RN OPTION APPLICATION

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1 4500 Steilacoom Blvd SW Lakewood WA RN OPTION APPLICATION WE DO NOT HAVE A DEADLINE FOR APPLICATIONS. WE ARE FIRST COME FIRST SERVED. ONCE AN APPLICATION IS RECEIVED AND CONSIDERED COMPLETE, YOU WILL BE SENT AN ACCEPTANCE LETTER BY AND PLACED ON THE WAIT LIST. THE WAITLIST IS CURRENTLY GREATER THAN FIVE YEARS. Welcome. We appreciate your interest in our RN Option Program. The Associate Degree in Nursing Registered Nurse Program application process consists of several requirements prior to admission please read the entire packet. Admission policies are subject to change. Applicants are accepted under the terms in place at the time the application is received. The student is advised to keep up to date on any changes that might affect his/her qualifications for acceptance. PROGRAM OVERVIEW Graduates of this program are educated in Nursing as a Registered Nurse with duties and responsibilities in accordance with the Washington Administrative code. RN Option program complies with all the guidelines set forth in WAC This program is designed to meet the needs of practicing LPNs who desire the additional education to progress to the role of the Registered Nurse. The combination of previous experience and further education via lecture and clinical practice will prepare the student to assume the role of the Registered Nurse in a variety of clinical settings. The student will receive the AAS-T degree upon successful completion of all prerequisites, nursing courses, and general educational courses required. After receiving the degree, the student is eligible to take the NCLEX-RN exam. CPTC courses with an & in the course name are seamlessly transferable to other Washington State educational institutions. Upon successful completion of university prerequisites, the CPTC nursing graduate with and unrestricted RN license can pursue a BSN. The curriculum contains theory and clinical experiences in the areas of medical/surgical nursing, obstetric nursing, nursing of children, psychiatric nursing, and history, trends, legal and ethical issues pertaining to the nursing profession. Clinical experiences will include opportunities for the student to demonstrate assessment, planning, implementation, and evaluation of nursing care of diverse individuals and groups as well as direct involvement in and accountability for nursing care for patients with acute and chronic illnesses.

2 PROGRAM COMPONENTS The Associate Degree Nursing Program begins each Fall quarter (September). The program is 4 Quarters in length. Classroom hours are Tuesdays and Wednesdays 4:00 P.M. to 8:00 P.M. and a first quarter laboratory/simulation class on Thursdays 4:00 P.M. to 8:00 P.M. with clinical experiences typically on Saturday & Sunday dayshift. During the second and third quarter you will have a clinical rotation, which may be held on rotating weekends and/or evening shifts. In the 4th quarter students are matched with an RN Preceptor and will be required to work the RN Preceptor s schedule to fulfill the capstone clinical hours required. The Clinical Capstone experience may include 8, 10 or 12 hour shifts and may be scheduled Friday through Sunday on any shift. HEALTH DECLARATION It is essential that nursing students be able to perform a number of physical activities during the clinical portion of the program. This will include lifting/transferring patients, observation/assessment of clients using the physical senses, standing for long periods, performing bending activities, and executing movements required to provide care for patients in all health care settings. The clinical experience also places students under considerable mental and emotional stress as they undertake responsibilities and duties that impact patients lives. Students must be able to demonstrate rational and appropriate behavior under stressful conditions. Individuals should carefully consider the mental and physical demands of the program prior to making application. Background checks are mandated by the clinical facilities. The student must receive a No Record on File report from the Washington State Patrol, related to DSHS Secretary s List of Crimes and negative actions to participate in the clinical aspect of the program. INSTRUCTIONS FOR ADMISSION **********Current Application Process********** Admission to the RN Option program involves 2 parts. Part 1 must be completed in order to receive notification of your projected assigned start date. Part 2 must be completed prior to the deadlines to secure your seat in the assigned class. Part 1: Complete items 1 and 2. Applications must be turned into the Cashier s office in building 17 along with payment of fees. Ensure the cashier s receipt with the time/date stamp is attached to your application. Maintain a copy of the application and receipt for your records. Once the nursing program receives your completed application (ALL ITEMS 1-4 must be submitted), you will receive an letter acknowledging application receipt and your expected start date. 1. Complete Clover Park Technical College RN Option Application Form 2. Non-refundable Admissions fee $ ALL FEES ARE SUBJECT TO CHANGE. Payment of fees is made to the cashier s office. DO NOT SEND payment to the nursing program. Note: Under the current application process, you do not have to produce the required documentation until approximately 3 months prior to the start date of anticipated entry into the program. It is the student s responsibility to ensure all required documents are received by the nursing department prior to the posted deadline. Applicants who do not submit required

