LNA Application Instructions

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Providing Quality Education in the White Mountains Region LNA Application Instructions Step 1 Fill out the scholarship application, program application, registration form, and deferred payment form. Return to Ellen St. Cyr at 646 Union Street, Suite 300, Littleton, NH 03561, asap. Please indicate the location you wish to go for your drug screening test. Step 2 After the college has received the payment, you will be sent instructions to start the criminal background check. The criminal background check should be completed prior to the start of class. Should your background check be conducted outside of NH, that expense will be deducted from your refund, should you be approved for the scholarship. Also, please note that you must have a clean record to enroll in this program. Please refer to page 13 of the handbook for more information. Step 3 You will be sent a voucher and instructions to schedule a urine drug screen for the location indicated on the registration. The urine drug screen must be done within 30 days of the start of the course. These results will be sent to Gail Minor- Babin. The voucher is valid for the standard minimum screening. Should your urine sample require further testing, please bring along $30 to cover that expense as the grant will not cover any additional testing. Step 4 Bring the White Mountains Community College Nursing Assistant Health Form to your medical provider to complete and sign. This form is to be returned to Ellen St. Cyr at our Littleton campus. This form must be received prior to the starting the Nursing Assistant Program. Step 5 Once the college receives confirmation of a passing drug test and criminal background check, the applicant will be notified of and receive: 2/17 acceptance into the program with a start date instructions of where and when to purchase scrubs, stethoscope, blood pressure cuff, and nursing shoes if scholarship eligible. Scholarship eligible applicants must acquire their materials from White Mountains Community College approved vendor. Scholarship students will not have to pay for these materials. The scholarship will be billed directly. 2020 Riverside Drive, Berlin, NH 03570 Phone (603) 752-1113 1-800-445-4525 TTD Access: relay NH (800) 735-2964 Fax 603-752-6335 www.wmcc.edu Accredited by the New England Association of Schools and Colleges (N.E.A.S.C.) As a Comprehensive Community College Part of the Community College System of New Hampshire

Providing Quality Education in the White Mountains Region WMCC LNA/MNA Checklist 45 DAYS Prior to Start of Course Applications for the program and scholarship completed and submitted to Ellen St. Cyr with the following: a) 2015 or 2016 Income Tax return OR b) Proof of public assistance (food stamps, Medicaid, etc.) OR c) If applying for the scholarship under educationally disadvantaged; be sure to include proof of eligibility. Confirm eligibility for scholarship. Make an appointment with your medical provider to review and update immunizations as necessary. Have the WMCC Medical Assistant Health Form completed (found in the handbook.) LNA only 30 Days Prior to Start of Course Payment for background check and urine drug screen mailed to Ellen St. Cyr at 646 Union Street, Suite 300, Littleton, NH 03561 LNA - $110 MNA - $80 Background check account created with Castle Branch (formally certified background.) NH Criminal Release form notarized and mailed to Castle Branch (formally certified background.) 30 Days Prior to Start of Course Make an appointment for the urine drug screen. Mail or fax the WMCC Medical Assistant Health Form to Ellen St. Cyr at 603-444-0981 LNA Only 7 Days Prior to the Start of Course Confirm your admission testing (background and drug screening) is clear and you are registered for the course. LNA course only - Go to Super Shoes in Conway or Littleton and pick up clinical supplies. Revised 2/17 2020 Riverside Drive, Berlin, NH 03570 Phone (603) 752-1113 1-800-445-4525 TTD Access: relay NH (800) 735-2964 Fax 603-752-6335 www.wmcc.edu Accredited by the New England Association of Schools and Colleges (N.E.A.S.C.) As a Comprehensive Community College Part of the Community College System of New Hampshire

