PRACTICAL NURSE 2015 2016 School Year 1
CONTENTS General Information and FAQs... 3-4 Pre-Entrance Test Dates... 3 Application Process Three Stages... 5-6 Immunization Guidelines... 7 Applicant Rubric Form/Selection Criteria...8 Application for Admission... 9-11 Driving Directions to PTC... 12 For Enrollment Information Please Contact: Pontotoc Technology Center 601 W. 33 rd, Ada, OK 74820 (580) 310-2260 -- FAX (580) 310-2286 www.pontotoctech.edu Training to Succeed Non-Discrimination Statement: Pontotoc Technology Center, in compliance with the Guidelines for Vocational Education Programs (34 CFR Part 100 Appendix B), Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990,Title IX of the Education Amendment of 1972, and the Age Discrimination Act of 1975, does not discriminate on the basis of race, ethnicity, religion, national origin, age, gender, disability or veteran status in any of its policies, practices or procedures. These equal opportunity provisions include, but are not limited to admissions, employment, financial aid & student services. Revised 10/2011, 9/2011, 4/2011, 5/2010, 10/2012, 10/14 2
Dear Applicant, Thank you for your interest in Pontotoc Technology Center and specifically our Practical Nurse Career Major. Our mission statement is Training to Succeed. There are specific steps and requirements to complete to be considered for admission to the Practical Nurse Career Major, which are all included in this Application Packet. Meeting the stated requirements does not guarantee admission to the Practical Nurse Career Major. Once all the testing information has been completed, informative session has been conducted, and applicant rating forms are completed, each applicant will receive notification by mail of acceptance or denial. Below are procedures to follow and FAQs (frequently asked questions). Admissions & Enrollment There are two options for admission: ACT: If you have taken within the last 5 years and scored a 19 or above as the overall score then you must bring an OFFICIAL ACT COPY when you submit your application. Any sub-scores below 19 will not be awarded points on selection rubric. The deadline for the application and ACT copy is February 19, 2015. TABE: Schedule the (TABE) test when you submit your application. There is no cost for the TABE test. Dates for testing are listed below. After you have tested, you will be notified within 2 weeks of your results. You may retake the test based upon your grade equivalency scores. Components of TABE testing & minimum scores are: reading/12, applied mathematics/10 (calculator allowed), and spelling. Applicants can retest with the following scores: Reading 11.0-11.9 & Applied Math 9.0-9.9. For practice questions go to www.testpreview.com/tabe_practice.htm. If you have any questions regarding your test scores and/or the process, you may contact the practical nursing office at 580-310- 2260 or the admissions counselor at (580) 310-2264. TABE TESTING DATES Daytime Dates Evening Dates Tuesday, 2/03/15 9:00 am-1:00 pm Thursday, 2/05/15 5:00 pm-9:00 pm Tuesday, 2/10/15 9:00 am-1:00 pm Thursday, 2/12/15 5:00 pm-9:00 pm Tuesday, 2/17/15 9:00 am-1:00 pm Thursday, 2/19/15 5:00 pm-9:00 pm Tuesday, 3/03/15 9:00 am-1:00 pm Thursday, 2/26/15 5:00 pm-9:00 pm Thursday, 3/05/15 5:00 pm-9:00 pm Thursday, 3/12/15 5:00 pm-9:00 pm RETEST DATE - Tuesday, 3/31/15 9:00 am-1:00 pm 1:00 pm-5:00 pm 5:00 pm-9:00 pm 3
Frequently Asked Questions How long is the Career Major? The career major is approximately 11½ months long. We follow most of the regular school holidays and breaks. A calendar of the school year is provided when classes begin. Classes begin in July and will end in June. The total career major hours are 1,463. What are our class hours? Classes run Monday through Friday. Class hours are 7:55 a.m. to 3:05 p.m. Occasionally, we will alter these times if needed to attend a workshop or field trip, etc. You will be notified of any time changes. Once clinical rotations start, times may be adjusted to fit the clinical settings, but in most cases, this will be 2 or 3 days a week from approximately 7:00 a.m. to 4:00 p.m. What can I wear to class? The student is expected to follow the guidelines in the Practical Nurse Handbook. Some days are designated as professional days and the student will be expected to dress appropriately. The students take various field trips or attend functions where jeans, shorts, tennis shoes, etc. are not appropriate. During clinical you will be expected to wear clinical scrubs. How is the class selected? Class selection is based on a point system including test scores, any college courses taken, certifications held, information in your completed file, and the written interview. There will be a MANDATY INFMATIVE SESSION held for all applicants, who meet criteria. Your letter will give the dates and times of the session. In the packet you will find an Applicant Selection Criteria form that we use in making the class selection. How much does it cost to attend? The total cost of the career major is available upon request. The cost includes: tuition, uniforms, testing and licensure fees, graduation supplies, lab kit, clinical supplies, all books, tablet, etc. Financial Aid is available for those who qualify. Contact the Financial Aid Office at (580) 310-2223 for a Financial Aid Application. 4
