AAS NURSING PROGRAM ADMISSION INFORMATION

Transcription

1 AAS NURSING PROGRAM ADMISSION INFORMATION 9/15/2015

2 Admission Information Packet Table of Contents PAGE Admission Information 3 Prerequisites 4 Admission Procedure (with deadline dates) 4 After Admission to the Program 5 Financial Assistance 5 Clinical Experience 5 RN Program Admissions Criteria 6 LPN Step-Out Curriculum 7 AAS Nursing Curriculum 8 Course Descriptions 9-10 Estimated Student Costs 11 RN Program Application Checklist 12 AZ DPS Card 12 Student Application Form RN Program Demographic Data Survey 15 RN Program Notice of No Guarantee of Licensure/Certification 16 Test of Essential Academic Skills (TEAS) Information Professional Reference Forms Request for Transcripts Form 22 Essential Skills & Functional Abilities Online Student PreCheck Directions 27 2

3 Associate Degree Nursing Program Admission Information Mohave Community College Department of Nursing provides students with the opportunity to acquire the knowledge and skills requisite to the safe, effective practice of nursing. The associate of applied science degree nurse uses the nursing process in supervised settings in assisting the client to optimal wellness, comfort or a peaceful death. The associate of applied science degree nurse fulfills the roles of provider of care, advocate, researcher, counselor, communicator, teacher, manager and member of the profession while exemplifying the qualities which are essential to the development of the nurse. These qualities are incorporated throughout the four core nursing courses and include: caring attitude, clinical competence, and critical thinking skills. The ultimate goal of the Nursing Department is to prepare graduates for safe and effective clinical practice. The mission of the Mohave Community College Nursing Department is to promote excellence in nursing education and practice by fostering communication and collaboration among faculty and students. This course of study incorporates knowledge and principles from the liberal arts with an emphasis on the sciences in theory and applied skills. Nursing Education at MCC is challenging, rewarding, and prepares graduates to utilize clinical judgment based on critical thinking processes. The Mohave Community College Nursing Program is accredited by the Accreditation Commission for Education in Nursing (ACEN), 3343 Peachtree Road NE, Suite 850, Atlanta, Georgia 30326, , Fax: This program is also approved by the Arizona State Board of Nursing, 4747 N. 7 th Street, Suite 150, Phoenix, Arizona 85014, The nursing program is a countywide program with classes being offered for the southern part of the County in Kingman, Lake Havasu City, and Bullhead City, and for the northern part of the County in Colorado City. Nursing I, the first core nursing course, is taught with a faculty member on site in Bullhead City and Colorado City. The Kingman and Lake Havasu City students have the same benefit of an onsite faculty member, but the lecture portion of the course is in Lake Havasu and the Nursing Skills Laboratory experience is in Kingman. Clinical site travel is required related to the number of facilities and number of students in the class. The remainder of the core nursing courses, Nursing II, III, and IV, also has the benefit of a face to face lecture by faculty member. The students will be required to travel between all three campuses in the southern part of Mohave County in Kingman, Lake Havasu City, and Bullhead City. Nursing II, III, and IV are team taught by varying faculty members. In preparation for school and industry-wide practices, and to provide equality of student learning materials, students are also required to be proficient in and use a computer, including the Internet and MCC s computer-accessible learning management system and application packets. Clinical experience takes place in Mohave County and Nevada health care facilities as well as Utah facilities for students in the northern part of the County. Travel between campuses and to clinical facilities will be required at the student s expense. Students interested in becoming nursing assistants do not need to apply for the nursing program, but should register for the Nursing Assistant class (NAP 115). Students interested in becoming practical nurses or registered nurses must apply for admission to the respective nursing program. The Arizona Nurse Practice Act (July 2010) states If convicted of one or more felonies, the applicant must have received an absolute discharge from the sentences for all felony convictions five or more years prior to the date of filing an application. Therefore, the student should contact the Arizona State Board of Nursing ( regarding eligibility to write the NCLEX for licensure PRIOR to application to the Mohave Community College Nursing Program. Fingerprinting is a part of the application process to the Arizona State Board of Nursing for nursing assistant, practical nurse, and registered nurses licensure. Department of Public Safety finger printing and Pre-check Background Check are a portion of the application process for admittance to the program. Revised 5/2015 3

