HUTCHINSON COMMUNITY COLLEGE PRACTICAL NURSING PROGRAM APPLICATION PROCESS. Prerequisites

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1 HUTCHINSON COMMUNITY COLLEGE PRACTICAL NURSING PROGRAM APPLICATION PROCESS Application and Testing Deadlines: (Steps 1 & 2 below) Full-time Program: August 1 to January 15 Part-time Program: April 1 to September 15 Prerequisites Have you completed: Human Anatomy & Physiology General Psychology Growth and Development Medical Terminology must be completed by: Full-time Program: July 30 th Part-time Program: December 20 th Please note: the grades for these courses are used to help determine admission criteria rating. Any course not completed by file completion date will receive zero points. Official transcript of all prerequisites are needed prior to beginning PN104. File Completion: (Step 3 below) For a file to be complete, steps 1, 2, and 3 must be complete and on file in the PN office by the following deadlines. Step 1- Application: Full-time Program: February 1 st Part-time Program: October 1 st a) Complete the HCC Application of Admission process. b) Submit the Initial Application for Admission on pages 4-11 of this document to: Hutchinson Community College Practical Nursing Program 2208 E. Kansas Ave. McPherson, KS c) Submit an Official Transcript to: Hutchinson Community College Records Office 1300 N. Plum Hutchinson, KS Hutchinson Community College, Practical Nursing Program, Application 1

2 Step 2 - Testing: a) Schedule a pre-admission test (KAPLAN) by calling program secretary at or , ext If needed, you may schedule a second attempt to meet the test criteria, but failure to meet criteria on the second attempt will render your application ineligible for acceptance at this time. In this case, we encourage you to meet with an advisor regarding remedial courses to assist your success on this exam in the future. b) If you have a physical or mental disability, and would like to use accommodations on the entrance exam, please contact the Coordinator of Disability Services at Students will need to furnish appropriate documentation of the disability before accommodations can be offered. c) All applicants must show proficiency in oral and written English if their primary language is not English by completing a transferable English Comprehension I course with a C or better, or meeting the minimum scores listed below for the TOEFL exam. Writing 20 Speaking 20 Reading 19 Listening 20 Step 3 CNA and Information Session: a) You must be an active certified Kansas CNA, verifiable through the Kansas Nurse Aide Registry. A copy of your current Kansas CNA certificate must be submitted with your PN application. If your certification is not verifiable through the Kansas Nurse Aide Registry and your certification is NOT current, you may schedule an appointment with one of the PN Program tutors to perform the 40 Hour Checklist to meet this requirement by calling or , ext This must be completed prior to: Full-time Program: February 1 st Part-time Program: October 1 st b) Attend Information Session. This session provides applicants the opportunity to tour the facility, meet current nursing students and visit with faculty regarding the nursing program (i.e., schedules, expectations, etc.). The applicant will be evaluated on professionalism and attendance, i.e., business attire, promptness, attentiveness. Failure to meet these requirements will result in a lower admission criteria rating. Hutchinson Community College, Practical Nursing Program, Application 2

3 Step 4 Admission Process: To be completed after acceptance into the program. a) Applicants who meet all the criteria for admission into the PN Program will be notified by mail of acceptance into the program, provisional acceptance, or placement on alternate list. b) Sign and submit KSBN Requirements & Technical Standards Policy (see pages 8-10 of this document). c) All students are required to either own a Smartphone or Ipod with 81 MB available memory for required nursing software. d) Submit a complete background check conducted by PreCheck, Inc., Student Check. Students are responsible for the cost of the background check. A PreCheck Report must be completed by: Full-time Program: August 1 st Part-time Program: December 1 st e) Submit proof of CPR certification at the Health-Care Provider level to the PN Program by: Full-time Program: July 1 st Part-time Program: January 1 st Hutchinson Community College, Practical Nursing Program, Application 3

4 HCC PRACTICAL NURSING PROGRAM 2208 E. Kansas MCPHERSON, KANSAS (Fax) INITIAL APPLICATION FOR ADMISSION Date Application Received: (For Office Use Only) Personal Information (Please print or type Date of Birth HCC Student ID# (If applicable) HCC address Other address: Last Name First Middle Other last name(s) Home/Legal Address City State Zip County Home Phone Number Cell Phone Number Work Phone Number Residency Status Are you a U.S. citizen? Yes No If no, are you a permanent resident? Yes No Is English a second language? Yes No If yes, see Step 2, Part C, of Application process. Educational Experiences H.S. Attended: H.S. Graduation Date: GED Date: Previous Colleges City and State Dates of Attendance Hutchinson Community College, Practical Nursing Program, Application 4