White Mountains Community College LNA Course Schedule Berlin Spring 2017 Ariel Alger, Instructor Theory Coos County Nursing Home Berlin 2:30 -- 10:00pm Clinical Coos County Nursing Home Berlin 2:30 10:00pm Tuesday April 25 Theory Thursday April 27 Theory Tuesday May 2 Theory Thursday May 4 Theory Tuesday May 9 Clinical Thursday May 11 Theory Tuesday May 16 Clinical Thursday May 18 Theory Tuesday May 23 Clinical Thursday May 25 Clinical Tuesday May 30 Clinical Thursday June 1 Clinical Tuesday June 6 Clinical Thursday June 8 Clinical Tuesday June 13 Clinical Thursday June 15 Make - up Clinical Tuesday June 20 Final Written Exam - Graduation Thursday June 22 LNA Licensing Exam 8:30am -12:30 WMCC Littleton Campus

WHITE MOUNTAINS COMMUNITY COLLEGE NURSE ASSISTANT EDUCATION PROGRAM APPLICATION Full Name: FIRST MI LAST DOB: Phone: Mailing Address: Physical Address (if different): E-Mail Address: Current Employer: Name Address and Phone Number Name of High School you graduated from & what year? If you did not graduate, do you have a G.E.D.? Please list any college courses you may have taken and where taken. Do you have health problems that may restrict your ability to carry out the duties of a Nurse Assistant? No Yes If yes, please explain: Do you need any ADA accommodations to take this course? Yes (if yes, additional documentation may be required) No Attach to this application a paragraph statement of the following: 1) Why I want to become a Licensed Nurse Assistant: Please provide the names and contact information for two references who would recommend you for consideration to become an LNA that we can contact. 1. 2.

WHITE MOUNTAINS COMMUNITY COLLEGE NURSE ASSISTANT EDUCATION PROGRAM APPLICATION By signing this document, I understand if I do not complete the program, I will be financially responsible for the course fees, materials, and supplies. I also acknowledge that upon completion of this course, I will receive a certificate of completion for the WMCC Nursing Assistant Program. This certificate entitles me to be eligible to take the NH Board of Nursing LNA Licensing Exam. In order to receive my LNA license, I must pass the LNA licensing test and submit the required state application. This includes the NH Board of Nursing Criminal Background check. The NH Board of Nursing makes the final determination to grant all LNA licenses. Printed Name Date Signature Revised 03/16

North Country Health Career Initiative Program Scholarship To be eligible and maintain eligibility for this scholarship, applicants must: Be a White Mountains Community College student who is enrolled in the Licensed Nursing Assistant (LNA), Medication Nursing Assistant (MNA), or in the Health and Wellness Advocate Certificate programs. Meet the attendance requirements of each program. Maintain a 2.0 GPA in order to remain eligible for a scholarship each term for credit bearing classes. Be U.S. citizens, non-citizen nationals, or foreign national who possess a visa permitting permanent residence in the United States. Individuals on temporary or student visas are not eligible for this scholarship. Meet the definition of either educationally* or economically disadvantaged. *Educationally disadvantaged individuals come from an environment that has inhibited the individual from obtaining the knowledge, skills and abilities required to enroll in and graduate from a health professions school or health program. Participate in an online cultural orientation specific to Northern New Hampshire. Provide job placement information following certification/licensure. Intend to seek employment or remain employed in a rural, underserved area, increasing workforce capacity to meet unmet needs of residents in rural communities. Criteria for Proving Economic or Educational Disadvantage: To be considered "Educationally Disadvantaged", students must prove one of the following: (1) The individual has taken the SAT within the last three years and performed below average (1500). An official score must be supplied as proof for meeting this criteria. (2) The individual graduated from (or last attended) a high school from which, based on most recent data available, had a high dropout rate. (3) The individual is able to supply a high school transcript, GED, or take an educational assessment that proves an educational disadvantage. (4) The individual is the first generation in his/her family to attend college. 1 North Country Health Careers Initiative: Scholarship for Eligibility

