Cherokee Nation W. W. Hastings Hospital Surgical Technology Program Application Booklet

Similar documents
CRAFTON HILLS COLLEGE PARAMEDIC PROGRAM Fall 2016 Application

PROCEDURE: 1. Prospective students are required to obtain the Pre-Entrance Physical Examination Form from the Nursing Program office.

Applicant Name (Please print) Last First MI. Northeast State Community College assigned Student ID Number: City: State: Zip Code:

Surgical Technology. Washburn Institute of Technology. Program Number Target Population. Description. Entry Requirements.

Shadow-a-Professional Program 2016 Application

Medical Assistant Training Program Checklist and Application. Student Name: Campus Requested:

CRAFTON HILLS COLLEGE PARAMEDIC PROGRAM Spring 2019 Application

Patient Care Technician Certificate. Career Talk and Program Requirements

MSU-Crowder Bachelor of Science in Nursing (BSN-C) Scholars Program.

BLINN COLLEGE ASSOCIATE DEGREE NURSING PROGRAM GENERIC APPLICATION PACKET

Applicant: Student ID Date:

APPLICATION FOR ADMISSION TO THE EMT-PARAMEDIC PROGRAM FALL 2018

MOUNTAIN VIEW COLLEGE Health Record

BLINN COLLEGE ASSOCIATE DEGREE NURSING PROGRAM LVN-TRANSITION APPLICATION PACKET

Admissions Packet

CNA CERTIFICATE PROGRAM APPLICATION PACKET

Disclosure and Release of Health History and Immunization Requirements

JOHNS HOPKINS SCHOOL OF NURSING PRE-ENTRANCE HEALTH FORM

DEPN AND GRADUATE NURSING MANDATORIES INFORMATION

Guide to CastleBranch

Middle Tennessee State University Master of Science in Nursing Health History and Physical Examination Form

South Plains College Respiratory Care 2017

Coastal Alabama Community College January 2017 NURSING PROGRAM TRANSFER APPLICATION

Spring 2017 Early County Practical Nursing Program Application

OWENS COMMUNITY COLLEGE DENTAL ASSISTING CERTIFICATE ORIENTATION

Cisco College Surgical Technology Program Application for Admission and Student Health Record

Paramedic Program Roseville, CA

Policy S-4 FLORIDA STATE UNIVERSITY COLLEGE OF NURSING CLINICAL CLEARANCE

Southwestern College Nursing & Health Occupations Programs MEDICAL EXAMINATION FORM

MEDICAL LABORATORY SCIENCE MANDATORIES INFORMATION

Oregon State University School of Biological and Population Health Sciences KIN 344: Pre-Therapy/Allied Health Practicum.

EMS Paramedic Program Application. Copies of the following: Completed Paramedic Application Due Date April 25, 2018

ALLIED HEALTH INFORMATION PACKET

Dear Prospective Volunteer:

MEDICAL ASSISTING CERTIFICATE PROGRAM APPLICATION PACKET

Phlebotomy Certification Course

HEALTH PROFESSIONS PROGRAM Physical Examination Form

ALLIED HEALTH INFORMATION PACKET

DMACC INSTRUCTIONS FOR COMPLETING STUDENT HEALTH AND IMMUNIZATION RECORD

PRACTICAL NURSING PROGRAM

RDA Registered Dental Assisting

Sexual Assault Nurse Examiner Job Description

ADN Program Application Packet

State Center Community College District MADERA CENTER VOCATIONAL NURSING PROGRAM

SOUTHWESTERN MICHIGAN COLLEGE NURSING PROGRAM

Southwest Mississippi Community College Practical Nursing Program

JUNIOR VOLUNTEER ORIENTATION REGISTRATION

Kapi`olani Community College MOBILE INTENSIVE CARE TECHNICIAN PROGRAM Admission Application Checklist

Columbia College Nursing Application Packet (revised 2/9/18)

If you would like to volunteer in the Gift Shop as part of the Hospital Auxiliary, please call for additional information.

