IMPORTANT INFORMATION FOR PROSPECTIVE NURSING STUDENTS

Transcription

1 IMPORTANT INFORMATION FOR PROSPECTIVE NURSING STUDENTS California Senate Bill 1309 was implemented in academic year All students meeting the established prerequisites and selection criteria for enrollment will be required to complete an assessment/readiness test. Those students that do not meet the minimum score will be referred to appropriate remediation. Students will be allowed one year to remediate and successfully retake the assessment/readiness test. Any student not meeting the remediation requirements will be required to restart the application process as a new student. Thank you. D. Amaro, RN, MSN Director, Allied Health Programs

2 Checklist for Completing the Licensed Vocational Nursing (LVN) Program Application DEADLINE: All documents should be placed in one envelope and must be postmarked no later than December 1, Obtain a certificate of mailing from the United States Post Office as proof of date. IMPORTANT: Applicant is responsible for completing application in its entirety. Late or incomplete applications will not be considered. Mail complete application to: Allied Health Department Gavilan College 5055 Santa Teresa Blvd Gilroy, CA A COMPLETE APPLICATION PACKET INCLUDES THE FOLLOWING: (Use this list as your checklist and submit per written instructions) LVN program application Don t forget to sign the application Prerequisite coursework and/or Placement test completed by December 1, 2017 or coursework Gavilan placement test scores completed by Fall Math placement test scores for enrollment (only the math requirement can consideration in the vocational nursing program must be eligible for be met with placement scores) Math 5 or higher. Completion of ENGL 1A is a prerequisite to the LVN Program Current health statement Physical exam performed no more than 90 days prior to the closing date of applications (December 1 st ) with physician stamp or business card included. Current CPR certification Current CNA license Two official (sealed) high school transcripts Two official (sealed) final transcripts from Gavilan College and other schools attended Foreign transcripts (if applicable) Meet with CTE counselor, Jessica Weiler (outside/transfer applicants only) Must be the BLS Provider card from the American Heart Association California State Certified Nursing Certification or American Red Cross Written and Skills Test results (CNA certification must be current at the time classes begin) High school transcripts or equivalent each in separate envelopes. If currently on file at Admissions, please request a copy for the AH Department using the included interoffice transcript request form. Each in separate envelopes. If currently on file at Admissions, please request a copy for the AH Department using the included interoffice transcript request form. Must be evaluated through the independent agency referred to in the Allied Health Nursing Career Ladder Have force completes for nursing prerequisites and general education courses posted on mydegreeworks by CTE counselor Jessica Weiler. She can be reached at (408) or by at JWeiler@gavilan.edu mydegreeworks Audit Log-in to MyGav & print the Gavilan College Unofficial Degree Audit from mydegreeworks All prerequisite courses must be completed by Fall semester Courses in progress during Fall 2017 semester must be marked in progress and 2 final transcripts must be sent to the Allied Health Department once final grades post. After notification of acceptance into the program, students will be required to have additional screening, vaccines, or titers and meet the background clearance requirements of all affiliating agencies for clinical placement.

3 APPLICATION FOR ADMISSION TO THE LICENSED VOCATIONAL NURSING (LVN) PROGRAM Name: G# Last First Middle Initial Mailing Address: Street number City State Zip D.O.B. Are you a veteran? No Yes: Please attach copy of DD214 Important: Name and address must be kept current with Allied Health Department and Admissions & Records Office Address: Phone Number ( ) NOTE: If accepted into the nursing program, Gavilan student will be used for all communications going forward High School(s) attended: Name during attendance: Completed: High School diploma GED College/University Degree Year of Completion: List all other schools attended including Gavilan College Name during attendance Dates attended PREREQUISITE INFORMATION Overall GPA of 2.5 in AH 3, BIO 7, BIO 9, AH/BIO 11, AH 180 and PSYC 10 (or equivalent) AND minimum of C in all courses listed below. VN Prerequisite Courses AH 3 Person in the Life Cycle BIO 7 Human Anatomy BIO 8 General Microbiology BIO 9 Human Physiology AH/BIO 11 Nutrition AH 180 Fundamentals of Nursing/Convalescent Course Discipline, Number & Title (if different from left column) School where completed Grade earned Semester & Year CMUN 1A Introduction to Public Speaking SOC 1A Introduction to Sociology ENGL 1A Composition PSYC 10 Introduction to Psychology MATH (Check one) 235 Integrated Algebra 240 Algebra II 242 Algebra II for statistics 5 Introduction to Statistics Gavilan College placement scores (must be eligible for Math 5 or higher)

