Nursing Program Application

1 Nursing Program Application 1 + 1 Nursing Program In accordance with the vision and mission of Coffeyville Community College, the purpose of the Nursing Program (CCCNP) is to foster the provision of quality nursing care by means of an exemplary nursing education based on academic and professional nursing standards for the fulfillment of professional and social responsibilities. By building upon a liberal arts foundation, and domain specific nursing knowledge graduates are prepared to provide safe and effective therapeutic care within the ethical and legal responsibilities of the Licensed Practical Nurse and/or the Registered Associate Degree Nurse. 2015 Application and Selection Process for 2016 Start Apply to the Program, pg.2 Application Requirements, pg.2 Pre-admission Exams, pg.2 PN Program Coursework, pg.3 RN Program Coursework, pg.3 LPN-RN Matriculation and Transfer Students, pg.4 Selection Process and GPA Requirement, p.4 Enrollment Requirements, pg.5-6 Readmission/Completion, pg.7 Requirements for Graduation, pg.7 Accreditation Status, pg.8 Costs, pg.8 KSBN Licensure, pg.9-10 Required Application Form, pg.11-12 The application period runs May 1- November 13, 2015

2 Apply to the Program 1. Submit the following documentation to the Director of Nursing s Office for the 2016 Nursing Program. Please call 620-252-7550, ext.32 to schedule a time to bring in your completed packet to the Nursing Director. Please do not mail your application packet; it MUST be handed in to the Nursing Director in person. The application period runs May 1- November 13, 2015. Address: Coffeyville Community College Technical Campus 700 Roosevelt Coffeyville, KS 67337 Application Requirements (Your packet will not be accepted without the following) 1. Completed application for admission (pg s11-12 of the application packet) 2. 2 (two) official transcripts for all colleges, universities, and/or vocational schools attended since high school, AND a high school transcript/ged equivalent are to be submitted with application packet. 3. Verification of an active CNA certification (or active Kansas LPN license), this includes placing a copy of your certificate or license in you completed packet. If you are currently taking the CNA course, you will need documentation in your packet that shows you are currently enrolled in the course. 4. A reference letter from either a current/previous faculty member, or current/previous employer. The reference must be told to supply a contact phone number and must be in a sealed envelope to be accepted. 5. A one to two-page typed, double-spaced letter expressing your goals for your nursing education and practice. 6. If applicable, a one-page typed statement explaining any unsuccessful completion of previous nursing program(s), nursing courses/curriculum. 7. Results of the HESI Admission Assessment (A2) Exam taken at CCC on date designated by the Director of Nursing (You will be assigned a test date upon turning in your completed nursing application packet). 8. Graduates of a Foreign Nursing School are required to have results of the TOEFL ibt test (This is a requirement of KSBN). 9. $25.00 application fee & $45.00 HESI Admission Assessment Exam Fee, Combined Total Due is $70.00 (cash or money order only). Pre-Admission Exams HESI Admission Assessment (A2) Exam will be required for all nursing applicants. The HESI A2 Exam is a computer based test consisting of several modules that examine academic knowledge in English, Math, Science, as well as examines personality and learning styles and critical thinking. All applicants are required to complete the HESI A2 Exam as part of the admission requirements. Total time allotted to complete the exam is 6 hours. You MUST have a composite score of at least 70% to be eligible for admission into the nursing program. This exam is only administered once a year and you MUST attend the scheduled test date given. There is a review book available to study for the exam. This can be rented or purchased through any book retailer, HESI Admission Assessment Exam Review, 3 rd. ed. ISBN: 978-1-4557-0333-3. (The CCC Bookstore DOES NOT carry this book). Notice: Graduates of a Foreign Nursing School are required to take the TOEFL (Test of English as a Foreign Language TM ) to measure how well students can read, listen, speak, and write in English in the classroom. This is a requirement of the Kansas State Board of Nursing to be eligible to take the NCLEX exam. The KSBN has approved the following scores for the new TOEFL ibt; each area must meet the minimum requirement. Minimum Scores: Writing- 20, Speaking- 20, Reading- 19, and Listening- 20.

