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March 2012Ohio NurseJoin the OhioNurses AssociationRegistration Form:Select the studies you are taking:Understanding Autism Spectrum DisorderBreaking the Cycle of Horizontal ViolenceGone Fishin’ Trolling for Strategies to Keep Up-to-Date on Nursing Law and RulesName:Address:StreetCityStateZipDay phone number: Email Address:RN or LPN?RNLPNONA MemberYES NOONA Member # (if applicable):ONA MEMBERS:Each study in this edition of the Ohio Nurse is free to members of ONA if postmarked by June 1, 2012. Please sendpost-test and this completed form to: Ohio Nurses Association, 4000 East Main Street, Columbus, OH 43213.NON-ONA MEMBERS:Each study in this edition of the Ohio Nurse is 15.00 for non-ONA Members. The studies can also be completedonline at CE4Nurses.org for 12. Please send check payable to the Ohio Nurses Association along with post-test andthis completed form to: Ohio Nurses Association, 4000 East Main Street, Columbus, OH 43213. Credit cards will notbe accepted.ADDITIONAL INDEPENDENT STUDIESAdditional independent studies can be purchased for 15.00 plus shipping/handling for both ONA members andnon-members. ( 12.00 for non-members online). A list is available online at www.CE4Nurses.orgONA OFFICE USE ONLYDate received: Amount: Check No.:Independent Study InstructionsTo help Ohio’s nurses meet their obligation to stay current intheir practice, two independent studies are published in this issueof the Ohio Nurse, with one available online.Instructions to Complete Online1. Go to www.CE4Nurses.org.2. Click on each study you want to take and add it to your cart.(ONA members will see a price of 0.00 after they are loggedin).3. Complete the check-out process. You will receive aconfirmation email with instructions on how to take the test.4. Go to the CE4Nurses Exam Manager (www.ohnurses.org/Survey) either from your confirmation email or theCE4Nurses site.5. Log in and click on “View My New Studies.” Click on the studyyou want to take, and follow the instructions provided inCE4Nurses Exam Manager to complete the study.6. Please read the independent study carefully.7. Complete the post-test and evaluation form for each study.Post-testThe post-test will be scored immediately. If a score of 70percent or better is achieved, you will be able to print a certificate.If a score of 70 percent is not achieved, you may take the test asecond time. We recommend that the independent study bereviewed prior to taking the second post-test. If a score of 70percent is achieved on the second post-test, a certificate will bemade available immediately for printing.Instructions to Complete By Mail1. Please read the independent study carefully.2. Complete the post-test and evaluation form for each study.3. Fill out the registration form indicating which studiesyou have completed, and return originals or copies of theregistration form, post test, evaluation and payment (ifapplicable) to:Ohio Nurses Association, 4000 East Main Street, Columbus,OH 43213ReferencesReferences will be sent upon request.QuestionsContact Sandy Swearingen at 614-448-1030 (sswearingen@ohnurses.org), or Zandra Ohri, MA, MS, RN, Director,Continuing Education at 614-448-1027 (zohri@ohnurses.org).Disclaimer: The information in the studies published in thisissue is intended for educational purposes only. It is not intendedto provide legal and/or medical advice.The Ohio Nurses Association (OBN-001-91) is accredited as aprovider of continuing nursing education by the American NursesCredentialing Center’s Commission on Accreditation.Apply online orgThe Ohio Nurses Association does a lot for the nursingprofession as a whole, but what does ONA do for itsmembers?FREE AND DISCOUNTED PRODUCTS ANDSERVICES Members take advantage of a wide array ofdiscounts on products and services, including professionalliability insurance, continuing education, and specialtuition rates to partner RN-to-BSN programs.WORKPLACE ADVOCACY ONA provides membersaccess to a wide range of resources to help them make areal difference in the workplace, regardless of work setting.ONA provides members with resources to create healthyand safe work environments in all health care settingsby providing tools to help nurses navigate workplacechallenges, optimize patient outcomes and maximizecareer benefits.EDUCATION Whether you’ve just begun your nursingcareer or are seeking to enhance or maintain your currentpractice, ONA offers numerous resources to guide you.For example, the Ohio Nurses Foundation awards severalscholarships annually with preference to ONA members.Members also save up to 120 on