Peer Reviews

BostonTerrierLover, BSN, RN · Apr 5, 2012

We had to go to a State Board of Nursing Disciplinary Hearing when I was in my RN-BSN Program at UMC, and I got to say, two cases really struck me as the same.First, waved peer review, and yeilded to board's decision, board took 5 minutes and gave her an "Indefinite Revoke," and without any advice on what to do to get her license back, just dismissed for a 15 minute break.Then, 3 cases later, an almost "exact" case. The two had a very similar experience, no lawyer, and even had the same allegations/charges pending- except this nurse had 2 charges. Both gave a very moving confession, took all blame, mapped a logical plan to "remedy" the situation, and then this RN moved to peer review. Peer Review did grill the fire out of her (as did the board with the other nurse), and then made the decision to recommend 90 days loss of compact rights, no overtime, no narcotic privelages, and 3 meetings a week, Random Drug Screens at her cost, and 3 monthly follow-ups with the board review member for progress (she had to get sheets filled out by her employer). After this, if successfully completed, she would be a fully fledged, fully privelaged, Compact Privelaged RN. Now, someone could come in with an opposite story, but I think if Boston's butt was on the line, I would want more people with the possibility of justice.I also wander if the board nurses might not be a little more "jaded" than the peer reviewers, who are of temporary service vs. the normal decision makers.**At that time it was easier and quicker to appeal a board decision vs. a peer review decision.

wish_me_luck, BSN, RN · Apr 5, 2012

I hate them. I used to be a tech and I went back to school (had to quit because I was full time and couldn't do full time school); but, I used to work with a nurse that was dead set on getting me fired. It didn't matter if it was a minor thing not done due to being with a patient or if it was something serious; she always went to the manager over the floor about everything. I am pretty sure I have a rap sheet a mile long because of it. My point is that while it can be a good tool, it can be used in ways that are very wrong. I guarantee that if she wrote my review I would have been fired. Now, ask other nurses on the floor, and I was ok.

I think they should be taken with a grain of salt, if used at all. Ultimately, it is up to the charge nurses and floor managers to make sure you are doing what you are supposed to be doing and evaluating you. That's my opinion.

BostonTerrierLover, BSN, RN · Apr 5, 2012

. . .as far as at the facility, I have never seen it done (rather see it, than go through it anyday!)

nurseprnRN, BSN, RN · Apr 5, 2012

this is another skill that is never taught in nursing school, and truth to tell i'm not sure it has to be. it is a management skill, though, so it would be a good idea to run all staff through a workshop on how to do it well before they are expected to demonstrate it.

Altra, BSN, RN · Apr 5, 2012

I think that the OP was referring to coworker peer reviews included as part of the annual performance review process ... not BON hearings.

I think it can be valuable when the hospital structure is such that a manager not otherwise in a position to observe an employee's day to day performance is the one responsible to do individual reviews. It can also be a meaningful adjunct to verbose HR forms which "align performance measurements to the organization's mission statement" but do little to describe an individual's actual performance as a nurse.

Vespertinas · Apr 5, 2012

Exactly what Altra said, thank you for helping clarify.

I know that my co-workers are not in the room with me and my patient, they do not review my charting, cannot confirm my assessments.... I don't feel that a co-worker has a basis to make a judgement about my performance.

Besides this, the way it was done at one of my jobs was the manager handed out forms and told us to find a co-worker to fill it out. Naturally, we all went to our closest friend. I assume that practice was just to check off a box under "open management style" for Magnet status.

Then again, I suppose a manager has limited avenues in assessing exactly how well we're doing. I suppose I should welcome it but I haven't seen it done in a way that would make me feel confident in its worth.

For the record, I don't fear peer-reviews. In fact, my co-workers have splendid things to say about me. I'm just not sure how they arrived at their conclusion since I don't know how I would form an assessment of them.

Altra, BSN, RN · Apr 6, 2012

At least in institutional settings, we do have a lot of opportunity to observe and work with each other. I can certainly easily think of the strengths and weaknesses of most of my coworkers. We read each other's charting when we hand off assignments; confirm (or not confirm) assessments when we hand off patients; work together on task-heavy patient interventions and on critical patients, etc.

Where I used to work, peer reviews were utilized. You were evaluated using a standardized form by 4 of your peers -- 2 chosen by the manager responsible for performance reviews and 2 chosen by the individual employee. The score derived from these peers comprised 40% of your performance review score.

Vespertinas · Apr 6, 2012

I agree: The opposite shift has a much greater opportunity to evaluate my performance because they hear my report and see my charting. The way peer reviews at another job went, we were evaluated by RNs from our same shift presumably because we spent more time together. But on a med-surg floor unlike in critical care, for the most part we work alone.

BostonTerrierLover, BSN, RN · Apr 6, 2012

:bugeyes: Boy do I feel reeeeeeeeeeeaaaaaaaaaalllll Stupid. You meant like when the Nurse Manager or DON delegates out performance (like quarterly)

If I was an ostrich, my head would be in the sand alot!

Vespertinas · Apr 6, 2012

More likely my mistake. Luckily you're not an ostrich but a Boston Terrier so instead you get to chase balls!

BostonTerrierLover, BSN, RN · Apr 6, 2012

Tug-o-war fun too, woof woof. . .