3 PN Program Coursework Prerequisite Courses for the PN Program General Psychology Anatomy & Physiology Intermediate Algebra or higher level Math Developmental Psychology Active Certified Nurse s Assistant (CNA) Certificate Corequisite Course for the PN Program English Composition I 5 credits (taken within the last 5 years) PN Nursing Courses Foundations of Nursing Foundations of Nursing Clinical Medical Surgical Nursing I Medical Surgical Nursing I Clinical Nursing Pharmacology Medical Surgical Nursing II Medical Surgical Nursing II Clinical Maternal Child Nursing I Maternal Child Nursing I Clinical Gerontology Nursing Mental Health Nursing 4 credits 4 credits 4 credits 1 credits RN Program Coursework Prerequisite Courses for the RN Program General Psychology Anatomy & Physiology English Composition I Intermediate Algebra or higher level Math Developmental Psychology 5 credits (taken within the last 5 years) RN Nursing Courses LPN Bridge Course Mental Health Nursing II Maternal Child Nursing II Maternal Child Nursing II Clinical NCLEX-RN Review Course Advanced Nursing Advanced Nursing Clinical Leadership and Management in Nursing ADN General Education Courses Microbiology Public Speaking 1 credit 1 credit 6 credits 5 credits (taken within the last 5 years)

4 LPN-RN Transfer Students Licensed Practical Nurses must seek admission to the Nursing Program by following the standard nursing admissions process. LPNs that have not graduated from the1 +1 PN Nursing Program are required to have a transcript evaluation by the Director of Nursing so that appropriate credit may be awarded. Additional Kansas Core PN Curriculum courses may have to be completed to continue in the Associate Degree Nursing Program. The LPN Bridge course must be taken concurrently in the first semester of the Associate Degree Nursing Program. CCCNP PN students are not guaranteed a seat in the RN program. Admission is primarily based upon a point system. The admission point scale is designed to objectively evaluate applicants for the nursing program. Applicants with the highest total points will be ranked above other applicants for the available positions in the program. For further information see the LPN-RN Program information. Selection Process and GPA Requirement Applicants must apply for the 2016 program. All completed admission packets must be brought to the CCC Technical Campus and handed in to the Director of Nursing. Please call 620-252-7550, ext. 32 to set up a time to bring in your completed packet for review. The application period runs May 1- November 13, 2015 Currently, we fill a max of 24 open seats each year for the Practical Nursing (PN) program. A limited number of seats are available for LPN s applying for the RN program; this number depends on the number of openings after the graduating class finishes the PN program. Enrollment in the Nursing Program may be limited because of available health care facilities in the community, as well as limited faculty and financial resources at the Community College. Notice: A cumulative GPA of 2.75 or 2.75 GPA in all required nursing general education courses is a requirement to make application to the Nursing Program, while maintaining a grade of C or higher in each prerequisite course. Admission is based upon a point system. The admission point scale is designed to objectively evaluate applicants for the 1 + 1 Nursing Program. Applicants with the highest total points will be ranked above other applicants for the available positions in the program. Higher admission scores will be given to applicants: Who have higher cumulative/nursing general education course GPA s. Who have earned acceptable HESI test scores indicative of successful college skill levels. Who have earned pre-requisite and/or CNA courses through Coffeyville Community College. Who have had a CNA certificate 1 year. Who have an exceptional reference letter from either a current/previous faculty member, or current/previous employer. Who have an exceptional letter expressing personal goals for nursing education and practice (Format: One-two-page typed, double-spaced).