5 Have you completed the following with a grade of C or better? 1. Human Anatomy & Physiology (6 cr hr, lab included) NOTE: A 5 cr hr course with lab may be considered upon request directed to program coordinator. If completed within the last 5 years College: Date: If in progress, give date to be completed: 2. General Psychology (3 cr hr) College: Date: If in progress, give date to be completed: 3. Medical Terminology (3 cr hr) If so, College: Date: If in progress, give date to be completed: 4. Human Growth & Development (3 cr hr) If so, College: when If in progress, give date to be completed: Human Anatomy & Physiology and General Psychology Human Growth & Development and Medical Terminology must be completed by: Full-time Program: July 30 th Part-time Program: December 20 th NOTE: If you have taken any of the above classes at a different institution you must have an OFFICIAL TRANSCRIPT sent to the Hutchinson Community College Records Office at: Hutchinson Community College Records Office 1300 N. Plum Hutchinson, KS Hutchinson Community College, Practical Nursing Program, Application 5

6 Demographics The following information is used for federal and state reporting. Your response is optional. Gender: Male Female Ethnic Code: 1. American Indian 5. Hispanic 2. Asian 6. Black, Non-Hispanic 3. White, Non-Hispanic 7. Other 4. Pacific Islander Have you previously applied for admission to a nursing program? Yes No Date(s) Have you ever been a student in another nursing program? Yes No If yes, please specify: LPN Diploma ADN BSN Why did you leave that program? Why did you choose the HCC Practical Nursing Program? PERSONS TO NOTIFY IN CASE OF EMERGENCY Name: Address: Relationship: Telephone: Name: Address: Relationship: Telephone: Hutchinson Community College, Practical Nursing Program, Application 6

7 REFERENCES On a separate page, type and attach references. Give name and complete address of three persons (not relatives) as references. At least two professional references must be included, i.e., employer, clergy, instructor, etc. One of the three references may be a non-professional acquaintance. ESSAY Submit on a separate sheet of paper, minimum one page, word processed. 1. Explain why you want to be a practical nurse. 2. Explain why you should be admitted to HCC, Practical Nursing Program 3. Identify your strengths and weaknesses. Position applying for: McPherson Full-time McPherson Part-time I certify that the information on this HCC, PN Program Application, Contacts and Essay is correct. Date: Signature: All records submitted to the college in the admission process are kept confidential. They become the property of Hutchinson Community College and will not be returned to the student. NOTICE OF NONDISCRIMINATION Hutchinson Community College is committed to a policy of nondiscrimination on the basis of race, age, sex, religion, color, national origin, creed, handicap, marital or parental status, in admissions, education programs or activities and employment as specified by federal and state laws and regulations. Inquiries may be addressed to Affirmative Action Office, Hutchinson Community College, 1300 North Plum, Hutchinson, KS 67501, or Director, Office of Civil Rights, HEW, Washington, DC Hutchinson Community College, Practical Nursing Program, Application 7

8 Please read and complete the following information: HUTCHINSON COMMUNITY COLLEGE PRACTICAL NURSING PROGRAM KSBN Requirements The Kansas State Board of Nursing requires this program to obtain the following information. A misdemeanor/felony conviction can prevent a graduate practical nurse from obtaining a Kansas Nursing license. Have you ever been convicted of any misdemeanor or felony? Yes No The Kansas Nurse Practice Act ( ) states: (a) Grounds for disciplinary actions. The board may deny, revoke, limit or suspend any license, certificate of qualification or authorization to practice nursing as a Registered Professional Nurse, as a Licensed Practical Nurse, as an Advanced Registered Nurse Practitioner or as a Registered Nurse Anesthetist that is issued by the board or applied for under this act or may publicly or privately censure a licensee or holder of a certificate of qualification or authorization, if the applicant, licensee or holder of a certificate of qualification or authorization is found to be guilty of a felony conviction for a crime against persons as specified in Article 34 of Chapter 21 of the Kansas Statutes Annotated and acts amendatory thereof or supplemental thereto; or other offenses stated in of the Kansas Nurse Practice Act. Have you ever been convicted of a misdemeanor or felony involving an illegal drug offense? Have you ever been convicted of a felony for a crime against persons*? Yes No Yes No If yes, to either question, write an account of the offense on the back of this sheet. (include dates and details of sentencing.) You may also want to contact the Kansas State Board of Nursing Legal Department at to make sure that these convictions will not bar you from being licensed as a Practical Nurse in the state of Kansas. *Crimes against persons include, but are not limited to, the following: murder in the first degree; murder in the first degree, attempt; murder in the first degree, conspiracy; murder in the first degree, solicitation; murder in the second degree, voluntary manslaughter, involuntary manslaughter; assisting suicide; aggravated assault; aggravated assault of a law enforcement officer, domestic battery, third or subsequent within last five years; battery of a law enforcement officer, aggravated battery; aggravated battery of a law enforcement officer; criminal threat; kidnapping; aggravated kidnapping; interference with parental custody; aggravated interference with parental custody; robbery; aggravated robbery; blackmail; mistreatment of a dependent adult, physical; stalking; capital murder, injury to a pregnant woman; injury to a pregnant woman by vehicle; involuntary manslaughter while driving under the influence of alcohol or drugs. Applicant's Signature Date If you are accepted into this program, it is your responsibility to promptly notify the Coordinator of the program of any convictions that occur after this date. Rev. 2/98; 3/99; 1/01; 02/02; 10/12 Hutchinson Community College, Practical Nursing Program, Application 8