3 documentation by the deadline will be removed from their assigned class and will be given a starting date for a future class. IMPORTANT PLEASE NOTE: Current deadline for Part 2 required documentation: Fall Admit Documentation due no later than June 25 of the year you are expected to start. Please submit documents to the nursing program office. Part 2: Complete and provide required documentation of items included in 1 through 5 below: (The deadline for submission of these documents is June 25 of the year you are projected to start. Submit documents to the nursing office.) 1. Prerequisite Academic Courses: College level courses in the following classes must be successfully completed with a B or higher prior to submitting the application. Please Note: If you have taken these college courses at a prior time, you may transfer your credits from another college. Please use the Request for Transfer Credit form and submit this form and official college transcripts to CPTC Student Records Office for evaluation. Please Mail your official transcript to Clover Park Technical College ATTN: Credential Evaluator (Bev Custard). Any questions or concerns regarding transferring credits can be made to the following ). After credit is granted, the Request for Transfer Credit form, with the Student Record s authorizing signature, will be returned to you. Approval of Transferred Credits must be submitted to the nursing program by June 25 th of the year you are projected to start. Please plan ahead as the evaluation process can take up to six weeks. ENGL& 101 OR ENGL& 102 OR ENGL&235 PSYC& 100 General Psychology PSYC& 200 Lifespan Psychology BIOL& 260 General Microbiology with w/lab CHEM& 121 General Chemistry w/lab MATH& 141 Pre-calculus or MATH& 146 Intro to Statistics or MATH 151& Calculus Two quarters of Anatomy and Physiology with a laboratory experience: BIOL& 241 Anatomy and Physiology I w/lab AND BIOL& 242 Anatomy and Physiology II w/lab Speaking understanding and writing the English language is required. 2. Unencumbered, current Washington State LPN license: Submit a copy of your WA LPN License. 3. Documented proof of 500 or more hours of employment as an LPN. This can be provided by either pay stubs or a letter from your employer. 4. A copy of both sides of the American Heart Association (AHA) Healthcare Provider CPR card. This is the only card accepted. American Red Cross and Online CPR courses are not accepted. This card must be kept current during your attendance in the program.

4 5. Proof of Medical/Health Insurance: Clinical facilities require this insurance. Call our Advising Office at for a low cost insurance offered to students. Please submit a copy of your insurance card. You may also sign a note stating that you will have insurance when school starts. 6. A copy of your driver s license. IMMUNIZATION INSTRUCTIONS: Please read carefully!!! You must have the immunizations listed below, but you are NOT required to submit any documentation to the nursing department prior to the first day of class. You are required to BRING a copy of proof of immunizations listed below on the first day of class. Please note: TB and Seasonal Flu vaccines are required annually and must be kept current throughout the program. You will be required to upload proof of immunizations into a program called certified background during your first weeks in class. This is a requirement that must be met in order to attend clinical rotations. Instructions for uploading these documents will be provided during your program orientation at the start of the quarter. You will not be allowed to attend clinical site rotations until proof of the required immunizations is met. NOTE: Immunization requirements are based on CDC recommendations for health care workers and Clinical site requirements. *****IMPORTANT*****ALL IMMUNIZATIONS MUST BE DOCUMENTED ON AN OFFICIAL FORM PRINTED FROM THE DOCTOR, CLINIC, OR PHARMACY WHICH INCLUDES THE NAME OF THE IMMUNIZATION, RESULTS, AND DATE. WE ALSO ACCEPT THE WASHINGTON STATE IMMUNIZATION BOOKLET ONLY IF THE IMMUNIZATIONS HAVE BEEN STAMPED BY HE CLNIC OR DOCTOR. ALL DOCUMENTATION OF TITERS MUST INCLUDE THE TYPE OF TITER, DATE, AND RESULTS. Hepatitis B Proof of immunity by series of three vaccinations and Titer. If you have a negative titer, you must repeat the series and receive a 2 nd titer. MMR (Measles, Mumps, Rubella) Proof of vaccination (two 92) doses) or Proof of immunity by titers for each Rubeola, Mumps, Rubella Tetanus, Diphtheria, Pertussis Tdap required one time prior to admission 9good for 10 years). Varicella (Chicken Pox) Proof of vaccination (2 doses) or Proof of immunity by Titer Tuberculosis (TB) Skin Test

5 2-step PPD required or 3 year concurrent history of annual tests or QuantiFeron serum test or If history of positive TB test results, a current chest x-ray report with the tests is required.

6 CLOVER PARK TECHNICAL COLLEGE RN OPTION APPLICATION STUDENT ID# NAME LAST FIRST MI ADDRESS CITY STATE ZIP CODE HOME PHONE CELL OR MESSAGE ADDRESS OTHER NAMES YOU HAVE BEEN KNOWN BY LAST HIGH SCHOOL ATTENDED CITY STATE LAST YEAR ATTENDED YES NO. GRADUATED? LAST COLLEGE ATTENDED CITY STATE LAST YEAR ATTENDED YES NO. GRADUATED? U.S. CITIZEN? YES NO (IF NO, CHECK TYPE OF VISA) I have provided true, correct and complete information with this application. I have read and understand the information included in this application packet. I have read and understand the Health Declaration & WSP background information on page 1 and certify that I will be able to perform the essential functions as a nursing student at Clover Park Technical College... Applicant Signature Date Non-Discrimination Policy: Clover Park Technical College does not discriminate on the basis of race, color, national origin, sex, disability, sexual orientation, or age in its programs and activities. Any person at the college who feels he or she has reason to claim discrimination or unfair treatment may contact Human Resources to speak to an Equity Representative, (253) Limit of Liability: The College s total liability for claims arising from a contractual relationship with the student in any way related to classes of programs shall be limited to the tuition and expenses paid by the student to the College for those classes of programs. In no event shall the College be liable for any special, indirect, incidental, or consequential damages, including but not limited to loss of earnings or profits.

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