Application Process THREE STAGES Stage One Application for Admission and Testing 1. Complete the Application for Admission located at the back of this packet. Incomplete applications will not be considered. 2. Bring to the Practical Nurse office: a) Completed Application for Admission b) Official ACT copy of your ACT scores c) Schedule to take the pre-entrance test (TABE). Test schedule is included in this packet. 3. Each applicant will receive envelopes and forms to provide to the 3 references listed in the application. Ask each reference to complete the form and return the form in the envelope provided. It would be advisable to provide postage for each envelope. 4. Take the TABE test on your scheduled day and time; arrive at least 15 minutes early as the door to the Assessment Center will be locked at the start time. Bring a photo ID. If you are unable to take the test at your scheduled time, then you MUST call the nursing office at 580-310-2260 and inform them of your need to reschedule. If you do not call, you will be considered a NO CALL NO SHOW and will not be able to reschedule a testing date. 5. Within two weeks after your test date, you will receive a letter notifying you of two things: a) Your test scores and if you have been invited to proceed with Stage 2 of the application process your need to retest* b) The date for the Mandatory Informative Sessions (you must attend 1 session only) If you do not receive a letter within 2 weeks of the test date, please call the practical nurse office at (580) 310-2260. *If you are advised to retake the TABE test, please schedule it as soon as possible as there is only one retest date, Tuesday, 3/31/15 there are three session times to choose from. 5
Stage Two The Informative Session 1. If you are invited to proceed with the application process, please submit the items listed below at the Informative Session. Failure to provide the items listed, may result in the applicant not being considered. An official copy of your high school transcript; GED scores and certificate Official college transcript(s) Verification of citizenship or qualified alien status. (See information from Oklahoma Board of Nursing provided in this packet). Federal State Bureau of Investigation background check, including fingerprint search (Results may take 6 weeks) CPR certification for adult, child, and infant through the American Heart Association or the American Red Cross. This certification must be current at the beginning of the career major and carry you through the completion of the career major. Copy of state issued Birth Certificate It is highly recommended that you bring your support system with you to the Informative Session. Please do not bring children. 2. After the informative sessions all qualified applications will be scored according to the selection rubric (see attached). Each applicant will be notified by letter of acceptance or denial into the PN program within 2 weeks of the final Informative Session. Stage Three Acceptance to the Practical Nurse Career Major 1. Upon receipt on the acceptance letter, please submit the following to Marsha Whittington in the Practical Nursing office: a) $150.00 non-refundable Registration Fee b) Completed Physical Examination form (mailed to you with your acceptance letter) 6
IMMUNIZATION GUIDELINES E A C H S T U D E N T M U S T P R O V I D E E V I D E N C E O F I M M U N I T Y A G A I N S T T H E F O L L O W I N G D I S E A S E S : IMMUNIZATION EVIDENCE OF IMMUNITY Tuberculin PPD Skin Test Evidence of two (2) negative tuberculin PPD test. The last one needs to be performed between June 1 st of current year and the first day of class If evidence of a positive Tuberculin test then: Evidence of a follow-up negative Chest x-ray (within the past 2 years) MMR (measles, mumps, rubella) Documentation of immunity by either: Evidence of two (2) vaccines at least 4 weeks apart after the age of 12 months old Evidence of a positive blood test indicating immunity HEPATITIS B (HBV) Documentation of immunity by either: Evidence of injections: 3 for Hepatitis B Evidence of a positive blood test indicating immunity Completion of a waiver indicating the student s unwillingness to undergo vaccination. VARICELLA (Chicken Pox) Documentation of immunity by either: Evidence of two (2) varicella vaccines given at least 28 days apart. Documentation by a healthcare provider of diagnosis of history of varicella or herpes zoster Evidence of a positive blood test indicating immunity. INFLUENZA (Flu Shot) Documentation of immunity by either: Evidence of one (1) vaccine annually in the Fall (October) Documentation from healthcare provider that vaccination is contraindicated. (you will be required to wear a surgical mask for a specific clinical site) Students who suspect that they may be pregnant or who are pregnant must consult a physician regarding the advisability of immunization. EVIDENCE OF IMMUNITY MUST BE COMPLETED AND submitted at the Informative Session except for PPD skin test (see above) which must not expire before the end of the school year. 7