To be considered "Economically Disadvantaged", students must prove one or more of the following: (1) The individual comes from a family that receives public assistance (e.g., Aid to Families with Dependent Children, food stamps, Medicaid, public housing). (2) Meet the family income requirements as listed below by submitting Federal Income Tax Forms the previous year: Size of Family Income level ** 1 $23,340 2 $31,460 3 $39,580 4 $47,700 5 $55,820 6 $63,940 7 $72,060 8 $80,180 **Note: For families/households with more than 8 persons, add $8,120 for each additional person. To meet the criteria of "Economically Disadvantaged", an individual must supply a prior year tax form. Any changes in financial status from previous tax year to current date (i.e. loss of income, unemployed), official documentation from the Unemployment Office stating benefit income is required. Please note: Any student who withdraws or is removed from the LNA, MNA, or Health and Wellness Advocate Certificate program will be responsible for full tuition repayment and related program expenses. Scholarships may only be used for tuition, books, liability insurance, criminal background checks, drug testing- no cash will be disbursed. Scholarships will only be disbursed upon successful completion of the LNA, MNA, and Health and Wellness Advocate Certificate Programs. Authorization Information: (Initial) I release to the White Mountains Community College (WMCC) and the North Country Health Consortium (NCHC) the right to access and discuss all my current and ongoing personal and academic records and transcripts between each of them. If awarded a scholarship, I understand that I must meet the scholarship criteria outlined above and Standards of Academic Progress for WMCC. (Initial) I release to the appropriate staff of WMCC and NCHC to serve as a reference with the right to discuss my academic progress and attendance with any future employer. (Initial) I understand my name and information from my academic history may be released to the scholarship selection committee(s) and the scholarship donor(s). If awarded a scholarship, I release to the WMCC and NCHC, the right to use my name, story, and picture for printed and video materials, reports, and press releases, without compensation, as well as I will attend ceremonies and receptions. 2 North Country Health Careers Initiative: Scholarship for Eligibility

Please print and use black or blue ink: TODAY S DATE: DATE OF BIRTH: LAST FIRST MIDDLE NAME: NAME: INITIAL: CURRENT MAILING ADDRESS: NUMBER AND STREET: CITY: STATE: ZIP: COUNTY: HOME WORK CELL PHONE: PHONE: PHONE: DID EITHER PARENT ATTEND COLLEGE? YES: NO: DON'T KNOW: **ETHNICITY: [ ] AMERICAN INDIAN/ALASKA NATIVE [ ] ASIAN/PACIFIC ISLANDER [ ] BLACK/NON-HISPANIC [ ] HISPANIC [ ] WHITE/NON-HISPANIC GENDER [ ] MALE [ ] FEMALE I AM ENROLLING FOR: [ ] FALL [ ] SPRING PROGRAM: [ ] LICENSED NURSING ASSISTANT [ ] MEDICATION NURSING ASSISTANT [ ] HEALTH AND WELLNESS ADVOCATE CERTIFICATE LIST LAST HIGH SCHOOL/GED CENTER ATTENDED BELOW. DID YOU GRADUATE? [ ] YES [ ] NO SCHOOL: YEAR: STATE: AT THIS TIME, DO YOU THINK YOU WOULD LIKE TO WORK IN A RURAL, UNDERSERVED AREA? YES: NO: DON'T KNOW: ARE YOU APPLYING FOR ELIGIBILITY AS (SELECT ONE): ECONOMICALLY OR EDUCATIONALLY DISADVANTAGED PLEASE ATTACH DOCUMENTATION SUPPORTING YOUR ELIGIBILITY. I certify that the statements herein are true to the best of my knowledge. Signature Date 3 North Country Health Careers Initiative: Scholarship for Eligibility

Self-Attestation Form for First-Generation College Student Eligibility Criteria On this date, I, (Name of Applicant), certify that I am a first-generation college student. (Application Initial) I understand this to mean that "neither of my parents have any education beyond high school." (Application Initial) I understand that my attestation will be considered as documentation of my eligibility for the North Country Health Careers Scholarship Initiative under the "educationally disadvantaged" criteria. (Application Initial) I understand that my submission of this form represents my acknowledgment of the criteria for eligibility as a "first-generation college student" and that I meet the criteria to the best of my knowledge. I certify that the statements herein are true to the best of my knowledge. Signature of Applicant Date Notary Public State of County of On this, the day of, 20, before me a notary public, personally appeared, known to me (or satisfactorily proved) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purpose therein contained. In witness hereof, I hereunto set my hand and official seal. Notary Public 2 North Country Health Careers Initiative: Scholarship for Eligibility First-Generation College Student Attestation Form