4 PRE-REQUISITES Before a student will be considered eligible to enter the nursing program, certain pre-requisites must be met. All pre-requisites must be completed before admission into the nursing program. 1. Graduation from an accredited high school, or GED certificate, or is 18 years of age or older and demonstrates evidence of potential success in the community college, or is a transfer student in good standing from another college or university. 2. Students must successfully complete the following (with a 2.0 or higher): A. BIO 100-level Courses (0-4) Student must complete one of the following options: Bio 100 Biology Concepts 4 credits OR Bio 181 General Biology 4 credits OR Complete the BIO Competency Exam to demonstrate competency in the concepts in BIO 100 OR Complete one semester of a 100 or higher level of BIO with lab B. CHM 100-level chemistry course: CHM 130 Fundamental Chemistry 4 credits OR CHM 151 General Chemistry I 4 Credits 3. Students must successfully complete (with a GPA of 2.85 or higher) all prerequisites for NUR 121 Nursing I Credits: (8) including the following courses (one of the 200 level BIO courses may be used to meet the requirements in 2.A above): A. BIO Anatomy & Physiology I B. BIO Anatomy & Physiology II C. BIO Microbiology D. ENG English Composition I E. PSY Intro to Psychology F. MAT 121 or higher (with 142 or 151, required starting Fall 2016) G. Note that BIO 201, BIO 202, BIO 205, ENG 101, PSY 101 and MAT 121 (MAT 142, 151 are preferred Gen. Ed classes) are part of the general education requirements for the AAS nursing degree. 4. College courses over ten (10) years old will not be accepted as credit for biology, chemistry, or general education science requirements. 5. GPA of 2.85 or above compiled of all Nursing prerequisites. 6. Acceptable score on the Test of Essential Academic Skills (TEAS) 70 (see enclosed forms.) 7. Copy of Department of Public Safety Fingerprint Clearance Card. 8. Copy of Student PreCheck online Background Check. 9. Consideration is given to applicants with Arizona residency, healthcare experience and (3) positive references. * TRANSFER STUDENTS MUST complete a minimum of 1/3 of their required program credits at MCC to graduate. This could mean you may have to take some of the required programs courses over to meet the minimum of 1/3 of the required program credits at MCC. ADMISSION PROCEDURE Students are admitted to the Nursing program without discrimination regarding age, creed, ethnic origin, marital status, or sex. Application for the program is in addition to the application for general admission to the college and must be completed in the semester before enrollment is planned. Student spaces are limited; therefore, students are encouraged to submit applications early. Applications do not guarantee admission to the program. INCOMPLETE applications as of the date of the Admissions Committee meeting will not be considered. 1. A completed application packet with the following items should be received in the nursing office at: 1977 Acoma Blvd. West, Lake Havasu City, AZ 86403, postmarked no later than February 15 for the fall admission and no later than October 1 for the spring admission. a. Completed nursing application. b. Three (3) professional references from persons who have known the applicant in a supervisory or educational setting and who are familiar with applicant s academic and/or work ethics. c. Official college transcripts, if any, should be submitted directly to the Nursing Department. d. Student copy of transcripts (other than MCC) should be attached to the application. e. Test of Essential Academic Skills (TEAS) test results (70 or higher). (Results will be sent directly to the Nursing Department after scoring.) f. Copy of Department of Public Safety Fingerprint Clearance Card must accompany application. g. Copy of Student PreCheck Background Check Report must accompany application. h. Verification of health care experience. 4

5 i. Verification of residency 2. Applications must be completed and in the nursing office by February 15 for fall admission, and October 1 for spring admission. It is the student s responsibility to verify that all documents have been received and his/her file is complete. Incomplete applications will not be considered. 3. Applicants will be notified of their status in 45 to 60 days after application deadline. 4. Admission to the program will be determined on the basis of: a. Ability to pass the online Student PreCheck. b. Ability to obtain Department of Public safety Fingerprint Clearance Card. c. GPA (Minimum of 2.85 overall GPA on prerequisite courses.) d. Test of Essential Academic Skills (TEAS) scores (form enclosed). The applicant s adjusted individual total scores on the TEAS must be at or above 70 to be considered for admission. The TEAS can be taken 3 times in an academic year (August to August), and the highest score will be considered. TEAS Exams must be taken one month apart. e. Number of courses completed pre-requisites and co-requisites at the time application was submitted for admission. f. Health Care experience. g. Professional references (3 must be completed). h. Arizona Residency. Applicants who are not accepted to the nursing program must notify the nursing office if they wish to be considered for the next admitting semester. AFTER ADMISSION TO THE PROGRAM 1. Students will be required to have a complete physical examination and must be able to meet the requirements identified on the form as well as the Essential Skills and Functional Abilities of a Nurse (See end of packet). Immunizations and drug testing are also necessary prior to the start of classes. 2. Proof of private health/accident insurance is required prior to the start of classes. 3. Students must attain CPR certification (American Heart Association-Healthcare Provider) no earlier than July 1 for fall admission and December 1 for spring admission. This certification must be maintained during the entire program. (Adult, child, or community CPR is not acceptable.) 4. Students must notify the nursing office of any changes in address, contact information, or plans to attend classes. Failure to do so could hinder your process in the RN Program. 5. Travel between campus sites for lecture and clinical experience is required throughout the Nursing Program for all students in all semesters. 6. The nursing courses are interrelated and are taken in sequence. A grade of C or better in all required courses must be maintained for continuation in the program. 7. After successful completion of the requirements for either the LPN step out certificate or the AAS nursing degree, the student will be eligible to apply to write the licensure examination offered by the National Council Licensure Examination for Registered Nurses (NCLEX-RN) or for LPN (NCLEX-PN). Licensure requirements are the exclusive responsibility of the Arizona State Board of Nursing and students must satisfy those requirements independently of requirements for graduation from the college. FINANCIAL ASSISTANCE Financial assistance is available in the form of scholarships, loans, and work-study assistance. The necessary forms can be secured at the Financial Aid Office. Students are encouraged to contact the Financial Aid Director in the year preceding admission to the nursing program. CLINICAL EXPERIENCE A majority of MCC nursing students will be required to travel to Las Vegas, Nevada for a portion of their clinical experiences. Usually the students are in Las Vegas for two days and one night per week for approximately four to six weeks. Transportation to and from clinical and all food/meals are the responsibility of the student. The College reserves the rooms, for the group in advance. Revised 9/2015 5

6 RN Program Admissions Criteria is based on the following: GPA TEAS Number of classes completed (pre-requisite and co-requisites are included) at the time application was submitted for admission. Healthcare Experience Reference Forms Received AZ Resident 6

