ill COVID-19 patients and their families, because he's the one holding up the iPad.

Social worker tries to fade into background as he connects families with ill loved ones

Scott Graney is a social worker at St. Joseph's Health Centre of Unity Health Toronto. (Frank Gunn/The Canadian Press, Submitted by Scott Graney)

Read story transcript

Inside a Toronto ICU, Scott Graney uses an iPad to allow patients with COVID-19 to speak to their families at home — and sometimes, to say goodbye.

Having to end those calls is "one of the worst parts" of his job. 

"Sometimes, families, they need permission to sort of end that call," said Graney, a social worker at St. Joseph's Health Centre of Unity Health Toronto. 

"I think it's probably one of the hardest things they have to do," he told The Current's Matt Galloway.

Not all calls are with patients in critical condition. Some are with families offering "love and encouragement," and "pleading with their loved one to keep fighting," Graney said.

Health-care workers attend to a ICU COVID-19 patient at Peter Lougheed Centre in Calgary, Alta., on Nov. 14. (Submitted by AHS/Leah Hennel)

During these calls, he tries to fade into the background.

"I want family members to pretend that I'm not even there so they can be as free and open and honest, and communicate in a heartfelt way, as much as they want," he said.

"And a lot of times that's what families are able to do — they're providing very heartfelt communication, very raw, very honest communication."

Before the pandemic, Graney helped patients and their families talk to their health-care teams, and advocated for their wishes where appropriate. But as COVID-19 restricted visits to hospitals, he and many other ICU staff around the world have turned to technology to keep patients and their families connected.

Though there is cautious optimism after the first Canadians received the Pfizer-BioNTech vaccine Monday following its approval for use by Health Canada late last week, the number of daily new confirmed cases has risen steadily as the winter months have set in, according to the CBC News Coronavirus Tracker.

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There have been 90,723 new confirmed cases recorded in Canada from Dec. 1-14, representing 19 per cent of those recorded throughout the entire pandemic.

Over 1,400 Canadians have died of the virus in those 14 days. 

Calls made at moment of death

There are 20 beds in the intensive care unit at St. Joseph's Health Centre. During the pandemic, Graney said he's seen COVID-19 affect people of all ages, from all walks of life.

Where patients are on a ventilator or have been sedated, he talks to the family beforehand "to help set realistic expectations."

"I want the family to know that it's not likely that their loved one is going to open their eyes, in a purposeful way, at the sound of their voice," he said.

"You don't want families to be continually disappointed when their loved one doesn't open their eyes."

Health-care workers don personal protective equipment before attending to a COVID-19 patient on the ICU at Peter Lougheed Centre in Calgary, Alta., on Nov. 14. (Submitted by AHS/Leah Hennel)

Graney said he's been humbled to help families on that journey, in some cases "right up until the end of life."

"There have been moments where I've been facilitating that communication with family, and during that communication, the loved one has passed away," he told Galloway.  

"Even if you're prepared that this is going to happen as a family member, it still comes, you know, as quite a shock when it actually happens," he said.

"I remember feeling quite helpless in those moments."

Stress on front-line staff

Additionally, Graney said he feels stress related to limited resources, in particular the amount of time he can offer each family.

"Necessarily, there has to be limits on that communication because there's another family that is perhaps waiting."

"And my resources, you know, I'm just one person." 

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But he said he's been surprised at the gratitude from patients' families, who tell him how meaningful the chance to connect is.

"It's a very limited amount of time that we're able to offer … but families, you know, by and large, they're just so appreciative to have that little piece," he said.

That in turn helps staff at the ICU, many of whom are suffering from COVID-19 fatigue, he said.

An ongoing study at the University of Alberta is assessing the toll of the pandemic on 5,000 health-care workers in Alberta, B.C., Ontario and Quebec.

Lead researcher Dr. Nicola Cherry told CBC News that part of the study is aimed at examining "the state of their mental health, with the goal to identify workplace practices and supports that could be improved to reduce stress."

Dr. Nicola Cherry, occupational epidemiologist at the University of Alberta, is studying the impact of COVID-19 on health-care workers. (Jamie Malbeuf/CBC)

Initial data and preliminary, non-peer reviewed results suggest high levels of anxiety among the workers, with the highest numbers among physicians.

"More than half the doctors now have these very high levels of anxiety that give us concern about how they're going to cope long term," said Cherry, an occupational epidemiologist at the University of Alberta.

The majority of health-care workers have access to mental health support, the study found, and those who take advantage of it are less anxious than those who don't.

The study also looks at exposure to the virus itself, which Cherry described as a threat to the entire health-care system.

"If a health-care worker is sick and not able to go to work, or goes to work and works less well than they would normally, that's going to very much affect all of us in the community," she said.

Graney wears full PPE to speak with patients, and said he trusts the efforts of his leadership and colleagues to keep everyone safe.

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Personally, he has tried to carve out his own downtime to decompress, so he can "return the next day with energy to give to the next set of patients and families."

"I didn't go into health care ever imagining that I would be considered a front-line worker, on the front lines of a war against the virus," he told Galloway.

But he said "this is the year that we were all conscripted in the war against the coronavirus."

"I'm just hoping that next year we're all going to be able to celebrate V-Day — Victory Day, vaccine day — where the majority of us have been vaccinated."


Written by Padraig Moran, with files from CBC Edmonton. Produced by Lindsay Rempel.

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