certification throughANCC, and can earn contact hours for free throughthe independent studies in the Ohio Nurse or onlineat a discounted rate, among many other educationalopportunities.NURSING PRACTICE ONA staff includes expertsin nursing practice and policy that serve our members byinterpreting the complexities of the Nurse Practice Act andaddressing practice issues with a focus of ethical, legal andprofessional standards on a case-by-case basis.LEGISLATIVE ADVOCACY ONA gives members adirect link to the legislators that make decisions that affectnursing practice. Members can become Legislative Liaisonsfor their district, join the Health Policy Council andparticipate in the legislative process in many other waysthrough their ONA membership.These are just a few of the benefits nurses receive asONA members. Dues range from 33– 50 a month and weoffer reduced dues rates to new graduates, unemployedand retired nurses. Go to www.ohnurses.org Join/Renewto start taking advantage of what ONA has to offer.Go towww.ohnurses.orgto join today!REGISTERED NURSES –WYOMING IS CALLING! 5,000 RN Recruitment Bonus 6,000 Manager Recruitment BonusPage 3“Help Make Recovery Reality”Psych/MR NurseOhio’s premier mental health hospital is seeking Registered Nursesto provide quality care to patients with mental illness. NorthcoastBehavioral Healthcare operates an inpatient facility with the Ohio Dept. ofMental Health network of hospitals. We have immediate openings at:Northfield Campus1756 Sagamore RoadNorthfield, Ohio 44067We Offer:Competitive Wages/Shift Differential/Pay SupplementsComprehensive Public Sector Benefits (OPERS)In-House Education/CEU’sNo phone calls please.Please forward all resumes to:Northcoast Behavioral HealthcareP.O. Box 305Northfield, Ohio 44067-0305Attn: Human Resourcesor Email: hrdapps@mh.ohio.govApply Online: www.careers.ohio.govDrug testing prior to appointment is required. An applicant withpositive test results will not be offered employment. People withdisabilities and those in recovery are encouraged to apply to all jobofferings.

Page 4Ohio NurseMarch 2012The IOM Report continued from page 1(LPNAO); Northeast Ohio Nursing Initiative (NEONI),The Center for Health Affairs, Cleveland; Nursing Instituteof West Central Ohio, Dayton; Ohio Board of Nursing(OBN); Ohio Hospital Association (OHA); Ohio Leaguefor Nursing (OLN); Ohio Nurses Association (ONA); OhioOrganization of Nurse Executives (OONE).In 2007, the Center to Champion Nursing in America(CCNA) sent out invitations to state groups to participatein the efforts centered around increasing the educationalcapacity of nursing programs through efforts to increasethe number of available faculty. ONNW responded to thatinvitation and invited other organizations in Ohio to jointhe effort expanding the participation in ONNW to includethe following: American Association of Retired Persons(AARP); Ohio Board of Regents; Ohio Council of AssociateDegree Nursing Education Administrators (OCADNEA);Ohio Council of Deans and Directors of Baccalaureate andHigher Degree Programs (OCDD); Ohio Department ofAging. Representatives of ONNW participated in nationalmeetings and state efforts to increase the educationalcapacity of nursing programs.NURSING 2015In June 2005, the Ohio Nurses Association (ONA),the Ohio Hospital Association (OHA), and the OhioOrganization for Nurse Executives (OONE) began workingcollaboratively to create, from concept to implementation,a vision for the future of nursing in Ohio and a strategy formaking that vision a reality.The following statement was adopted: Professional nursesare self-directed, accountable, and control their environment.Nurses are professionally empowered to influence the deliveryof high-quality care that promotes positive patient outcomesthrough nursing leadership, coordination and collaboration.Nurses are adequate in number, diverse, highly educated andvalued as clinical leaders across the continuum. The professionof nursing is respected and valued. The practice environmentis attractive, supportive of work/life balance, flexible andincorporates state-of-the-art technology. Compensation andbenefits are reflective of nurses’ contributions to the delivery ofcare.A statewide meeting where 250 nurses participatedwas held in September 2006 at which time the vision forNursing 2015 was shared with nurses across the state andbroad based participation was encouraged. To move theinitiative forward, the work was divided among four groupsidentified as the red, yellow, green and blue teams. The“Race to the Future” theme was chosen to provide identityand help motivate the groups to move forward and fit intothe bigger picture of health care reform. A Group of Twenty(GOT), 10 from ONA and 10 from OONE was selected toprovide overall guidance and direction to the effort. In2010 the Ohio League for Nursing was invited to join theGOT and became the GOT plus Two.The Yellow team was tasked with ensuring Ohio has asufficient number of highly educated nurses who are selfdirected, accountable, in control of their environment,and able to fulfill evolving roles. The Red Team wastasked with promoting the leadership roles all nurses playin today’s health care system. The Blue team was taskedSIGN-ON BONUS!up to 5000(for FT/PT staff nurse positions)with ensuring safe working environments that result inbetter consumer outcomes. Lastly, the Green team wastasked with recognizing the leadership roles all nursesplay and promote the skills nurses need to be self-directed,accountable, and in control of their environment. Directionfor each team was set forth by the GOT.CONCLUSIONAt the initial meeting of ONNW, Nursing 2015 andother interested stakeholders, held on July 14, 2011, itwas recognized that there were mutual goals and activitiespresent in both the ONNW and Nursing 2015. Joiningefforts to submit an application to the CCNA, Campaignfor Action, to become an action coalition was agreed upon,the application was submitted, and Ohio was approved asan action coalition in September 2011.The first meeting of the Ohio Action Coalition washeld on November 10, 2011. Plans were laid out for howto proceed and a Vision Team was appointed to considerstrategies and organization for the Ohio Action Coalition.Recommendations from the Vision Team will be presentedat the next meeting of the Ohio Action Coalition to be heldon February 24, 2012.As the Ohio Action Coalition moves forward there willbe opportunity for participation by many interested nurses,organizations, and stakeholders to develop strategies forimplementation of the IOM report in Ohio. This is a uniqueopportunity for nursing to make a vital contribution to thehealth care of persons in Ohio through collaboration andaction.Contact jfmahowald@aol.com or seanm@ohnet.org forfurther information.TheScience Spiritof Medical Excellence.Springfield Regional Medical Center &Mercy Memorial Hospital have wonderful opportunities forexperienced leaders. Our commitment to excellence and patient care focusedstaff make Community Mercy Health Partners a wonderful place to work.Professional Opportunities Available:At Mercy,every associatehas a chance tomake a difference,by delivering thebest quality carein accordance withcore values. Therewards are great:a clinically excellentenvironmentand a chance towork alongsideother dedicatedassociates.Apply online or viewmore of our currentjob openings atMercyOnline.org.ExperiencedRegistered NursesCVICU * ER * MICUResource PoolMust have a minimum of 2 years’ work experiencePalliative CareNurse PractitionerNew Life HospiceCardiac NursePractitionerMercy Tri-City MedicineEP NurseElectrophysiology Lab Manager of Patient Care – MedicalCardiology Director of Hospice/Cancer Center Manager of Patient Care – OR Director of Clinical Services – Women’sand Children’s Service Line Experienced RNs – various unitsFor information contact:Don Austindmaustin@health-partners.org100 Medical Center DriveSpringfield, OH 45504(937) 523-5363Community-Mercy.orgto apply onlineVisit our website foradditional opportunitiesGRADUATENURSINGDoctor of NursingPractice (DNP) Post Masters OnlineDepartment of NursingMaster of Science inNursing (MSN) New Curricula Choose from 5 majors:– MSN/MBA(2 degrees in 3 yrs)– Nursing ServiceAdministration (NSA)– Clinical Nurse Leader– Family NursePractitioner– Nurse Anesthesia(7 semesters, full time)Questions? Contact:Dorothy Crider, MS, RNP: (614) 823-3210E: SINGNurse PractitionerPre-Admission TestingLearn more at.MercyOnline.orgMercy Regional Medical Center Mercy Allen HospitalYOUR MOMENT OFPROFESSIONAL PRIDE