7 LPN STEP-OUT CURRICULUM PRE-REQUISITES: CHM 130 Fundamental Chemistry or CHM 151 General Chemistry I, BIO 100 Biology Concepts or BIO 181 General Biology I, BIO 201 Anatomy & Physiology I, BIO 202 Anatomy & Physiology II, BIO 205 Microbiology, ENG 101 English Composition I, PSY 101 Introduction to Psychology, MAT 121 Math. CO-REQUISITES: ENG 102 English Compositions II, PSY 245 Lifespan Development Pre-requisites for LPN Certificate Semester I NUR 121 Pre-requisites for Semester II BIO 100 (Can Demonstrate Competency; 0-4 NUR 121 Nursing I 8 Prerequisite to Program.) CHM 130 Or Prerequisite to Program. CHM Total Credits: 8 GPA 2.85 Semester II NUR 122 TEAS 70 Co-requisites BIO 201-General Education Requirement for PN Step-out certificate BIO 202- General Education Requirement for PN Step-out Certificate BIO 205- General Education Requirement for PN Step-out Certificate ENG 101- General Education Requirement for PN Step-out Certificate PSY 101- General Education Requirement for PN Step-out Certificate MAT 121 -General education requirement for AAS Nursing Degree. (142 or 151 required Fall 2016) 4 NUR 122 Nursing II 8 4 NUR Pharmacology 3 4 Total Credits: 11 3 NUR 123 Transition to PN Or NUR 221 Nursing III is acceptable TOTAL NURSING CREDITS: Co-requisites for LPN Certificate ENG 102- General Education Requirement for PN Step-out Certificate 3 PSY 245- General Education Requirement for PN Step-out Certificate 3 TOTAL GENERAL EDUCATION CREDITS: TOTAL CERTIFICATE CREDITS: Each core nursing course must be completed and successfully passed before progression into next core nursing course. *MAT 142 or 151 are preferred Gen. Ed math classes and will be required the fall of Revised 9/2015 7

8 AAS NURSING CURRICULUM PRE-REQUISITES: CHM 130 Fundamental Chemistry or CHM 151 General Chemistry I, BIO 100 Biology Concepts or BIO 181 General Biology I, BIO 201 Anatomy & Physiology I, BIO 202 Anatomy & Physiology II, BIO 205 Microbiology, ENG 101 English Composition I, PSY 101 Introduction to Psychology, MAT 121 level Math. CO-REQUISITES: ENG 102 English Compositions II, PSY 245 Lifespan Development Pre-requisites: Admission AAS Program Semester I NUR 121 BIO 100 (Can Demonstrate Competency; Prerequisite to Program.) CHM 130 Or Prerequisite to Program. CHM NUR 121 Nursing I 8 4 Total Credits: 8 TEAS 70 Semester II NUR 122 GPA 2.85 Co-requisites NUR 122 Nursing II 8 Total Credits: 8 NUR 227 Pharmacology 3 Pre-requisites: Semester I NUR 121 Total Credits: 11 4 Semester III NUR 221 Co-requisites BIO 201-General education requirement for AAS Nursing Degree. BIO 202-General education requirement for AAS Nursing Degree. BIO 205-General education requirement for AAS Nursing Degree. ENG 101-General education requirement for AAS Nursing Degree. MAT 121 -General education requirement for AAS Nursing Degree. (142 or 151 required Fall 2016) PSY 101-General education requirement for AAS Nursing Degree. 4 4 NUR 221 Nursing III 8 3 Nursing 228 Pharmacology Nursing Specialties Total Credits: 9 3 Semester IV NUR 222 Co-requisites NUR 222 Nursing IV 8 Total Credits: Nursing 229 Adv. Pharmacology 1 Required: Co-Requisite General Education for AD Program taken prior to NUR 221 ENG 102-General education requirement for AAS Nursing Degree. PSY 245-General education requirement for AAS Nursing Degree. Total Credits: 9 Total Nursing Credits: 37 3 Each core nursing course must be completed and successfully passed before progression into next core 3 nursing course. Total Credits: 6 Total Program Credits: Note: Pre-requisite general education courses must be completed prior to acceptance into the nursing program. All Co-requisite general educational core courses must be satisfactorily completed prior to starting NUR 221, Semester 3 of the Nursing Program. Nursing Co-requisites must be taken as stated on page 7. 8