Term: Summer Fall Spring X WHITE MOUNTAINS COMMUNITY COLLEGE 2020 Riverside Drive, Berlin, NH 03570 (603) 752-1113 Phone (603)752-6335 Fax www.wmcc.edu Registration Form *Social Security Number First Name Middle Initial Last Name ADDRESS: City State Zip Phone Email Major *Federal law requires that WMCC collect names and corresponding social security numbers for all students attending the college. The college is required by the Internal Revenue Code to produce a 1098-T tax form (26 U.S.C.A. Section 6050 or Federal Register, Vol. 67, No.2244, page 777686(ii)) which requires the college to report the names and social security numbers of all students taking credit-bearing courses. Please note, that the college will ensure the security of the student s social security number and will not disclose it to anyone outside the college, except as authorized by federal or state laws or applicable policies. NEW! Make a Payment (Log on to the Student Information System (SIS) through www.wmcc.edu) Nelnet Payment Plan (Connect to the e-cashier Web Site through www.wmcc.edu) Company Billing (Attach signed authorization letter on company letterhead) my employer,, agrees to pay for course(s). I understand that if, for any reason, my employer does not remit tuition or other fees, all expenses are my responsibility. Initials. Federal Governmental Statistical Information (optional): Birth Date: Sex: Male Female Residency: NH Other ETHNIC BACKGROUND: Hispanic/Latino Not Hispanic/Not Latino RACE: American Indian/Alaskan Native White Asian Native Hawaiian/Pacific Islander Black/African American Veteran Currently Guard/Reserve State Employee CRN Course# Section Course Title Credits Campus 25763 003W LNA Course n/a Berlin 27417 003W Pre-admission Testing Test Site AVH - Berlin Refund Policy--Students must complete and submit in writing the official college withdrawal form to be eligible for a refund. Student who officially withdraws from the college or an individual course by the end of the eighth (8 th ) calendar day of the semester will receive a 100% refund of tuition, less non-refundable fees. This policy applies to all semester length and alternative semester formats. Exception: students in courses that meet for two weeks or fewer must drop by the end of the first day of the class in order to get a 100% refund. Students registered for workshops must withdraw in writing at least three (3) days prior to the first workshop session in order to receive a full refund of tuition and fees. Financial Obligation Statement -- I agree that by registering for courses within the Community College System of New Hampshire (CCSNH), I am financially obligated for ALL costs related to the registered course(s). Upon a drop or withdrawal, I agree that I will be responsible for all charges as noted in the student catalog and handbook. I further understand that if I do not make payment in full, my account may be reported to the credit bureau and/or turned over to an outside collection agency. I also agree to pay for the fees of any collection agency, which may be based on a percentage of the debt up to a maximum of 35%, and all additional costs and expenses, including any protested check fees, court filing costs and reasonable attorney s fees, which will add significant costs to my account balance. STUDENT SIGNATURE DATE ADVISOR SIGNATURE DATE

