Receiving a message from an editor that transmits a “do not accept” decision is a uniformly disappointing experience for author-investigators. In this dispiriting situation, it is critical that correspondence from the Editor is clear and courteous, includes the reviewer comments, provides an explanation for any Editor disagreement with the reviewers that had bearing on the decision, and conveys some indication of why the paper was not accepted. In all scientific fields, every step in the peer review and editorial decision-making process involves judgment and balance of factors including importance and timeliness of the topic, technical accuracy, clarity of exposition, novelty, and interest to readers (“Decisions, decisions,” 2002). The processes we use at Nursing Research are systematic. We attempt to ensure that every submission receives a prompt, thorough, and fair review. We select peer reviewers with content and methodological expertise, ask reviewers to report any potential conflicts of interest (to the extent that these are knowable in a blinded review process), provide structured guidelines for completing a review, and continuously monitor review quality. The decision to accept or reject a manuscript is based on the advisory input from reviewers (who may disagree in their appraisals of a paper) and editor assessment of the scientific rigor of a manuscript and its potential contribution to advancing the science, as well as to its fit with the editorial mission of the journal. The Editor has the final authority and responsibility for making the decision about the disposition of each manuscript. Editors and peer reviewers are fallible. Even when fair and informed processes are in place, errors in decision-making can occur. For this reason, journals should have a declared mechanism for authors to appeal against editorial decisions (Committee on Publication Ethics [COPE], 2011). Consistent with recommendations from COPE, Nursing Research has instituted a process for handling appeals against editorial decisions to reject a manuscript. The appeal process is intended for use in situations where authors can make a convincing argument that a serious lapse in the peer review or editorial decision-making process may have occurred. Simple disagreement with a decision to reject a paper is not grounds for an appeal. The appeal process at Nursing Research is delineated in the Information for Authors (http://journals.lww.com/nursingresearchonline/Pages/informationforauthors.aspx). Key details are as follows: The appeal must be submitted to the Editor between 14-28 calendar days after the date of the decision to reject a manuscript. Specific rationale for the appeal must be provided. The Editor will notify the corresponding author whether an appeal is warranted or not. Upon determination by the Editor that an appeal is warranted, the Editor will convene an Appeal Panel composed of the Associate Editor and two Editorial Board Members and convey this to the corresponding author. The Appeal Panel will review the original manuscript, the reviewer comments, and author correspondence. They will independently provide their recommendations, with rationale, to either retain the Editor’s decision or rescind the decision to reject in favor of an invitation to revise and resubmit. The Associate Editor will inform the Editor of the Appeal Panel’s recommendations and the Editor will consider the recommendations and make a decision, which will then be communicated to the corresponding author within six weeks of receiving the letter requesting an appeal. In conclusion, the development of an appeal process has provided the editors, the editorial board, and our reviewers with the opportunity to reflect anew on how critical our manuscript decision-making responsibilities are. It has also provided a forum for a thoughtful discussion, with other nursing editors at the recent International Academy of Nursing Editors (INANE) meeting this past August in London that is reflected in this editorial (Henly, Chyun, Sullivan, & Vessey, 2016). We also hope that in delineating the process for an appeal that authors have a better appreciation of when an appeal is justified and how the process unfolds at Nursing Research.