9 *MAT 142 or 151 are preferred Gen. Ed math classes and will be required the fall of Revised 9/2015 COURSE DESCRIPTIONS NUR 121 Nursing I (8 Credit Hours) The focus is on fundamental concepts of contemporary professional nursing, student s development as caring competent nurse within the legal/ethical and scientific frameworks of the profession, critical thinking, and communication skills. Using the transitions model, students learn to provide nursing care for individuals undergoing situational transitions in well-defined practice settings. Situational transitions include that of the individual to the nursing student role and the client s admission to and movement within the healthcare system. Concepts of nutrition, pathophysiology and pharmacology are integrated. 5 lecture; 9 lab Pre-requisites: BIO 201 Anatomy & Physiology I, BIO 202 Anatomy & Physiology II, BIO 205 Microbiology, ENG 101 English Composition I, PSY 101 Introduction to Psychology, MAT 121 or higher level Math (MAT 142, 151 are preferred Gen. Ed classes), Admission to the AAS Degree Nursing Program. General Co-requisites: ENG 102 English Composition II, PSY 245 Lifespan Development NUR 122 Nursing II (8 Credit Hours) The focus is on nursing care to promote healthy transitions for individuals and families with chronic health conditions in well-defined practice settings. Emphasis is on basic management concepts and continued development of critical thinking, clinical judgment, and skills. Principles of pharmacology, culture, pathophysiology, and nutrition are integrated throughout the course. 4 lecture; 12 lab Pre-requisites: Successful completion (with a C or better) of NUR 121. Co-requisite: NUR 227 General Co-requisites: ENG 102 English Composition II, PSY 245 Lifespan Development NUR 227 Pharmacology (3 Credit Hours) The focus is common drug classifications, actions, uses, and side effects of pharmacological agents. Accurate calculation of dosages, administration techniques, legal/safety considerations and nursing implications of common medications will be emphasized. 3 lecture Pre-requisites: Successful completion (with a C or better) of NUR 121, current LPN or Paramedic licensure with intention of enrollment in nursing courses beyond NUR 121 or permission of the instructor. Co-requisites: NUR 122 General Co-requisites needed prior to NUR 221: ENG 102 English Composition II, PSY 245 Lifespan Development NUR 123 Transition to Practical Nurse (3 Credit Hours) The focus on scope of practice issues specific to the practical nurse, including care of individuals and families experiencing developmental and acute health-illness transitions. Concepts of clinical judgment, pathophysiology, pharmacology, and nutrition are integrated. Also, includes practical nurse level concepts of management and supervision. 2 lecture; 3 lab Pre-requisite: Successful completion (with a C or better) of NUR 121, NUR 122, NUR 227 NUR 221 Nursing III (8 Credit Hours) The focus on nursing care to promote healthy transitions for individuals and families experiencing developmental milestones. Course includes the transition of birth, childhood, adolescence, and young adulthood, childbearing and middle adulthood. The student s transition to nurse includes group theory and nursing therapeutics when assisting the client through acute health care issues. Topics of nutrition and pharmacology are integrated. Concepts of critical thinking, organizational skills and psychosocial nursing are included. 4 lecture; 12 lab Pre-requisites: Successful completion (with a C or better) of NUR 122, NUR 227 Co-requisites: NUR 228 9

10 NUR 228 Pharmacology for Nursing Specialties: Mental Health, Pediatrics, Obstetrical (1 Credit Hours) Focus is review of common drug classifications, actions, uses, and side effects of pharmacological agents in the specialties area of Mental Health, Pediatrics, and Obstetric. Accurate calculation of dosages, administration techniques, legal/safety considerations and nursing implications of common medications will be emphasized. 1 lecture Pre-requisites: Successful completion (with a C or better) of NUR 121, NUR 122, NUR 227, admission to LPN to RN or Paramedic to RN Tracks. Co-requisites: NUR 221 NUR 222 Nursing IV (8 Credit Hours) Focus is on the impact of acute health/illness transitions on individuals, families, and groups. Emphasis is on synthesis and application of nursing therapeutics in the transition of students to their role in the profession of nursing with an introduction to organizational transitions. Concepts of nutrition, pharmacology, pathophysiology and nursing therapeutics are integrated. 4 lecture; 12 lab Pre-requisites: Successful completion (with a C or better) of NUR 221, NUR 228 Co-requisites: NUR 229 NUR 229 Advanced Pharmacology for Nursing (1 Credit Hours) Focus is review of common drug classifications, indications, actions, and side effects of pharmacological agents commonly utilized in the acute care setting. Accurate calculation of dosages using three factor dimensional analysis, significant laboratory tests, and monitoring parameters will be emphasized. 1 lecture Pre-requisites: Successful completion (with a C or better) of NUR 221, NUR 228 Co-requisites: NUR 222 Reviewed 5/

11 ESTIMATED STUDENT COSTS Prior to admissions and Nursing I, there will be additional Health Requirement costs for Physical, titers, TB test, immunizations, DPS Card, Background Check, etc. 1st-Year Student 1st Semester 2nd Semester Totals 1) Registration Fees: Registration $ $ $ 1, Technical Fee $ $ $ Activity Fee $ 8.00 $ $ Program Fee $ 1, $ 1, $ 2, Gen Ed Co-requisites Tuition and Fee $ $ $ Semester Fee Totals $ $ 2, $ 4, ) Miscellaneous: Books: Nursing $ 1, $ $ 1, Co-requisites $ $ $ Uniform, Watch, Shoes $ $ Miscellaneous Totals $ 1, $ $ 2, st Year Totals $ $ 2, $ 7, nd-Year Student 3rd Semester 4th Semester Totals 1) Registration Fees: Registration $ $ $ 1, Technical Fee $ $ $ Activity Fee $ 9.00 $ 9.00 $ Program Fee $ 1, $ 1, $ 2, Co-requisites Fee Semester Fee Totals $ 2, $ 2, $ 4, ) Miscellaneous: Books: Nursing $ $ $ Co-requisites Miscellaneous Totals $ $ $ nd Year Totals $ 2, $ 2, $ 4, Allied Health Programs at MCC are exempt from the Western Undergraduate Exchange (WUE) Tuition Rates. Out of state tuition is $ per credit hour. The Nursing Department recognizes that the MCC Governing Board reserves the right to change or withdraw, without notice, curriculum, policies, tuition or any other matters contained in this information packet. Clinical travel is likely all semesters of the program. Students should plan on an additional $2,000 or more for semesters 3 and 4 to cover car fuel and food expenses. Registration costs are based on tuition fees plus technology and activity fees as applicable. Book, uniform, watch, shoes and clinical equipment costs are estimates and do not include involved sales tax. Graduation Gala, nursing pins, and testing fees for NCLEX are responsibility of the student. You may obtain more information regarding tuition and fees when registered for course. Revised 5/

