Supervision of Patients
When a PT is in the facility, that person becomes the de facto supervisor for me. That means I can make his day very easy or a nightmare. I could easily present him with a long list of issues and clinical concerns that I feel need to be addressed with each of the 10 patients on my list or I could wait until the regular PT comes back and then discuss the issues with him.
Any therapist or health provider who tells me they don't know the patient, yet they are the supervising provider for that patient's care is a danger to patients. If one wishes to be a supervising provider of care to patients, that person should at least become familiar with each resident he is in charge of. If a patient is injured because of negligence, it's usually the supervising provider who has to explain his role and the role of others regarding why and how a patient became injured. A statement of, "I was filling in for the regular supervisor and didn't know the patients" should go over real well with a jury; it seems like a legitimate excuse.
The clinical portion of what I do is to report any changes in condition or relevant data to the supervising PT so he can be aware of any issues that need his skills and attention. If I fail to report data, then I too as a PTA could be directly responsible for a patient injury or death. What a supervisor does with this data is not for me to decide. I report results of testing and the condition of patients but it's up to the PT to interpret that data and make appropriate decisions. Allowing a "fill-in" supervisor to make these decisions doesn't seem right, but ultimately that person is the responsible party for every patient on the therapy list. And some places consider the evaluating therapist the supervisor of that patient, so trying to get another therapist to make a clinical decision regarding care can be difficult.
I'm not sure if there's a way to adequately resolve who is the actual supervisor versus the acting supervisor for patients. Either way, if a person is in charge of patient care, he needs to "therapy up" and make a decision.