4 List complete prior work experience with most recent first (use additional paper if needed): Job Title Employer Dates employed (Month and Year) From: To: Address Brief Job Description Job Title Employer Dates employed (Month and Year) From: To: Address Brief Job Description Job Title Employer Dates employed (Month and Year) From: To: Address Brief Job Description ` Describe briefly your life goals and the role your acceptance into the Vocational Nursing Program would play in meeting these goals (use additional paper as needed). I certify that the statements in this application are true and complete to the best of my knowledge and that I have read and understand the nursing program application/admissions criteria. Student s Signature: Date:

5 HEALTH STATEMENT TO BE COMPLETED BY STUDENT: Name of Applicant: Program: Last Name First Name Do you have any medical condition or disability which may limit your ability to perform the tasks and functions of a healthcare worker? Yes No If yes, what can be done to accommodate your disability?. Students admitted to the program are required to complete immunizations or titers in accordance with agency policies and CDC recommendations for healthcare personnel. Written proof must be on file. TO BE COMPLETED BY EXAMINING PHYSICIAN/NURSE PRACTITIONER: Please review the attached requirements for healthcare students. Complete this form and return to the student. Please include business card or physician/clinic stamp. Date of complete physical examination: Does the applicant have any medical condition or disability which may limit his/her ability to perform the tasks and functions of a healthcare worker? Yes No If yes, what can be done to accommodate his/her disability?. Upon review of the physical exam and lab results, I certify that this student is medically able to perform all clinical activities without restrictions and that the student does not have a health condition that creates a hazard to self or others. MD/NP Signature Date Print Name: License #: Address: Phone number ( )