Santa Rosa Junior College Health Sciences Department Health Evaluation Form. STUDENT NAME: Last First MI BIRTHDATE: SRJC ID # GENDER: M F

South Plains College Surgical Technology Program Admissions Information and Application Fall 2018-Fall 2019

Proof of current (within 1 year) Tuberculin PPD or skin test administration. If PPD result is positive a negative chest x-ray is required.

Internship Application x2645

Health & Safety Packet for Incoming Students

Radiologic Technology Program Student Orientation. Technical Standards Checklist for Clinical Observation Requirements for Entry

Southwest Mississippi Community College Practical Nursing Program

Southwest Mississippi Community College Practical Nursing Program

Davidson Campus: P.O. Box 1287, Lexington, NC Telephone: FAX:

CREATING THE SURGICAL ENVIRONMENT AST. Association of Surgical Technologists

CHAPTER VII ST PROGRAMMATIC EVALUATION STANDARDS FOR SURGICAL TECHNOLOGY

Perioperative Learning Center Mission Statement: The mission of the Perioperative Learning Center is to provide excellence in the education and

Division of Community Education Application for Certified Nursing Assistant Program CNA APPLICATION CHECK LIST

Bachelor of Science in Nursing (BSN) Program Application

Nurse Aide TIDEWATER COMMUNITY COLLEGE

BEFORE COMPLETING THIS PACKET

Allan Hancock College 2019 Licensed Vocational Nursing Program Application Period: April 1 st June 30 th, 2018

Nurse Aide. We reserve the right to cancel any class due to insufficient enrollment.

PEARL RIVER COMMUNITY COLLEGE PRACTICAL NURSING FULL-TIME PROGRAM APPLICATION DEADLINE: MARCH 1 DEFINITION OF PRACTICAL NURSING

bring it with you to your scheduled interview (do not submit this with your application);

DISCOVERY COMMUNITY COLLEGE

Student Health Form Howard Community College Health Science Division

NORTHEAST TEXAS COMMUNITY COLLEGE Professional Education and Allied Health

DMACC INSTRUCTIONS FOR COMPLETING STUDENT HEALTH AND IMMUNIZATION RECORD. Questions about uploading the form or CastleBranch?

NURSING ASSISTANT ADVANCED PLACEMENT PROGRAM REGISTRATION PACKET AND INFORMATION

SPECIAL MESSAGE TO PROSPECTIVE DOCTORAL NURSING STUDENTS

College of Sequoias Physical Therapist Assistant Program Student Health Release Form

Post-Masters Nurse Educator Graduate Certificate.

Student Health Form Howard Community College Health Science Division

Vocational Nursing Program

LICENSED PRACTICAL NURSING

COLUMBUS STATE COMMUNITY COLLEGE Veterinary Technology

NORTHWEST FLORIDA STATE COLLEGE

ATHLETIC TRAINING MANDATORIES INFORMATION

Monday through Thursday 9:30am 11:30am And 2pm 4pm

ATHLETIC TRAINING MANDATORIES INFORMATION

Middle Tennessee State University School of Nursing Undergraduate Program Clinical Policy

Novant Health Auxiliary

ORANGEBURG-CALHOUN TECHNICAL COLLEGE PATIENT CARE TECHNICIAN PROGRAM ADMISSION CHECKLIST

University of South Alabama College of Nursing Bachelor of Science in Nursing

Davidson Campus: P.O. Box 1287, Lexington, NC Telephone: FAX:

CERTIFIED NURSE AIDE (CNA)

Frequency: O = Occasionally (1-33%) F = Frequently (34-66%) C = Constantly (67-100%)

Medication Aide. Program Application Packet. Northeast Texas Community College is an equal opportunity, affirmative action, ADA institution.

RSU 25 ADULT AND COMMUNITY EDUCATION Create Your Path to Success

Occupational Therapy Assistant Program Application Packet. Fall 2017

WEST LOS ANGELES COLLEGE DIVISION OF ALLIED HEALTH MEDICAL ASSISTING PROGRAM 9000 OVERLAND AVE

UNIVERSITY OF HAWAI I KAPI OLANI COMMUNITY COLLEGE 4303 Diamond Head Road, Honolulu, HI

NURSING ASSISTANT TRAINING PROGRAM PROGRAM APPLICATION

THIS PROGRAM IS COMPETITIVE. Minimum Grades DO NOT Guarantee Admission.