5 Selected candidates will be notified by mail in writing for the 2016 Nursing Program. Immunizations and Clinical Requirements A licensed nurse must be capable to function safely and effectively in a variety of clinical situations, as well as meeting specific legal standards and professional guidelines. The theory and clinical practicum requirements of the Nursing Program are essential for nursing practice and students are expected to participate and perform the skills at the competent level to be successful in the Nursing Program. A disabled prospective nursing student may apply for reasonable accommodations to likewise function safely and effectively in the Nursing Program. The Director of Nursing will work in conjunction with the CCC Disabilities Coordinator to review the requests for reasonable accommodations prior to determining if such requests can be provided. Once you have been accepted into the nursing program, students MUST provide documentation of required immunizations, American Heart CPR Certification, background check, and a CCCNP Health Form. a complete Hepatitis B vaccination series (series of three, or titer), or documentation of the start of the series of three, and update documentation until completed, MMR vaccination(s) or a positive titer, a negative TB Skin Test (PPD) or negative chest X-Ray, Tdap booster or tetanus toxoid vaccination (within last 5 years) written verification of varicella history (either written by yourself or physician containing the year in which you had chicken pox), varicella vaccination, or titer, Note: Additional random screenings may be required by the clinical facilities. A student will not be able to attend clinical in an agency if immunizations are not current. Reference: CDC Immunization Schedules: http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm American Heart CPR Certification All nursing students are required to have Healthcare Provider CPR Certification, which is renewed every two years. You can call the Technical Campus to find out the next scheduled CPR class being held, 620-252-7550, Ext. 10. We will hold a CPR course every year with the mandatory nursing orientation in November.

6 Background Check Once you have been accepted into the nursing program, you will need to initiate a background screening. The profile information that you input will be directly sent to the school upon completion. Please complete this as soon as you receive your acceptance letter for the program (the letter will give directions as to how to complete the background screening). Criminal History Record Search Social Security Number Trace Residency History Nationwide Sex Offender Registry OIG (Office of Inspector General) ***All students must be able to pass the Background Check and Urine Drug Screen without limitations to attend Clinical Rotations*** Any student may be subject to licensure denial according to the following: Statute 65-1120: Grounds for disciplinary actions; proceedings; witnesses; costs; professional incompetency defined; criminal justice record information (http://kansasstatutes.lesterama.org/chapter_65/article_11/65-1120.html) The CCCNP Health Form You must have this health form completed by a Physician or Nurse Practitioner/Clinical Nurse Specialist/Physician s Assistant. This form is mailed to you with your acceptance letter for the program. Clinical Sites Please complete the following searches to visit and familiarize yourself with following the health care facility websites. Clinical rotations are currently scheduled at the following sites; Coffeyville Regional Medical Center (CRMC) (http://www.crmcinc.com) Windsor Place (http://www.windsorplace.net) Area physician s offices, health departments, and schools

7 Readmission Readmission to the Nursing Program is contingent on an evaluation of past academic performance in class, clinical, availability of clinical space, and nursing faculty recommendations. Any student who is unsuccessful in a nursing course will not be permitted to continue in the Nursing Program. Unsuccessful is defined as receiving a grade of D or F or W. A student may not repeat any nursing program course more than two (2) times. The student must submit a written request for readmission to the Director of Nursing by the Monday after final exams with the following information: 1. Students name, date, day of exiting the Nursing Program, and which semester the student is seeking readmission 2. Student s request for readmission and Academic Success plan to complete the nursing program; includes the submission of a type-written essay describing the changes the student plans to make in order to return and successfully complete the required course(s). 3. A copy of the students previous clinical evaluation tool (if readmission course has a clinical component) and an official transcript once updated from the Registrar s office with current semester of course withdrawal/failure (may be turned in at a later time once updated). **The student must be aware that financial aid may not cover the cost of repeating coursework** Program Completion The PN Program must be completed within 4 semesters (2 academic years). The ADN RN Program must be completed within 6 semesters (3 academic years). Students who do not meet the specified program completion deadlines as mentioned above will be required to re-apply to the Nursing Program. Students in the PN program must successfully pass the NCLEX-PN to be eligible to apply for admission into the RN program. Requirements for Graduation A student is eligible for a Certificate in Practical Nursing by meeting the following requirements Complete 30 credit hours of the Practical Nursing Program at CCC Complete 10 credit hours of prerequisite and general education courses at a regionally accredited college recognized by the U.S. Department of Education. Maintain a GPA of 2.5 or higher while enrolled in the Practical Nursing Program. Be enrolled during the semester in which requirements for the Practical Nursing Program are completed. A student is eligible for an Associate of Applied Science Degree in Nursing by meeting the following requirements. Complete the total 73 credit hours of the ADN RN Nursing Program. Maintain a GPA of 2.5 or higher while enrolled in the ADN RN Nursing Program. Earn a minimum of 15 of the last Nursing Program credit hours at CCC. Be enrolled during the semester in which requirements for the ADN RN are completed.