2020 Riverside Drive Berlin, NH 03570 Phone: (603) 752-1113 Fax: (603) 752-6335 DEFERRED PAYMENT AGREEMENT FORM q Fall q Spring q Summer Year AMOUNT DEFERRED $ Deferred Plan: q Financial Aid q Third Party/Agency Name q NBS Payment Plan Student Name: STUDENT ID # A Street or PO Box: City, State, Zip: Primary Phone: Cell Phone: Date of Birth: Driver s License #: State: Place of Employment: Address: Work Phone: City, State, Zip: Parent s Name: Telephone: Parent s Address: City, State, Zip: Please list a person who we may contact if we are unable to reach you at the numbers/address(s) you have provided on this form. Reference Name: Address Telephone City, State, Zip IN SIGNING THIS AGREEMENT, I AM INDICATING MY UNDERSTANDING AND AGREEMENT THAT: 1) Payment must be made in accordance with the Deferred Payment Agreement Plan outlined above. 2) If I do not make payment as scheduled above, I will be allowed to finish the course, but I will be unable to receive an official transcript, certificate, professional certificate, or degree. 3) Furthermore, I will not be able to register for future terms at the college and will be restricted from registering at other CCSNH colleges. 4) If payment is made, I will be allowed to register for future classes, however, full payment of all tuition and fees for any new classes may be required before the semester/term begins. 5) If I fail to make a payment as scheduled, I will receive a letter from the Business Office informing me that payment must be made within 14 calendar days. If payment is not made within that timeframe, my account will be referred to Educational Computer Systems Inc.(ECSI). If my account is not cleared up at that point, my account will be turned over to the credit bureau and an outside collection agency. 6) WMCC can contact me using the phone numbers listed above. I agree that by registering for courses within the Community College System of New Hampshire (CCSNH), I am financially obligated for ALL costs related to the registered course(s). Upon a drop or withdrawal, I agree that I will be responsible for all charges as noted in the student catalog and handbook. I further understand that if I do not make payment in full, my account may be reported to the credit bureau and/or turned over to an outside collection agency. I also agree to pay for the fees of any collection agency, which may be based on a percentage of the debt up to a maximum of 35%, and all additional costs and expenses, including any protested check fees, court filing costs and reasonable attorney s fees, which will add significant costs to my account balance. Signature Date OFFICE USE ONLY SPACMNT CODE COMMENTS: Revised 9/02/2015

PROGRAM POLICIES NURSING ASSISTANT PROGRAM HANDBOOK 9

TABLE OF CONTENTS Philosophy.11 Program Objectives 12 Methods of Instruction & Evaluation.12 Admission Requirements...13 Health Requirements..14 Health Form..15 Attendance & Dress Code.16 Program Completion Criteria 17 LNA Licensing Procedure.18 10

WHITE MOUNTAINS COMMUNITY COLLEGE NURSING ASSISTANT PROGRAM PHILOSOPHY The faculty of the Nursing Assistant Training Program supports the philosophy of the White Mountains Community College. The goal of the faculty is to prepare competent nurse s aides who function in an ever changing society. The faculty believes that individuals are multidimensional persons. These dimensions include physical, emotional, intellectual, cultural, and spiritual aspects, and the totality of which creates a unique person who has basic and specific needs. Throughout life, individuals strive to meet the needs through innate potentials and/or through interactions with others. We further believe individuals have inherent worth and dignity that need support during situational and maturational events that influence their basic and specific needs. Individuals needs fluctuate according to their state of health. Health is a dynamic phenomenon, a state of physiological, psychological, social and spiritual well-being; health is not merely the absence of disease. The environment is consistent externally with the individual s social and cultural matrix. As such, the environment influences the individual s ability to achieve optimal wellness. Thus, individuals function on a continuum from wellness to illness. Individuals grow and mature when there is an orderly sequence to their development which enable them to retain their integrity and strive towards optimal wellness with the parameters of their environment. Nursing is a responsive process which provides humanistic care for individuals throughout the life span. Nursing actively supports and promotes individuals adaptive responses as they adjust to their environment and move toward optimal wellness, or toward death. Nurses interact with patient s families, the community and other members of the health care team in order to promote, maintain and restore health as well as give palliative care. The scope of practice for beginning assistant-to-nurses, is directed toward assisting the RN/LPN in supporting individuals responses to common well-defined health problems which usually suggest predictable outcomes. Nursing care is delivered at extended-care facilities, home health agencies, and acute care facilities and is provided through collaboration with other members of the health care team. The faculty believes that learning is enhanced in an environment of mutual respect between teacher and learner. The educational process is shared opportunity and process. All faculty accept responsibility to provide an environment which encourages a learner s development as a person and as a productive member of the health care team. The faculty facilitates, motivates and guides learning through the use of basic teaching/learning principles. The faculty respects and builds on the learner s individuality, previous education, and experiences. Revised 1/2015 11