6 Physical Requirements for healthcare workers The health and safety of the consumer of health care must be protected. The student must be able to perform the work required in the program without limitation. The student will refrain from attending the clinical area if any condition would interfere with patient safety. 1. Standing / Walking - 75% to 95% of work day spent standing/walking on carpet, tile, linoleum, asphalt and cement while providing patient care. 2. Sitting - 5% to 25% of work day spent sitting while operating computers, answering the telephone, writing reports, reviewing computer printout, charting, and gathering data. 3. Lifting - 10% to 15% of work day spent floor to knee, knee to waist, waist to waist and waist to shoulder level lifting while handling supplies, handling IV bottles, using trays, charting patient information, assisting with positioning and transferring patients. 4. Carrying - Up to 65% of work day spent carrying at waist level miscellaneous patient supplies. 5. Pushing / Pulling - Up to 40% of work day spent pushing/pulling patient care equipment. 6. Climbing - Up to 25% of work day spent climbing stairs going to and from other departments, clinics, office, and homes. 7. Balancing - Up to 25%, see climbing. 8. Stooping / Kneeling - Up to 10% of work day spent stooping/kneeling while retrieving medications from refrigerator, loading tray from supplies on lower shelves, using lower shelves of cart, stocking shelves, and retrieving items from bedside stands, bathrooms, storerooms, and providing patient care. 9. Bending - Up to 20% of work day spent bending at the waist while performing patient checks, gathering supplies, assisting with patient positioning, priming IV tubing, adjusting patient beds, adjusting exam table, tying and untying patient restraints, bathing patients, emptying tubes, and retrieving patient belongings. 10. Crawling - Up to 2% retrieving patient belongings. 11. Reaching / Stretching - Up to 35% of work day spent reaching/stretching while hanging IV bottles, checking IV solutions, gathering supplies, operating the computer, disposing of dirty needles in containers, plugging in tubing over bed, assisting with patient positioning, connecting equipment and retrieving patient files. 12. Handling - Up to 90% hand-wrist movement, hand-eye coordination, simple firm grasping required. 13. Fingering - Up to 90% fine and gross finger dexterity required. 14. Feeling - Up to 90% normal tactile feeling required. Sensitivity to heat, cold, pain, pressure, etc. 15. Twisting - Up to 15% of work day spent twisting at the waist while gathering supplies and equipment, operating equipment, and performing patient care. 16. Talking - Up to 95% average ability required. Fluent in English. Ability to communicate with wide variety of people and styles, ability to be easily understood. 17. Hearing - Up to 95% ability to hear and interpret many people and correctly interpret what is heard; i.e., physicians orders whether verbal or over telephone, patient complaints, physical assessment, fire and equipment alarms, patient call bells, paging system, etc. 18. Seeing - Up to 95% acute visual skills necessary to detect signs and symptoms, coloring and body language of patients, color of wounds and drainage, infiltrated IV sites, and possible infections anywhere, interpret written work accurately, read characters and identify colors. 19. Smelling - Up to 95% acute olfactory skills to detect signs and symptoms of infection, bleeding, acidosis, smoke, fire, noxious chemicals, and/or gasses. Essential Cognitive Learning Skills 1. Possess critical thinking abilities sufficient for clinical judgment: the ability to assess patient status and make appropriate clinical decisions regarding course of action within given time constraints. 2. Effectively synthesize clinical data from a variety of sources including written, verbal, and observational (assessment). 3. Prioritize nursing care for needs of multiple patients simultaneously. 4. Demonstrate independence in reasoning and decision making based on written, verbal, and observational data. 5. Solve practical problems and deal with a variety of variables in situations where only limited standardizations exist. 6. Perform mathematical calculations for medication preparation and administration. Essential Communication Skills 1. Communicate clearly, verbally, nonverbally and in writing, demonstrating appropriate grammar, vocabulary, and word usage. 2. Interact effectively on an interpersonal levels with clients, families, and groups from a variety of social, cultural, emotional, and educational backgrounds. 3. Function effectively under stress. 4. Provide client teaching in a variety of modalities including written, oral, and demonstration. 5. Receive instruction verbally, written, and by telephone; interpret and implement. 6. Demonstrate appropriate control of affective behaviors, verbal, physical, and emotional levels to ensure the emotional, physical, mental, and behavioral safety in compliance with ethical standards of the American Nursing Association.

7 TRANSCRIPT / RECORD REQUEST FORM FOR NURSING STUDENTS Submit this form to the Admissions and Records office if you wish to have A&R send your transcripts to the Allied Health Department instead of including them in your nursing application packet. Use this form only if you have submitted official records to A&R in the past. Deadline to submit the Transcript / Record Request Form is 5 working days prior to the nursing application deadline. The 2017/2018 nursing application deadline is December 1 st, Instructions: 1. Complete form 2. Submit form to the Admissions and Records Office (SC 110) 5 working days prior to the nursing application deadline Admissions will send the records you select below to the Allied Health Department. IMPORTANT: Transcripts requested via this form after the deadline will not be processed. The Admissions and Records Department will not be held responsible for any late requests. This form is not intended to request your transcripts from other schools. Name: Last Name First Name Middle Initial G# Main Phone #: ( ) - Applying for: LVN program RN program Other names used on Gavilan records: Dates of attendance at Gavilan: From To Month/Year Month/Year PLEASE SEND THE FOLLOWING RECORDS TO THE ALLIED HEALTH DEPARTMENT AT GAVILAN COLLEGE: Gavilan College transcripts Transcripts from other college or university List School(s): Name (if different) Name (if different) Name (if different) High School, GED or equivalent transcripts List School(s): Advanced Placement (AP) Test Scores Student s Signature: Date: Admissions & Records Office SC110 (408) OFFICE USE ONLY Date submitted to A&R: