Dear Nancy,

I work at a state-supported living center as a nurse manager on one of the units. The case managers do not report to me, they are on my unit, but report to a manager in nursing administration. We were in a patient’s room, and I made a comment about the amount of pain medication this hospice patient was receiving, or not receiving. I said to the case manager, “You should stub your toe.”

I never touch the medications for our clients, and I did not touch it that day, but I have been reported to my CNE. I also was notified that I could not talk with case managers because I was being referred to peer review. I have been nursing 36 years and have never had to go before peer review. I don’t even know how to proceed.

Elisa

Dear Elisa,

Peer review can vary greatly from one institution to another and from one state to another. You need to contact a nurse attorney or other attorney in your state who works with healthcare providers, including nursing, in peer review and professional disciplinary proceedings. You can identify such an attorney from reviewing attorneys listed under this or a similar heading online by typing “lawyers who represent nurses in peer review and disciplinary proceedings” in the online search bar. Alternately, you can visit The American Association of Nurse Attorneys and click on the lawyer referral link and follow the instructions to find a nurse attorney member in your state.

An attorney may or may not be allowed to actively participate in your institution’s peer review process. If not, at least he can coach you as you go through the process.

It is not clear what you meant by saying what you did say, but apparently that is the focus of the peer review. You need to get a copy of the policy and procedure of peer review in your institution and review it prior to seeing the attorney.

If the peer review outcome is not in your favor, keep in mind you may be reported to the state board of nursing. Your attorney can then represent you in those proceedings, should they take place.

Regards, Nancy