12 RN Program APPLICATION CHECKLIST Application for General Admission to Mohave Community College Completed RN Program Application General Education Courses must be received and evaluated in the MCC Registrar s office. Official college transcripts, if any, should be submitted directly to the RN Department. Three (3) Professional references from persons who have known the applicant in a supervisory or educational setting and who are familiar with applicant s academic and/or work ethics. Student copy of transcripts (other than MCC) should be attached to the application. Copy of your Test of Essential Academic Skills (TEAS) Entrance Exam Scores. Copy of your Student PreCheck Background Check Report. Copy of FRONT AND BACK of your Arizona Department of Public Safety (DPS) Fingerprint Clearance Card. Verification of Health Care Experience. Verification of Residency. AZ DPS Card Please contact the Mohave Community College RN Department or Student Service Department for an Arizona Department of Public Safety (DPS) application packet. Please Note: It takes 6-8 weeks for the Arizona Department of Public Safety to process your application. 12

13 AREA OF INTEREST Please Select from the Following Location(s) you wish to be considered for: ASSOCIATE DEGREE NURSING PROGRAM Student Application Form Kingman Campus Lake Havasu City Campus Bullhead City Campus North Mohave Campus (Only admits in Fall) Please Specify the Semester and Year You wish to begin: FALL (or) SPRING APPLICANT INFORMATION Date: Social Security #: / / Birthdate: / / MCC ID#: Full Name: Other Name(s) Used: Mailing Address: City: State: Zip: Home Phone: ( ) Cell Phone: ( ) Address: ACADEMIC HISTORY List all colleges, universities and institutions attended, including high school. High School: Location: Degree: Dates: College: Location: Degree: Dates: College: Location: Degree: Dates: Other: Location: Degree: Dates: Nursing Program PREREQUISITES: Please state if Completed or In Progress (Official Use Only) 100 level Biology or Biology Competency Location: Completed: Grade: In Progress: Verified: Chemistry 130 Location: Completed: Grade: In Progress: Verified: BIO 201: Anatomy & Physiology I Location: Completed: Grade: In Progress: Verified: BIO 202: Anatomy & Physiology II Location: Completed: Grade: In Progress: Verified: BIO 205: Microbiology Location: Completed: Grade: In Progress: Verified: ENG 101: English Composition I Location: Completed: Grade: In Progress: Verified: PSY 101: Introduction to Psychology Location: Completed: Grade: In Progress: Verified: MAT 121: Intermediate Algebra Location: Completed: Grade: In Progress: Verified: WORK HISTORY Last (5) years, beginning with most recent: Occupation/Job Title Employer City/State Start Date End Date

14 LICENSURE If you have a current licensure such as Arizona LPN/LVN, CNA Paramedic or Certificate of an Allied Health profession or current license in another state, PLEASE submit a copy with this application. Are you a current resident of the State of Arizona? YES NO Answer the Following Question 1. Have you ever been dismissed from any course or program? YES NO If YES, please explain and state which program: AZ DPS Fingerprint Clearance Card StudentCheck Online PreCheck Background Check Expiration Date: Report #: Date Completed: (MUST provide copy of BOTH front & back of card) (MUST provide copy of FULL report) Licensure is the sole responsibility of the Arizona State Board of Nursing. If you have been convicted of a felony, contact the Arizona State Board of Nursing to verify eligibility to be licensed prior to submitting this application. DISCLAIMER & SIGNATURE I understand that if accepted into the Nursing Program, I will be required to travel for class lectures and clinical experiences, and that I will be responsible for my own transportation and meals. I understand that if accepted, if a clinical agency to which I have been assigned does not accept me based on my criminal background check it may result in my inability to complete the RN Program. I also understand that MCC Nursing department may, within its discretion, disclose to a clinical agency that I have been rejected by another clinical agency. I further understand that MCC has no obligation to place me when the reason for lack of placement is my criminal background check. Since clinical agency assignments are critical requirements for completion of the RN Program, I acknowledge that my inability to complete required clinical experience due to my criminal background check will result in non-completion of the RN Program. I understand that if accepted, I will be required to meet the health requirements of the RN Program. I hereby certify that the facts set forth in this Student Application are true and complete to the best of my knowledge. I understand that if accepted into the nursing program, any falsified statements on this application shall be considered cause for suspension or dismissal. Signature: Date: Mail COMPLETED Application To: Mohave Community College, Department Of Nursing; 1977 Acoma Blvd. West; Lake Havasu City, AZ

15 RN Program 1801 Detroit Ave Kingman, AZ (928) RN PROGRAM DEMOGRAPHIC DATA SURVEY (Optional) The RN Program is required to report the following demographic data to the accrediting agency. Please provide this data for accurate reporting of numbers only. Gender: Male Female Age: Ethnicity / Race: American Indian or Alaskan Native White / Non-Hispanic Hispanic Asian or Pacific Islander Black/Non-Hispanic Other/Unknown Marital Status: Single Married Divorced Widowed Highest Degree Currently Held: Associate Baccalaureate Master s Doctoral Return with COMPLETED Application To: Mohave Community College, Department Of Nursing; 1977 Acoma Blvd. West; Lake Havasu City, AZ