Transcription:

Cherokee Nation W. W. Hastings Hospital Surgical Technology Program Application Booklet Dear Prospective Student: Thank you for your interest in Cherokee Nation W. W. Hastings Hospital Surgical Technology Program. We know you have a choice when it comes to your education, and we hope you consider attending Cherokee Nation W. W. Hasting Hospital Surgical Technology Program. This booklet of information is intended to provide general information about our program, as well as to guide you through the application and enrollment process. Although there is a great deal of information we present it in an easy to follow format. Health care professionals are in high demand today, especially surgical technologist. Surgical technology can be a rewarding career choice with opportunities for advancement. We believe our surgical technology program is challenging and competitive with a dedicated faculty and excellent facilities. As you consider making one of the most important decisions of your life, we hope you will find Cherokee Nation W. W. Hasting Hospital Surgical Technology Program is the next step for you. Please feel free to contact us for information and enrollment Patricia Sumner Program Director (918) 316-0718 Rochelle Lewis Instructor (918) 772-8002, and Cheryl Sturgeon 918-718-5774. Sincerely, Patricia Sumner CST Patricia Sumner CST patricia-sumner@cherokee.org Program Coordinator/Instructor

Cherokee Nation W.W. Hastings Hospital Surgical Technology Program Application Booklet Table of Contents Application Process Surgical Technologist Application Process Selection Points Checklist Session Schedule OSBI Background Check Information Surgical Technologist Program Information Immunizations Requirements

Surgical Technologist Application Process 1. Fill out application and take Finger Point Dexterity test and Entrance Exam 2. List of documents needed: A. Obtain official high school transcripts or GED certificates and/ or college/vo-tech transcripts B. Submit Documentation of Required Immunizations C. Obtain an Oklahoma State Bureau of Investigation (OSBI) Background Check D. A copy of your blue and white Cherokee Nation Card E. A copy of your Driver s License and Social Security Card F. Proof of Health Insurance is required 1 month prior to start of class if selected. 3. Turn in all documents as soon as possible 4. Scrub Boot Camp will be scheduled you will be notified by the Program Director 5. Program Director will give you a time and date for the T.A.B.E. Test (blue) with Career Service 6. Applicants must research five questions and give a list of resources. a) Describe the typical job responsibility of a surgical technologist b) List several career paths available to surgical technologist (list at least three). c) What hazards are surgical technologists exposed to on a daily basis in the operating room (list three-five examples)? d) What characteristics do you possess that make you a good fit for this career? e) What does professionalism, work ethic and being structured mean to you? 7. Attend an Interview with the Instructors (dates and times will be announced) Call for additional information (918) 316-0718 Patricia Sumner, (918) 772-8002 Rochelle Lewis, And Cheryl Sturgeon (918) 718-5774. All complete applications will be reviewed and students will be notified of selection

Selection Points Checklist You may turn in all your documentation at one time to Cherokee Nation W.W. Hastings Hospital Surgical Technology Program, all required documents must be submitted before the date of your interview. Vaccinations MMR (2) Varicella (2) Hep B Tetanus Vaccine TB Skin Test must already Have one done Assessments Cherokee Nation W.W. Hastings Hospital Surgical Technology program entrance exam, Finger point dexterity test T.A.B.E. - Test of Adult Basic Education Scrub Boot Camp Informational Meeting Transcripts (GED, high school diploma, collage transcripts) Interview Applicant s name Applicant s Signature Total

Cherokee Nation W. W. Hasting Hospital Surgical Technology Program Date of Application: (Please print clearly when completing application) Name: (First) (MI) (Last) Mailing Address (Address) (City) (State) (Zip) Home Phone: Cell Phone: SSN# D.O.B. Email Do you have a High School Diploma? Yes or No, GED: Yes or No What year did you graduate or get certificate Do you have educational records under any other name (i.e. maiden name)? No/ Yes If yes, what name: Emergency Contact (Name) (Phone) (Relation) Emergency Contact: (Name) (Phone) (Relation)

