There are clearly two very different usage workflows here. My group actually uses both at different times.
1) When bugs/defects are logged, reviewers click the wait button so they're notified on one of various conditions. Once all bugs/defects are resolved, they click the Send to Completed.
2) After looking over the code and logging any bugs/defects, reviewers immediately click the Send to Rework or Send to Completed button (name depends on whether there are bugs/defects open at the time). This is clearly the workflow SmartBear intended to be used.
As MrDubya pointed out, explaining why clicking the Send to Rework button when using workflow 2 changes the reviewer's status to "Approved" requires extra explanation and has caused no end of confusion to new users. For this specific feature request, just changing that participant status text to "Reviewed" instead of "Approved" would be sufficient. Any additional changes should be filed as separate feature requests.