WHITE MOUNTAINS COMMUNITY COLLEGE NURSING ASSISTANT PROGRAM OVERALL OBJECTIVES On completion of this course, the learner will be able to: 1. Describe the role of the Licensed Nurse Assistant in the health care field and the qualities required for successful integration into the work force. 2. Demonstrate various communication skills that will enhance relationships with patients and with other health care team members. 3. Identify the ethical and legal parameters of an LNA. 4. Discuss and demonstrate in the clinical area the concepts of safety and infection control. 5. Explain and write medical terms and abbreviations necessary for the LNA to communicate verbally and in charting. 6. Describe and demonstrate in the clinical area knowledge and skills necessary to meet the needs of a patient, including care during death and dying. 7. Explain the differences in patient care between institutional and home health care. 8. Complete a resume, list skills necessary to facilitate job seeking, and discuss the elements of human relations as applied to successful employment. Methods of Instruction Interactive lectures, diversified instructional activities with various teaching methods and strategies, classroom discussion, A-V materials, and sim-lab practice. The clinical experience will take place in various cooperating health care facilities. Student Evaluation The Instructor will evaluate the NA student s ability to understand the role of the LNA and to safely perform and give quality care, in order to determine if he/she is qualified to perform nursing related activities. The instructor will make this determination utilizing the following methods: Quizzes, tests, sim-lab practice and performance, classroom participation, clinical performance, and observation of interaction with patients, peers and faculty. Students are responsible and accountable for care they have provided. Malpractice insurance is provided by the college. Prior to the clinical experience, students are instructed not to provide care nor conduct any activities for which they have not been theoretically and clinically prepared. Revised 2/2015 12

WHITE MOUNTAINS COMMUNITY COLLEGE NURSING ASSISTANT PROGRAM ADMISSION REQUIREMENTS 1. High School Diploma or GED 2. Complete NA Application and Registration Form and send $110.00 check for urine drug screen and criminal background check expenses 3. Students will receive a voucher for the urine drug screen and instructions for completing the criminal background check 4. Once college receives confirmation of passing the drug test and criminal background check, the applicant will be notified of acceptance and program start date. 5. For scholarship eligible applicants, students must use WMCC approved vendors to purchase scrubs, stethoscope, blood pressure cuff, nursing shoes. Information will be sent about where these items can be purchased. Scholarship students do not need to pay for these materials. The scholarship program will be billed directly. 6. Students taking the program that are not scholarship eligible, are required to abide by the program s dress code and to have the required materials for the program. Refer to p. 8 7. Be aware that there are several factors which may, according to the New Hampshire State Board of Nursing Rules and Regulations, affect the person s ability to become licensed as an LNA in the State of New Hampshire. These include: A. Conviction of a felony B. Abuse of chemical substances C. Mental and physical incompetence to provide nursing-related activities D. Disciplinary action against an nursing or nursing assistant license. Revised 2/2015 13

WHITE MOUNTAINS COMMUNITY COLLEGE NURSING ASSISTANT PROGRAM VACCINATION, TESTING AND HEALTH REQUIREMENTS Nursing Assistant students must be in good physical & mental health to perform the physical requirements and duties of nursing assistant work in the clinical setting and free from communicable diseases. A 2-step TB Mantoux Skin Test is required to be done within the past year, prior to the start of working in the clinical setting. (note, some institutions require this TB test to be done within six months of working in the clinical setting) A QuantiFERON TB Gold blood test within this timeframe is also acceptable in place of the 2-step Mantoux Skin Tests. Students must show proof of the series of three Hepatitis B Vaccines and/or a positive Hepatitis B Titer. Students must show proof of a current Influenza Vaccine. The students must have a form signed by their medical provider stating that they are able physically and mentally able to take the nursing assistant course. Revised 2/2015 14