Education, Training and Experience High School: School name: School address: School city, state, zip: Number of years completed: Did you graduate? [ ] Y or [ ] N Degree / diploma earned: College / University: School name: School address: School city, state, zip: Number of years completed: Did you graduate? [ ] Y or [ ] N Degree / diploma earned: Vocational School: Name: Address: City, state, zip: Number of years completed: Did you graduate? [ ] Y or [ ] N Degree / diploma? : Military: Branch: Rank in Military: Total Years of Service: Skills/duties: Related details: If selected will there be a need for accommodations or modifications in order to successfully perform the essential functions of the career major? if yes, please include documentation.

How did you hear about the Cherokee Nation Surgical Technology Program. Employment History Name of Employer: Name of Supervisor: Telephone Number: Business Type: [ Address: City, state, zip: Length of Employment (Include Dates): Position Name of Employer: Name of Supervisor: Telephone Number: Business Type: [ Address: City, state, zip: Length of Employment (Include Dates): Position

OSBI Background Check Information As part of the Cherokee Nation W.W. Hastings Hospital Surgical Technology Program, you will be required to practice your skills in facilities requiring background checks. Before you can be assigned to a hospital, clinic or other facility for your clinical or externship experience, you must have a background check that includes a sex offender check, violent offender check, and criminal offender check. There are 3 boxes at the bottom of the OSBI form and all 3 should be stamped. If your criminal history is positive, the facility will review your personal criminal history background. Each facility has the right to accept or reject any student based on information shown in the criminal history background check. If you lived in Oklahoma less than one year, you must submit the information from the state where you previously resided as well as the OSBI report. These reports must also include information regarding sex offender history. It is your responsibility to obtain your record from the Oklahoma State Bureau of Investigation (OSBI) and provide it with your documentation. The OSBI office is located at 6600 North Harvey off NE 63 r, Oklahoma City, OK. The telephone number is (405) 879-2689. The cost is $15.00; OSBI accepts cash or credit card. They will not accept checks. You will be required to complete the process. The original document will only be accepted and photocopies, foxes copies, or other forms cannot be accepted.

Standards for Surgical Technology Program Philosophy: The Surgical Technology program is accredited to provide graduate surgical technologist who meet national standards while satisfying the needs of the community of interest served by the program. Technical standards are an accreditation requirement meant to assist both students and program faculty in determining appropriate qualification for the program. Technical standards must meet state and federal requirements that preserve the rights of individuals with disabilities. Purpose: Technical standards will be utilized to identify which students will need assistance in performing tasks and to identify students who would be unable to perform the job of Surgical Technologist prior to program entry Areas of Functional Ability: A. Gross Motor Skills B. Fine Motor Skills C. Physical Endurance D. Physical Strength E. Mobility F. Hearing G. Visual H. Tactile In addition to the areas tested prior to entry, students must be able to demonstrate a variety of knowledge, psychomotor, and behavioral skills to graduate from the Surgical Technology Program. Surgical Technologist Standard Procedure 1. All applicants will be tested. 2. Only one applicant will be tested at a time. 3. One program faculty member will conduct testing for all applicants. 4. Results of testing will be used to identify abilities of applicants but not for admission. Applicants who receive a below standard score will be referred to the Health Sciences counselor for advising. Advising may include determination of appropriate interventions/assistive devices, assistance in determining appropriateness of the profession for the applicant, presence of disability, or other counseling as deemed necessary