8 Accreditation Status Coffeyville Community College is accredited through The Higher Learning Commission and the Nursing Program is approved through the Kansas State Board of Nursing as required by the Kansas Nurse Practice Act. The Kansas State Board of Nursing does not require additional national accreditation of nursing programs in Kansas. Although national accreditation is optional, Coffeyville Community College Nursing Program plans to seek accreditation for its LPN and RN programs. At this time, our programs are not nationally accredited. Our accreditation status does not 1) affect being able to take the NCLEX exam for licensure, 2) affect obtaining your nursing license, and 3) has not affected our graduates when securing employment as an LPN or RN. The only issue you may encounter is if you plan to further your education into a BSN or Master s program. These programs may require you to be a graduate of an accredited nursing program. We currently have agreements with Labette Community College, Pittsburg State University, Tabor College, Southwestern College, Newman University, National American University, and Oklahoma Wesleyan University, where these institutions will readily accept our graduates at this time for their RN and BSN programs respectively, while we are seeking national accreditation. Costs In addition to Coffeyville Community College tuition and fees, please visit; http://www.coffeyville.edu to access the Student Services link for information regarding tuition, financial aid, and many student services. CCCNP Projected Costs Cost subject to change without notice Nursing Program Tuition and Fees Tuition Program Fees Books PN $120.00 cr/hr $1,530.00 $1003.00 RN $120.00 cr/hr $1,578.00 $638.60 Program Fees include: Uniforms (scrubs & lab coat), lab supplies, liability insurance, Nursing Pin, Kansas State Board of Nursing (KSBN) and National Council for State Boards of Nursing (NCSBN) registration, fingerprint and background check and testing fees, standardized testing fees, graduation fee, and a parking fee. Out of Pocket Expenses include: Application fee $25 & HESI A2 Exam Fee $45 and Background Check/Immunization Tracking Fee $97.00. Estimated Total Cost PN Program $7,439.80 Estimated Total Cost RN Program $5,328.60

9 Kansas State Board of Nursing (KSBN) Licensure The following qualification is required for any individual who seeks to take the NCLEX-PN (Practical Nurse) or NCLEX-RN (Registered Nurse) for licensure in the state of Kansas. Have graduated from a KSBN approved practical nursing /professional registered program(s) in the United States or in a foreign county. Have you ever been convicted of a misdemeanor or felony? (Please be familiar with 60-3-113. Reporting of certain misdemeanor convictions by the licensee, found at http://ksbn.org/npa/npa.pdf) 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 after hearing: (1) To be guilty of fraud or deceit in practicing nursing or in procuring or attempting to procure a license to practice nursing; (2) to have been guilty of a felony or to have been guilty of a misdemeanor involving an illegal drug offense unless the applicant or licensee establishes sufficient rehabilitation to warrant the public trust, except that notwithstanding K.S.A. 74-120 no license, certificate of qualification or authorization to practice nursing as a licensed professional nurse, as a licensed practical nurse, as an advanced registered nurse practitioner or registered nurse anesthetist shall be granted to a person with 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 (Grounds for disciplinary actions; proceedings; witnesses; costs; professional incompetency defined; criminal justice record information. July 2009). Any student may be subject to licensure denial according to the following: Statute 65-1120: Grounds for disciplinary actions; proceedings; witnesses; costs; professional incompetency defined; criminal justice record information (http://kansasstatutes.lesterama.org/chapter_65/article_11/65-1120.html)