APPLICANT RUBRIC FM/SELECTION CRITERIA NAME OF APPLICANT: ENTRANCE REQUIREMENTS SUPERI RATING GOOD RATING FAIR RATING PO RATING SUPERI 4 points GOOD 3 points FAIR 2 points PO 1 point High School Transcript GPA A Average 4.0 3.6 B Average 3.5 3.0 C Average 2.9 2.0 GED Scores 70 65 or 640 564 64 55 or 563 487 54 45 or 486 410 Pre Entrance Exam Scores MATH Pre Entrance READING Exam Scores 12.9 12.0 11.9 11.0 10.9 10.0 12.9 12.7 12.6 12.4 12.3 12.0 Pre Entrance SPELLING Exam Scores 12.9 12.0 11.9 11.0 10.9 10.0 ACT MATH 23+ 22 21 20 19 ACT ACT READING ENGLISH 23+ 22 21 20 19 23+ 22 21 20 19 Employment Background Educational Background College (GPA = ) Educational Background College (Nursing Pre requirements A&P, Microbiology, Chemistry, Nutrition)*NOT for advanced standing for admission points only Maintained Employment in health Extensive education (30+ hours) with GPA 2.0 or > Maintained employment for 1 year Pursued education (29 15 hrs.) with GPA 2.0 or > Short term jobs In health GPA less than 2.0 3 + courses 2 courses 1 course References: (Employer, teacher, counselor) APPLICANT CHARACTERISTICS 3 good References 2 good References IMPTANT CONSIDERATIONS 1 good Reference SUPERI 4 points GOOD 3 points FAIR 2 points PO 1 point Professional Appearance Impression created by dress, grooming, and personal hygiene. Communication Skills Ability to express self, speak clearly, and respond appropriately to questions. Written Skills Personality Characteristics Time Commitment to School High degree of selfmotivation & determination COMMENTS Ability to write legibly, spell correctly, use correct grammar, punctuation, & convey thoughts clearly & concisely. (see Written Interview Questionnaire) Possess self confidence, optimism, flexibility, and a caring attitude when interacting with nursing program staff. Ability to make needed time commitment to school hours with work schedule and family responsibility as shown by support person participation in informative session. Ability to talk about yourself, nursing and your motivation for a career in healthcare Knowledgeable about particular school able to talk about specific criteria Can inspire confidence in your ability to become a nurse 8
Pontotoc Technology Center Practical Nursing APPLICATION F ADMISSION Applicants are selected in accordance with nondiscriminatory practices. We use a self-managed application. in which the applicant submits all transcripts and other required documents to the school in a complete packet by the deadline INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. PRINT TYPE CLEARLY PLEASE USE BLACK INK ONLY. U S E F U L L L E G A L N A M E ( N O I N IT I A L S ) First Name Middle Name (no initials) Last Name Home Address: Street City State Zip Code Mailing Address (if different from above) City State Zip Code Email Address: Home Phone Cell Phone Daytime Phone Contact Phone C I T I Z E N S H I P S T A T U S Effective November 1, 2007, applicants for licensure/certification by examination or endorsement, for Please check the appropriate box below to indicate reinstatement, and for renewal must provide verification of citizenship or qualified alien status as a your citizenship status. requirement for licensure. HB 1804, The Oklahoma Taxpayer and Citizen Protection Act of 2007, I am a U.S. Citizen requires all state agencies to cooperate with federal immigration authorities in the enforcement of I am U.S. national federal immigration laws. Questions about your immigration status should be directed to the Bureau of I am a legal permanent resident alien Citizenship and Immigration Services (BCIS) at 1 800 375 5283. I am a qualified alien F I N A N C I A L A S S I S T A N C E Will you be requesting Financial Assistance? NO YES P R E V I O U S A P P L I C A T I O N Have you previously applied for admission NO YES If yes, what year? E D U C A T I O N A L B A C K G R O U N D : List all educational schools attended with degrees, diplomas or certificates received. SECONDARY EDUCATION: Include an official high school transcript or copy of GED scores. Date: From/To Name of Institution City & State Date of High School Graduation (month & year) If you did not graduate, what is the highest grade you completed? Date of GED Test (month/day/year) GED Score: 9
E D U C A T I O N A L B A C K G R O U N D C O N T I N U E D POST SECONDARY EDUCATION: List formal education beyond high school and provide official transcript(s). Date: From/To Name of Institution City & State Major Diploma, Cert./Degree, # of Credits O R G A N I Z A T I O N A L M E M B E R S H I P, A W A R D S, H O N O R S List participation in high school/college organizations and/or offices held in organizations. List awards won. List any extracurricular and scholastic honors received. You may attach an additional page if necessary. E M P L O Y M E N T : L i s t w o r k e x p e r i e n c e b e g i n n i n g w i t h t h e m o s t r e c e n t. Date: From/To Employer s Name & Supervisor Position Held City & State Phone C O M M U N I T Y S E R V I C E / V O L U N T E E R W O R K / A D D I T I O N A L D A T A List any information regarding community service or volunteer work you are or have been involved with that you feel may be helpful to us in considering your application. Use space below to also give any other information you desire concerning work experience, qualifications, accomplishments, etc. You may attach an additional page if necessary. 10