16 RN Program 1801 Detroit Ave Kingman, AZ (928) RN PROGRAM NOTICE OF NO GUARANTEE OF LICENSURE/CERTIFICATION Admission or graduation from the RN Program does not guarantee obtaining a license or certificate to practice nursing. Licensure and certification requirements and the subsequent procedures are the exclusive right and responsibility of the Arizona State Board of Nursing. Students must satisfy the requirements of the Nurse Practice Act: Statues, Rules, and Regulations independently of any college or school requirements for graduation as they exist at the time of licensure/certification. Although this explanation and handbook materials may provide information concerning the licensing process, the applicant/student is solely responsible for understanding and meeting licensure/certification requirements. MCC does not guarantee the accuracy of any of the information presented here or in any other materials presented to the applicant/student concerning the licensure process. Verifying the accuracy of such information is solely the responsibility of the applicant/student. If convicted of a felony, an applicant for licensure/certification must submit proof that he/she has received an absolute discharge from the sentences for all felony convictions five or more years prior to the date of filing an application (Nursing Practice Act 202, and ). Such proof includes completion of any sentence including imprisonment, probation, parole, community supervision or any form of court supervision. Examples of unprofessional conduct, but not limited to, are felony or misdemeanor convictions, substance abuse, conviction of an offense involving immoral behavior, or being guilty of acts which deceive, defraud or harm the public in any way. Fingerprinting will be part of the application process for the Nursing Assistant, LPN, and RN applicants. If there is any question about eligibility for licensure or certification, contact the Arizona State Board of Nursing ( ). I have read and understood the above statement. Signature Print Name Date This statement will become part of your permanent record. PUBLIC NOTICE OF NONDISCRIMINATION: Mohave Community is committed to providing equal employment opportunity, educational opportunity, and advancement to individuals without regard to race, color, religion, gender, national origin, age, mental or physical disability, sexual orientation, veteran status, or any other legally protected class in any of its policies, practices, or procedures. The equality of employment opportunity for all persons must be consonant with all applicable provisions of state and federal laws. The college shall promote equal opportunity and treatment on a continuing basis. See the MCC Diversity webpage for further information. Return with COMPLETED Application To: Mohave Community College, Department Of Nursing; 1977 Acoma Blvd. West; Lake Havasu City, AZ Revised 7/

17 TEST OF ESSENTIAL ACADEMIC SKILLS (TEAS) MOHAVE COMMUNITY COLLEGE WHAT IS THE TEAS TEST? The Test of Essential Academic Skills evaluates nursing program applicants in four (4) foundational areas which are essential to your academic success in the Nursing Program. The Nursing Program requires you to take the TEAS Test as an entrance examination. Basically, the test has four parts that ask you to answer multiple-choice questions covering the following: Reading: paragraph comprehension, passage comprehension, and inferences/conclusions. (48 items, 58 minutes) Math: Whole numbers, metric conversion, fractions, decimals, algebraic equations, percentages, and ratio/proportion. (34 items, 51 minutes) Science: science reasoning, science knowledge, biology, chemistry, anatomy, physiology, basic physical principles, and general science. (54 items, 66 minutes) English and Language Usage: punctuation, grammar, sentence structure, contextual words and spelling. (34 items, 34 minutes) Total of 170 multiple choice questions. WHO ADMINISTERS THE TEAS TEST? The Testing Centers at Mohave Community College administer the TEAS Test. The test is purchased from the Assessment Technologies Institute (ATI). Your TEAS scores are stored by ATI and are available to you and to your school via the Internet. You can also have TEAS results sent to other nursing schools at minimum cost through ATI. HOW MUCH DOES THE TEAS TEST COST? The cost of taking either test is $60.00 for students and $70.00 for non-students. HOW CAN I BEST PREPARE FOR TAKING THE TEAS TEST? A review of basic concepts and theories in mathematics, reading, science, English and language usage is recommended. ATI has two products, the TEAS Study Manual and a TEAS Online Practice Assessment, available to guide your review and provide feedback on your study progress. These products can be purchased online at the ATI website which is CAN I USE A CALCULATOR ON THE TEAS TEST? Calculators are NOT allowed during the TEAS TEST. WHAT DO I BRING TO THE TESTING CENTER? Photo bearing identification such as a; passport, driver s license, student identification card. WHAT CANNOT BE BROUGHT TO THE TESTING CENTER? Cell phones, textbooks, backpacks, calculators. Scratch paper and pencils will be provided. 17

18 CAN YOU ACCOMMODATE STUDENTS WITH DISABILITIES? Students with documented disabilities requiring accommodations should contact the Disability Services Office at the local campus to make arrangements to take their test. Students requiring extra time will not be able to take the computer based test because the program is self-timing and cannot be adjusted. These students will be given a paper and pencil test instead. This test cannot be scored locally, but must be sent back to ATI for scoring, requiring at least a one (1) to two (2) week turnaround. Please take this into consideration when scheduling and allow sufficient time prior to nursing program application due dates. HOW LONG WILL IT TAKE TO GET MY TEAS TEST SCORES? If you have taken the computer administered TEAS Test, your scores are available immediately after the examination. If you have taken the pencil/paper version of the test, your examination will be scored within 24 hours of receipt by ATI. Note that the 24-hour window is NOT 24 hours from the time you tested, but within 24 hours of ATI s receipt of testing materials from Mohave Community College. HOW DO I KNOW IF I PASSED THE TEAS TEST? The applicant s adjusted individual total score must be at or above 70% to be considered for admission. CAN I RETEST TO GET A HIGHER SCORE? Tests may be retaken after a minimum of 30 days and up to 3 times a year period. HOW TO REGISTER YOURSELF AS A TEST CANDIDATE FOR THE TEAS. If you are not a current user on you need to set up a new account. This will allow you access to the testing and to complete a purchase on ATI s online store. Please follow the steps below to setup a new account: 1. Go to Just under the Username and Password fill-in boxes, there is a small link that states, New to ATI? Create an account. Click on that link to register yourself with ATI. 2. Next, a web form will appear. Fill in all of the blue fields. Blue fields are required information necessary to create a new account. 3. You will receive an from ATI confirming your user login and password. 4. You will need to bring your user name and password with you when you go to the testing center to take the TEAS. TO SCHEDULE THE TEAS TEST, CONTACT THE TESTING COORDINATOR AT YOUR LOCAL CAMPUS PROVIDED BELOW: Priscilla Sarabia: psarabia@mohave.edu, Bullhead City Campus, Cheri Stromle: cstromle@mohave.edu, Neal Campus Kingman Campus, Kevin Smith: ksmith@mohave.edu, Lake Havasu City Campus, Kim Naylor: knaylor@mohave.edu, North Mohave Campus, MCC Toll Free: Reviewed 5/