9 HUTCHINSON COMMUNITY COLLEGE ALLIED HEALTH DEPARTMENT Technical Standards Policy Students in the Allied Health Department must have the following minimum abilities: COGNITIVE Observation Students must o Be able to observe lectures and demonstrations. Communication Students must o Be able to use multiple communication techniques including verbal, nonverbal, written, group processes and information technology in order to communicate with instructors, peers, health professionals, patients and others. o Be able to speak, read and write in English Intellectual/Conceptual/Integrative/Quantitative Students must o Read, understand and be able to discuss information from reading. o Acquire and apply information from classroom instruction, lectures, laboratory experience, independent learning and team projects. o Measure, calculate reason, analyze, evaluate, and process information EMOTIONAL Behavioral, Emotional and Social Students must o Possess the emotional health required for full use of his or her intellectual abilities. o Be able to function under stress. o Develop mature, sensitive and effective relationships with others. o Adapt to changing environments. o Work cooperatively with instructors, peers, health professionals, patients and others. PHYSICAL Motor Function Students must o Possess the skills necessary to carry out the procedures in their discipline. Physical Endurance Students must possess o Physical stamina sufficient to complete assigned periods of clinical practice within allotted time frames specific to their discipline. Hutchinson Community College, Practical Nursing Program, Application 9

10 HUTCHINSON COMMUNITY COLLEGE PRACTICAL NURSING PROGRAM Technical Standards Policy The Hutchinson Community College Practical Nursing Program's faculty has identified specific abilities that are critical to the practical nursing students success. Students must demonstrate the ability to meet these standards, with or without reasonable accommodations. PHYSICAL: Ability to manipulate equipment and supplies as required in providing nursing care. Ability to use senses of hearing, seeing, touch and smell to make observations regarding client conditions for the purpose of demonstrating competency to engage in nursing practice. Ability to lift a minimum of 50 pounds. COMMUNICATION: Ability to effectively communicate with members of the health care team, clients, peers, and faculty. Skills include verbal, written/computerized, and non-verbal abilities. The clinical rotations require independent reading of medical records and independent recording of nursing care plans and communication analysis. EMOTIONAL: Ability to demonstrate emotional coping skills necessary to provide nursing care as determined by standards of practice. Ability to carry out activities consistent with safe nursing practice without demonstrated behaviors of addiction to, abuse of, or dependence on any drug that might impair behavior or judgment. COGNITIVE: Ability to measure, calculate and problem solve to engage in the safe practice of nursing. Ability to exercise judgment skills as required in providing nursing care. Ability to identify, gather data, and understand patient conditions to provide nursing care. Ability to determine appropriate conclusions and course of success necessary for providing client care. Ability to demonstrate responsibility and accountability for actions as a student that are required by nursing practice. The Hutchinson Community College Practical Nursing Program adheres to the Kansas Act Against Discrimination (KAAD) which prohibits discrimination against those with a disability. The KAAD is in compliance with the Federal Americans with Disabilities Act. If anyone needs accommodations to meet the above criteria, please contact the Program Director immediately. I have read and understand the above criteria and believe I can meet these requirements with reasonable accommodations. Date: Signature: Witness: Please sign with a witness, date and return with application to: Hutchinson Community College Practical Nursing Program 2208 E. Kansas McPherson, KS Hutchinson Community College, Practical Nursing Program, Application 10

11 **HUTCHINSON COMMUNITY COLLEGE** PRACTICAL NURSING PROGRAM ADMISSION CRITERIA RATING Name: Maximum Point Value 1. Application complete and submitted to the nursing program by due date. 1.0 CNA status verified? Yes No IF NO, THEN 0 POINTS 2. Personal Philosophy References (Must rate 41 or higher) Professional 1.0 Professional 1.0 Professional/Acquaintance KAPLAN Exam Cumulative Score : Points Below Cumulative Score below 44.9 Reading Comprehension or Math below 44.9 No Acceptance Subtract 1.0 point off of total points for KAPLAN Exam (for each if applicable) 5. Information Session: Presentation of Self 1.0 Attendance College Courses Taken (Must be C or Better, A&P within last 5 years): Date College Grade General Psychology A = B = 2.0 C = 1.0 IP = 0 Anatomy and Physiology A = B = 2.0 C = 1.0 IP = 0 Human Growth & Development A or B = C = 1.0 IP = 0 Medical Terminology A or B = C = 1.0 IP = 0 Total possible: 23.0 (10 points or fewer totals, no admittance) Upon review and consideration of the admission criteria rating, it is recommended that this applicant be: (check one) Reason: Admitted in good standing Provisional admittance Not admitted Hutchinson Community College, Practical Nursing Program, Application 11

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