74-1112. Applicant for licensure as a professional nurse, practical nurse or mental health technician to be fingerprinted and submit to a state and national criminal history record check. (a) The board of nursing may require an original applicant for licensure as a professional nurse, practical nurse or mental health technician to be fingerprinted and submit to a state and national criminal history record check. The fingerprints shall be used to identify the applicant and to determine whether the applicant has a record of criminal history in this state or other jurisdictions. The board of nursing is authorized to submit the fingerprints to the Kansas bureau of investigation and the federal bureau of investigation for a state and national criminal history record check. The board of nursing may use the information obtained from fingerprinting and the applicant s criminal history for purposes of verifying the identification of any applicant and in the official determination of character and fitness of the applicant for any licensure to practice professional or practical nursing or mental health technology in this state. (b) Local and state law enforcement officers and agencies shall assist the board of nursing in taking and processing of fingerprints of applicants to practice professional or practical nursing or mental health technology in this state and shall release all records of adult convictions and non-convictions and adult convictions or adjudications of another state or country to the board of nursing. 10 Please complete the following application and submit in your application packet for admission. Thank you for making application to the Coffeyville Community College Nursing Program.

11 1 + 1 Nursing Program Please complete this form and compile the Application Requirements and submit as a complete application packet to the Director of Nursing at the CCC Technical Campus. Please call 620-252-7550, ext.32 for any further questions and to schedule a time to bring in your completed packet to the Nursing Director. Please do not mail your application packet; it MUST be brought in and reviewed with the Nursing Director in person. The application period runs May 1- November 13, 2015 Application Requirements 1. Completed Nursing Program application (this two-page form) 2. 2 (two) official transcripts for all colleges, universities, and/or vocational schools attended since high school AND a high school transcript/ged equivalent) are to be submitted with application packet. 3. Verification of an active CNA certification (or active Kansas LPN license). Copy of certification/license must be placed in packet. 4. A reference letter from either a current/previous faculty member, or current/previous employer. The reference must supply a contact phone number and must be in a sealed envelope to be accepted. 5. A one to two-page typed, double-spaced letter expressing your goals for your nursing education and practice. 6. If applicable, a one-page typed statement explaining any unsuccessful completion of previous nursing program(s), nursing courses/curriculum. 7. Results of the HESI Admission Assessment (A2) Exam taken at CCC on date designated by the Director of Nursing (You will be assigned a test date upon turning in your completed nursing application packet). 8. Graduates of a Foreign Nursing School are required to have results of the TOEFL ibt test (This is a requirement of KSBN). 9. $25.00 application fee & $45.00 HESI Admission Assessment Exam Fee, Combined Total Due is $70.00 (cash or money order only). I affirm by my signature that I have furnished all information requested in this application. I understand that submitting any false information to the Nursing Program, including but not limited to false transcripts, or withholding information about my previous academic history will render my application for admission invalid and subject to refusal. I have read and understand the information within this program application packet, the admission requirements, nursing admission procedure, and legal qualifications for PN and RN licensure. If I am accepted and enroll in the Coffeyville Community College 1 +1 Nursing Program, I pledge to conduct myself with academic integrity and abide by the tenets of Coffeyville Community College and the 1+1 Nursing Program. Legible Signature: Date:

12 Last Name First Middle SS Number Address City State Zip Cell Phone/Primary Contact Phone Email Address Emergency Contact Information: Last Name First Phone Relationship PN Prerequisite Courses Active CNA Certification Number Grade Earned School Year General Psychology () Anatomy & Physiology (5 credits) Intermediate Algebra or higher level Math () Developmental Psychology () PN Co-requisite Course English Composition I () Nursing RN Prerequisites Active Kansas LPN License/ License Number/Expiration Grade Earned School Year General Psychology () Anatomy & Physiology (5 credits) Intermediate Algebra or higher level Math () Developmental Psychology () English Composition I () RN General Education Co-requisites Microbiology (5 credits) Public Speaking ()