BOARD OF NURSING STATEMENT The Pontotoc Technology Center Practical Nursing Program is approved by the Oklahoma Board of Nursing. Graduates of this state approved program are eligible to apply to write the National Council Licensure Examination (NCLEX) for practical nurses. Applicants for Oklahoma licensure must meet all state and federal requirements to hold an Oklahoma license to practice nursing. In addition to completing a state approved nursing education program that meets educational requirements and successfully passing the licensure examination, requirements include submission of an application for licensure, a criminal history records search, and evidence of citizenship or qualified alien status. Applicants for practical nurse licensure must also hold a high school diploma or a graduate equivalency degree (G.E.D.) [59 O.S. 567.5 & 567.6]. To be granted a license, an applicant must have the legal right to be in the United States (United States Code Chapter 8, Section 1621). In addition, Oklahoma law only allows a license to be issued to U.S. citizens, U.S. nationals, and legal permanent resident aliens. Other qualified aliens may be issued a temporary license that is valid until the expiration of their visa status, or if there is no expiration date, for one year. Applicants who are qualified aliens must present to the Board office, in person, valid documentary evidence of: 1. A valid, unexpired immigrant or nonimmigrant visa status for admission into the United States; 2. A pending or approved application for asylum in the United States; 3. Admission into the United States in refugee status; 4. A pending or approved application for temporary protected status in the United States; 5. Approved deferred action status; or 6. A pending application for adjustment of status to legal permanent resident status or conditional resident status. The Board has the right to deny a license to an individual with a history of criminal background, disciplinary action on another health related license or certification, or judicial declaration of mental incompetence [59 O.S. 567.8]. These cases are considered on an individual basis at the time application for licensure is made, with the exception of felony convictions. An individual with a felony conviction cannot apply for licensure for at least five years after completion of all sentencing terms, including probation and suspended sentences, unless a presidential or gubernatorial pardon is received [59 O.S. 567.5 & 567.6]. R E F E R E N C E S : D o n o t u s e f a m i l y m e m b e r s o r f r i e n d s. References are an important part of the selection process and should be from past or present employers, counselors, supervisors, or teachers. Reference forms must be mailed by PTC not the applicant. PTC will not mail reference forms to an incomplete address. It is your responsibility to complete this section accurately. It is also your responsibility to insure that the address information is correct. Reference forms will only be mailed out one time. PTC is not responsible for lost or stolen mail. REFERENCE #1 Name of Company/ Business Name of Reference & Position/Title Relationship to Applicant Mailing Address City, State & Zip Code REFERENCE #2 Name of Company/ Business Name of Reference & Position/Title Relationship to Applicant Mailing Address City, State & Zip Code REFERENCE #3 Name of Company/ Business Name of Reference & Position/Title Relationship to Applicant Mailing Address City, State & Zip Code 11
Driving Directions Pontotoc Technology Center is located south of Ada on J.A. Richardson Loop Coming from the North: Take HWY 99 South to Ada. Continue on HWY 99 as it becomes J.A. Richardson Loop. Exit to the right on Oak Avenue. Left turn at stop sign. Travel 3/10 of a mile. Main entrance is on the right. Coming from the South: HWY 99, HWY 377 or HWY 3, head north to Ada. Continue NW on J.A. Richardson Loop following Shawnee and OKC signs. Exit right at Kerr Lab Road. Take short access road from highway to Kerr Lab Road. Turn left and cross overpass. Immediately, turn right onto access road. Travel 3/10 of a mile. Main entrance is on the left. Coming from the West: HWY 3W, HWY 19, or HWY 1 proceed east to Ada. Turn right at the Roff Coalgate Exit. Exit to the right on Oak Avenue. Left turn at stop sign. Travel 3/10 of a mile. Main entrance is on the right. Coming from the East: HWY 1 proceed west to Ada. Turn right at Monte Vista stop light and proceed 3/10 of a mile to Lonnie Abbott Industrial Blvd. Turn left (North). Continue forward past Wal-Mart, Pizza Hut, and Agri-Plex. Continue following HWY 1 & 3W (J.A. Richardson Loop). Travel 3/10 of a mile. Main entrance is on the right. 12