Surgical Technology (1392 Hours) Cherokee Nation W.W. Hastings Hospital Surgical Technology Program provides training and skills necessary to become a surgical technologist. Our goal is to prepare competent entry-level surgical technologist in the cognitive (knowledge), psychomotor (skills), and affective (behavior) learning domains. A surgical technologist is an integral member of the surgical team, responsible for preparation of sterile supplies, equipment and instruments, and assisting the surgeon in their use. The surgical technologist most frequently serves as instrument handler, setting up instruments, and then passing them to the surgeon. A surgical technologist may also assist the surgeon by performing tasks such as retracting incisions, cutting sutures, and utilizing suction to maintain a clear field of vision for the surgeon. Cherokee Nation W.W. Hastings Hospital Surgical Technology Program students who complete the 9.5 month program will be able to test for the CST exam. Students must be at least 18 years old by the first day of class. Enrollment is limited. Students must meet all entrance requirements. It is the applicant s responsibility to be sure their documentation is turned in and complete. Students will attend class Monday-Thursdays 08:00-4:00pm each day until clinical beginning. Occasional Fridays from 08:00-4:00 as needed. When students attend clinical Monday thru Thursdays from 6:15 am to 4:00 pm, and attend class on Friday from 08:00 until 4:00 pm. The Career Major is completed in two consecutive semesters, August through January and January through June and the second class January thru November. Training Includes: Blood borne/airborne Pathogens Anatomy, Physiology, and Surgical Patho-Physiology Surgical History, ethics, and Law Organization of the OR Team Concepts Microbiology, Disinfection, and Sterilization Aseptic Techniques Gowning, Gloving, and Maintaining a Sterile Field OR Furniture Surgical Counts, Emergencies, and Communication Anesthesia, Pharmacology, and Radiology All Hazards Preparation Homeostasis, wound care, and closure Dressings, Packing, and Drains Pre-op, Intra-op, and Post-op Care Surgical Specialties, and special Patient Needs Surgical Instrumentation Medical Terminology Surgical Procedures Career Success Professional Organization Clinical Electrical Concepts Concepts of Physics Robotics & Computer Usage Transporting and Positioning Prepping and Draping

Surgical Technology career major Immunization / screening requirements The following documented immunizations, titers, and records must be submitted prior to acceptance in the Surgical Technology Career Major. You must submit documentation to Cherokee Nation W.W. Hasting Surgical Technology Program at the time of your interview. MEASLES, MUMPS, RUBELLA (MMR) You must have documentation of receiving 2 MMR vaccinations, or positive titers (blood tests that shows immunity to Rubella, Mumps, and Rubella) HEPATITIS B VACCINATION The hepatitis B vaccination is a series of 3 injections given over a 6 month period. The cost ranges from $0-$200. If you wish, you may sign a declination form and not take the series. The area of work you are going to puts you at risk for coming into contact with infected blood and body fluids, so think seriously about refusing this protective vaccination. You must submit documentation of having had all 3 shots of the series or have a signed declination statement before being accepted into the Career Major. TUBERCULOSIS SKIN TEST You must submit documentation of having had a recent NEGATIVE TB (PPD) skin test. For positive reactors, you must show proof of the positive reaction and then have a negative chest x- ray. If accepted into the Surgical Technology Program, you must receive and submit another negative TB skin test to the Program Coordinator. Be sure to get your TB skin test prior to taking any other immunizations or you will be required by your physician to wait one month after receiving a vaccine such as an MMR. You must have two Negative TB test within one year to start clinical. VARICELLA IMMUNIZATION You must have documentation of receiving 2 vaccinations, or have a positive titer (blood test showing immunity to Varicella). Submitting a physician s statement that you had chicken pox will not be accepted. Vaccinations Required MMR (2) Varicella (2) Hep B x 3 Tetanus Vaccine TB Skin Test must already Have one done

Physical Requirements 1. Heavy lifting (45lbs and over) 2. Straight pulling (8 hours) 3. Pulling hand overhand (8 hours) 4. Reaching above shoulders 5. Use of fingers 6. Both hands required 7. Walking (8 hours) 8. Standing (8 hours) 9. Kneeling (8 hours) 10. Both legs required 11. Near vision correctable at 13 to 16 12. Far vision correctable in one eye to 20/20 and to 20/40 in the other 13. Ability to distinguish basic colors 14. Ability to distinguish shades of colors 15. Hearing without aids 16. Hearing whispers 17. Mental and emotional stability