A "Good" OT

I had a really sad home visit this morning, which as it turns out, wasn't really a home visit at all. This patient's illness is terminal, though they haven't been able to find signs of cancer histologically, they think he has cancer...mesothelioma, because he was a fireman and several of his old work mates have passed away with that diagnosis. The patient's daughter has come over from Australia to care for him, as the consultant believes he has maybe 8 weeks left. And the daughter wants to care for him at home, rather than have him admitted to hospital or even direct to palliative care. She knows that's what he wants, and unless something totally unforeseen happens, it's what she wants to do for him. He's not able to do his own personal care at this point, is having trouble feeding himself and drinking, requires the maximum amount of assistance whenever he is trying to stand up, and has become more and more disoriented and "vague" as the daughter put it. So this morning, once I had taken all of this in, my role became to support the daughter as well as I could in her role of caring for her father. Most of the equipment they need is already there, thanks to a diligent district nurse-- an electric armchair that stands him up, an electric profiling bed, etc. But I did identify a few odds and ends I could do for her, and also advised her to move his armchair into his bedroom, as well as the commode when it arrives, so that he doesn't have to deal with moving around more than one room in his flat.

His daughter became very emotional at one point, and probably to distract herself, started asking me about my accent, why was I in England (she herself had previously said she'd left England as soon as she could), and whether I'd ever think about coming to Australia. I told her I had investigated the possibility when I decided to work abroad and discovered it was virtually impossible for me to get a work permit there. She talked about an OT shortage in Australia, and especially a shortage of good OTs, so I laughed and said, but the Australian government doesn't want me. She made a comment I've heard now in three countries, something to the effect of, "all the good ones leave." I heard that a lot at Roosevelt before I left, I've heard it at Whipps just recently when I said to someone I was looking for a new job, and now I've heard it from this British woman who lives in Australia. Are good OTs such a rare breed? I know I graduated with a fair amount of people I think must be good OTs, I've trained with a couple of good OTs...is it American training? Is is the setting? Is it just the OTs who go above and beyond or who really show they care? What makes the people and families we work with think that a certain OT is "good" and another is not?