March 2012Ohio NursePage 5Understanding Autism Spectrum DisorderDeveloped by: Pamela S. Dickerson, PhD, RN-BCThis independent study has been designed to assist thenurse in better understanding autism spectrum disorder.The author and planning committee members havedeclared no conflict of interest. There is no commercialsupport or sponsorship for this independent study.Disclaimer: Information in this study is intended foreducational purposes only. It is not intended to providelegal and/or medical advice.1.1 contact hours will be awarded for successfulcompletion of this independent study.The Ohio Nurses Association (OBN-001-91) is accreditedas a provider of continuing nursing education by theAmerican Nurses Credentialing Center’s Commission onAccreditation.Copyright 2011, Ohio Nurses Association. Expires8/2013.OBJECTIVES1. Define the conditions within the autism spectrum.2. Identify issues in providing appropriate nursingcare for the person with a condition in the autismspectrum.STUDYIntroductionThe autism spectrum disorders (ASD) are a cluster offive separate diagnostic categories. While each of thesedisorders has its own characteristics, there are somecommonalities within the spectrum. Due to the nature ofthe condition, even within each category, persons exhibitunique symptoms. Therefore, assessment and nursingcare of a person within the autism spectrum requiresindividualized knowledge, thoughtful implementation, andcollaboration with all members of the healthcare team.This article provides an overview of the conditions withinthe spectrum and suggestions for nursing care for theperson who has one of these conditions.The Spectrum of DisordersThere are three conditions within the autism spectrum.They include Asperger Syndrome, Autistic Disorder,and Pervasive Developmental Disorders-Not OtherwiseSpecified (PDD-NOS). These conditions were not namedprior to the mid-20th century but now are listed in theDiagnostic and Statistical Manual of Mental Disorders(DSM-IV-TR). While the conditions each have uniquefeatures, and persons with these conditions display arange of symptoms, Asperger Syndrome is the mildestcondition within the spectrum. Autism can range frommild symptoms to severe compromise in ability to function.There are two other conditions that, along with the threeabove, fall into the category of pervasive developmentaldisorders: Rett’s Syndrome and Childhood DisintegrativeDisorder. Each of the conditions is described below in moredetail.Autistic Disorder is characterized by impairment in socialinteraction and communication, engagement in repetitivepatterns of behavior, and delayed development in socialinteraction, language, and/or play. Criteria are developedbased on behaviors of children diagnosed at three yearsor older. There are degrees of impairment in each ofthese behavioral areas. For example, some persons haveno verbal communication, some communicate by picturesand/or sign language, and some have a semblance of verbalcommunication ability.Asperger Syndrome, the mildest condition on the autismspectrum, is evidenced by poor relationships with peers,lack of empathetic understanding of feelings/emotionsin self and/or others, and repetitive, consistent focuson certain topics or activities. There is some debate as towhether Asperger Syndrome is part of the autism spectrum,sometimes called “high-functioning” autism, or a separatecondition. In contrast to autistic disorder, the person withAsperger typically has normal intelligence and is able tocommunicate verbally, although there may be quirks inthe communication patterns. Communication may be veryhigh-level in terms of vocabulary but may be very narrowlyfocused in terms of topic. Nonverbal cues, gestures, and theconcept of personal space may not be understood.Pervasive Developmental Disorder–Not Otherwise Specified(PDD-NOS) is used when some of the characteristics ofautistic disorder are present, but not the full constellationof symptoms. This diagnosis is often used for childrenunder the age of 3 who have exhibited evidence of delayeddevelopment in communication and social interaction.However, because of their age, they have not yet reachedthe point where some of the traits assessed for an officialautism diagnosis can be identified as present or absent.Sometimes, children under 3 who have been diagnosedwith PDD-NOS are re-diagnosed with autistic disorder at orafter age 3.Rett’s Syndrome is a neurodegenerative disorder thataffects primarily girls, in contrast to those on the autismspectrum, which more typically affect boys. There hasbeen a genetic mutation identified for this condition,which causes regression in development of languageand psychomotor skills after one to two years of typicalbehavioral development.Childhood Disintegrative Disorder is rare. The onset is afterage two and results in profound loss of previously presentsocial and motor skills as well as language. These losses arepermanent.The autism spectrum conditions are being diagnosedwith increasing fre

The Institute of Medicine Report (IOM Report), “The Future of Nursing: Leading Change, Advancing Health” released in October 2010, contained recommendations for major changes in the education and practice of nursing in the United States. This report was the result of a partners