White Mountains Community College Nursing Assistant Health Form Please fill in your name and date of birth on this form. Bring this form to your provider to complete and sign. This form is to be returned to Gail Minor-Babin, LNA Program Coordinator at the White Mountains Community College. This form must be received prior to the starting the Nursing Assistant Program. Student name: DOB: 1. Hepatitis (series of three, must be initiated prior to class) #1 Date rec d #2 Date rec d #3 Date rec d Or evidence of a Hepatitis B Titer. Date completed Result 5. Two-Step TB test to be completed one year prior to the start of the NA Course. (*note that the Morrison Nursing Home requires the TB tests to be done within six months of starting the NA Course.) Date Result Date Result If positive result Chest x-ray date Result Annual Health Screening Questionnaire for History of Positive TB Skin Test Submitted Or QuantiFERON-TB Gold blood test. Date Results 6. Influenza Vaccine: Date Received CURRENT HEALTH STATUS (allergies, chronic illnesses, medications, injuries, Provider must sign below that the student is in good health and is physically and mentally capable of performing the duties of a Nursing Assistant): The above information concerning this student s health record is correct. Provider s Signature and Date Adopted 2/2015 15

Class Attendance Students are expected to attend all classes and complete all work assigned. Any absence in excess of two (2) days, must have a physician s note to be considered permitted to continue in the program. Students are expected to attend all clinical days of this course and only one absence is permitted on a clinical day. This absence must be made up. *(Note that only one make-up clinical day will be offered at the end of the course) Students will not receive a certificate of completion unless they have completed the required number of hours for this course. Instruction Ratio The maximum ratio of students to instructor in the clinical setting is 8:1. While conducting classroom or clinical learning experiences, the instructor does not have any other work responsibilities. Dress Code The Nursing Assistant Program uniform: Maroon scrub top and gray scrub bottoms, close toed non-canvas shoes, and no holes in the top of the shoes are allowed. A watch with a second-hand is required to be worn in the clinical setting as part of the uniform. Minimal jewelry: no dangling earrings, no visible body piercings, no bracelets or necklaces should be worn in the clinical setting. No colognes or perfume is to be worn in the clinical setting Finger nails should be short. If nail polish is worn only clear or light-colored nail polish is acceptable; no artificial nails are allowed in the clinical setting Name tags, provided by the college, are required to be worn in the clinical setting Hair can be worn short, or pulled back from the face and contained. No Smoking is allowed on campus. It is strongly advised that if a student is a smoker, that they do not smoke while wearing their uniform. If a student smokes, they must ensure that the smoke odor does not adhere to their uniform. Revised 2/2015 16

Nursing Assistant Program Completion Requirements 1. Academic Achievement: Students must achieve an average score of 70% or better on their quizzes. They must achieve a score of 70% or higher on their mid-term exam and final course exam. 2. Clinical Achievement: In all the clinical areas, students must be considered satisfactory in all competencies listed on the student evaluation forms. A. Clinical Evaluation Tool B. Skills Profile Revised 2/15 17

Obtaining an LNA License All student s must pass the Nursing Assistant Program final course exam with a score of 70 or better. Students are then eligible to take the Competency Licensing Exam required by the State Board of Nursing to become a Licensed Nurse Assistant. Upon successful completion of the Nursing Assistant Program, the student needs to take the NH Board of Nursing required Competency Test. An Excel Tester from WMCC offers the NH BON Competency Evaluation Test following the completion of the course. The cost to take the Competency Evaluation Test is $125.00. If a student feels they need more time to prepare for this test, a later date may be scheduled. Other testing companies, Red Cross and Pearson View, offer this testing and the student is free to choose where and when to take this test. Once you pass the Competency Licensing Exam, the student must complete and file an application with the required fee, (currently $35.00) to the New Hampshire Board of Nursing to become a Licensed Nurse Assistant. (The college does not license you or do this for you) The NH Board of Nursing also requires a fingerprint test for the initial LNA License. Your LNA Instructor will assist you with finding the application and answering any questions you may have about this process. You may also contact the NH Board of Nursing if you have any questions at 603-271-6604. The NH Board of Nursing wedbsite is www.nh.gov/nursing Revised 8/26/15 18