19 ASSOCIATE DEGREE NURSING PROGRAM PROFESSIONAL REFERENCE FORM To Be Completed by Applicant (please print) Complete the following section and give this form as soon as possible to someone who has observed you in a professional setting for a reasonable period of time. This should be an employer or community leader for whom you have worked or volunteered, or an instructor who has had the opportunity to view your accomplishments in a classroom setting. Name: Date: Address: (Street or P.O. Box) (City) (State) (Zip) The Family Educational Rights and Privacy Act of 1974 permits a matriculated student to have access to his/her file unless a waiver of that right has been signed. If you wish to waive your right to access your file, sign your name in the space provided. The waiver is NOT required as a condition of admission. I hereby waive my right of access to this letter of recommendation. Applicant s Signature: Date: To be Completed by Evaluator This student is applying for admission to Mohave Community College RN Nursing Program. Evaluations are invaluable to the decision making process. Please include any information that you feel is pertinent, and remember that the sooner you return this form to MCC, the sooner we can give this student our admission decision. Thank you. Please rate the applicant in each of the following areas: Excellent Good Average Poor Do Not Know Ability to work with others Conceptual ability Dependability Leadership ability Integrity / Honesty Initiative / Motivation Maturity Empathy / Caring Judgment Overall Potential for Nursing Program *Any additional comments you feel might be of value to the Nursing Department, please state them on the back. Name: Agency Represented: Title: Address: (Street or P.O. Box) (City) (State) (Zip) Signature: Department Of Nursing Mohave Community College 1977 Acoma Blvd. West Lake Havasu City, AZ Date: PLEASE RETURN TO 19 Reviewed 5/2015

20 ASSOCIATE DEGREE NURSING PROGRAM PROFESSIONAL REFERENCE FORM To Be Completed by Applicant (please print) Complete the following section and give this form as soon as possible to someone who has observed you in a professional setting for a reasonable period of time. This should be an employer or community leader for whom you have worked or volunteered, or an instructor who has had the opportunity to view your accomplishments in a classroom setting. Name: Date: Address: (Street or P.O. Box) (City) (State) (Zip) The Family Educational Rights and Privacy Act of 1974 permits a matriculated student to have access to his/her file unless a waiver of that right has been signed. If you wish to waive your right to access your file, sign your name in the space provided. The waiver is NOT required as a condition of admission. I hereby waive my right of access to this letter of recommendation. Applicant s Signature: Date: To be Completed by Evaluator This student is applying for admission to Mohave Community College RN Nursing Program. Evaluations are invaluable to the decision making process. Please include any information that you feel is pertinent, and remember that the sooner you return this form to MCC, the sooner we can give this student our admission decision. Thank you. Please rate the applicant in each of the following areas: Excellent Good Average Poor Do Not Know Ability to work with others Conceptual ability Dependability Leadership ability Integrity / Honesty Initiative / Motivation Maturity Empathy / Caring Judgment Overall Potential for Nursing Program *Any additional comments you feel might be of value to the Nursing Department, please state them on the back. Name: Agency Represented: Title: Address: (Street or P.O. Box) (City) (State) (Zip) Signature: Department Of Nursing Mohave Community College 1977 Acoma Blvd. West Lake Havasu City, AZ Date: PLEASE RETURN TO 20 Reviewed 5/2015

21 ASSOCIATE DEGREE NURSING PROGRAM PROFESSIONAL REFERENCE FORM To Be Completed by Applicant (please print) Complete the following section and give this form as soon as possible to someone who has observed you in a professional setting for a reasonable period of time. This should be an employer or community leader for whom you have worked or volunteered, or an instructor who has had the opportunity to view your accomplishments in a classroom setting. Name: Date: Address: (Street or P.O. Box) (City) (State) (Zip) The Family Educational Rights and Privacy Act of 1974 permits a matriculated student to have access to his/her file unless a waiver of that right has been signed. If you wish to waive your right to access your file, sign your name in the space provided. The waiver is NOT required as a condition of admission. I hereby waive my right of access to this letter of recommendation. Applicant s Signature: Date: To be Completed by Evaluator This student is applying for admission to Mohave Community College RN Nursing Program. Evaluations are invaluable to the decision making process. Please include any information that you feel is pertinent, and remember that the sooner you return this form to MCC, the sooner we can give this student our admission decision. Thank you. Please rate the applicant in each of the following areas: Excellent Good Average Poor Do Not Know Ability to work with others Conceptual ability Dependability Leadership ability Integrity / Honesty Initiative / Motivation Maturity Empathy / Caring Judgment Overall Potential for Nursing Program *Any additional comments you feel might be of value to the Nursing Department, please state them on the back. Name: Agency Represented: Title: Address: (Street or P.O. Box) (City) (State) (Zip) Signature: Department Of Nursing Mohave Community College 1977 Acoma Blvd. West Lake Havasu City, AZ Date: PLEASE RETURN TO 21 Reviewed 5/2015

22 TRANSCRIPT REQUEST (DO NOT SEND FOR MCC OFFICIAL TRANSCRIPTS) Institution Name Mailing Address City State Zip Please send one (1) OFFICIAL COPY of my transcript to: Department Of Nursing Mohave Community College 1977 Acoma Blvd. West Lake Havasu City, AZ I do not know the Transcript fee, please bill me. I am enclosing the transcript fee of $ for (number) transcripts. PLEASE PRINT Student Name Social Security Number Mailing Address City State Zip Maiden or Previous Name(s) Address While attending your institution If there is a charge against my account, I hereby agree to clear all indebtedness before this record will be released. STUDENT is responsible for mailing this form Student Signature Reviewed 5/

23 Essential Skills & Functional Abilities for Nursing Mohave Community College Individuals who apply for admission to the Mohave Community College Nursing Program must be able to perform essential skills. Any applicant who has met the necessary prerequisites and who can perform the essential functions will be considered for admission. If a student believes that he or she cannot meet one or more of the standards without accommodations, the nursing program must determine, on an individual basis, whether a reasonable accommodation can be made. Functional Ability Standard EXAMPLES of required activities Motor Abilities Skills Gross Motor Skills Manual Dexterity Fine Motor Skills Physical abilities and mobility sufficient to execute gross motor skills, physical endurance, and strength, to provide patient care. Demonstrate fine motor skills sufficient for providing safe nursing care. Mobility sufficient to carry out patient care procedures such as assisting with ambulation of clients, administering CPR, assisting with turning and lifting patients, providing care in confined spaces such as treatment room or operating suite etc. Motor skills sufficient to handle small equipment such as insulin syringe and administer medications by all routes, perform tracheotomy suctioning, insert urinary catheter, etc. Perceptual Sensory Ability Visual Tactile Smell Sensory / perceptual / Auditory ability to monitor and assess clients Normal or corrected visual ability sufficient for accurate observation and performance of nursing care. Tactile ability sufficient for physical monitoring and assessment of health care needs. Olfactory ability sufficient to detect significant environmental and client orders. Sensory abilities sufficient to hear alarms, auscultatory sounds, cries for help, hears normal speaking levels sounds, etc. Visual acuity to read calibrations on 1cc syringe, assess color, see objects up to 20 ft. away (cyanosis, pallor, etc.) Tactile ability to feel pulses, temperature, palpate veins, etc. Olfactory ability to detect smoke or noxious odor, foul smelling drainage, alcohol, etc. Behavioral Interpersonal Emotional Emotional/Behavioral Ability to relate to colleagues, staff and patients with honesty, integrity, and nondiscrimination. Capacity for development of mature, sensitive and effective therapeutic relationships. Establish rapport with clients, instructors and members of health care team. Work with teams and workgroups. 23

24 Professional Attitudes and Interpersonal Skills Interpersonal abilities sufficient for interaction with individuals, supervisors, members of health care team, families and groups from various social, emotional, cultural and intellectual backgrounds, achieve a positive and safe work environment. Ability to work constructively in stressful and changing environments with the ability to modify behavior in response to constructive criticism. Follow instructions and safety protocols. Capacity to demonstrate ethical behavior, including adherence to the professional nursing and student honor codes. Establish and maintain therapeutic boundaries. Emotional skills sufficient to remain calm in an emergency situation and maintain behavioral decorum in stressful situations. Behavioral skills sufficient to demonstrate the exercise of good judgment and prompt completion of all responsibilities attendant to the diagnosis and care of clients. Honesty and integrity beyond reproach. Adapt rapidly to environmental/stress changes and multiple task demands. Exhibit ethical behaviors and exercise good judgment. Communication Ability to communicate in English with accuracy, clarity and efficiency with patients, their families and other members of the healthcare team (including spoken and nonverbal communication, such as interpretation of facial expressions, affect and body language.) Required communication abilities, including speech, hearing, reading, writing, language skills and computer literacy. Gives verbal directions to or follows verbal directions from other members of the healthcare team and participates in healthcare team discussions of client care. Elicits and records information about health history, current health state and responses to treatment from clients or family members. Conveys information to clients and others as necessary to teach, direct and counsel individuals in an accurate, effective and timely manner. Establishes and maintain effective working relations with clients and co-workers. Recognizes and reports critical client information to other caregivers. Cognitive Conceptual Quantitative Abilities Ability to read and understand written documents in English and solve problems involving Calculates appropriate medication dosage given specific client parameters. 24

25 measurement, calculation, reasoning, analysis and synthesis. Ability to gather data, to develop a plan of actions, establish priorities and monitor and evaluate treatment plans and modalities. Ability to comprehend three-dimensional and spatial relationships. Ability to react effectively in an emergency situation. Analyzes and synthesize data and development of an appropriate plan of care. Collects data, prioritize needs and anticipate reactions. Comprehend spatial relationships adequate to properly administer injections, start intravenous lines or assess wounds of varying depths. Recognizes an emergency situation and responds effectively to safeguard the client and other caregivers. Transfers knowledge from one situation to another. Accurately processes information on electronic medical records (EMR), medication container, physicians orders, and monitor equipment calibrations, printed documents, flow sheets, graphic sheets, medication administration records, other medical records and policy and procedure manuals. Safe environment for patients, families, and co-workers Ability to accurately identify patients. Ability to effectively communicate with other caregivers. Ability to administer medications safely and accurately. Ability to operate equipment safely in the clinical area. Prioritizes tasks to ensure client safety and standard of care. Maintains adequate concentration and attention in inpatient care settings. Seeks assistance when clinical situation requires a higher level or expertise/experience. Ability to recognize and minimize hazards that could increase healthcare associated infections. Ability to recognize and minimize accident hazards in the clinical setting including hazards that contribute to patient, family, and co-worker falls. Responds to monitor alarms, emergency signals, call bells from clients, and orders in a rapid and effective manner. 25