BLINN COLLEGE ASSOCIATE DEGREE NURSING PROGRAM LVN-TRANSITION APPLICATION PACKET



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BLINN COLLEGE ASSOCIATE DEGREE NURSING PROGRAM LVN-TRANSITION APPLICATION PACKET Welcome Letter Application Information for LVN-Transition Application Requirements TEAS Information Required Tests/Immunizations Contact Information Application Checklist Employment History Student Application (10-16-15)

A Letter from our Program Director Dear Licensed Vocational Nurse Transition Option Candidate: Thank you for inquiring about the LVN Transition Option Program. Enclosed you will find program information, including the admission requirements and an admission application for the LVN-T Program. The LVN-T Program starts a new class once a year beginning in the Summer I semester (which usually begins about the third week in May). The LVN-T program is designed to be completed in one year. If you wish to be considered for admission into the program, you must submit evidence of meeting all of the application/admission requirements. The applicant is responsible to ensure all application information has been received at the Blinn College ADN Program office, and that their admission file is complete. If you have questions once you have reviewed the application packet please call 979-691-2012 or email timmye.posey@blinn.edu. Best wishes in the pursuit of a rewarding career in nursing through our Associate Degree Nursing Program at Blinn College. Sincerely, Michael W. Hutton, MSN, RN Director Associate Degree Nursing Program TAMHSC Clinical Building 1, Suite 2500 8441 State Highway 47 Bryan, Texas 77807 (979) 691-2012 Fax (979) 691-2410

APPLICATION INFORMATION FOR THE LVN-TRANSITION OPTION This application is a special option available for LVNs who meet specific admission criteria to complete the ADN Program requirements in one calendar year. Students admitted to the LVN Transition Option take five nursing courses (Transition - Theory and Clinical, Mental Health Theory and Clinical, and Nursing Skills II) during the summer then join 2 nd year generic nursing students in the Fall Semester. The program allows the applicant to have classes in progress when applying. All program prerequisites must be complete by the end of the semester in which you submit your nursing application. Decisions regarding acceptance are made at the end of the semester in which you apply. Applicants are notified of acceptance shortly after final grades are received or posted. All applicants are required to provide proof of current Texas licensure and work status when they submit their nursing application. If accepted into the program, then applicant must complete a drug screen, a health/physical exam, and provide proof of all required tests/immunizations required, at their own expense.

APPLICATION REQUIREMENTS FOR LVN-TRANSITION OPTION All of the following requirements must be fulfilled and evidence of their completion must be submitted. Failure to submit evidence of ALL application requirements will exclude the applicant from consideration for admission. The LVN must have current unrestricted license in Texas and must have approximately one year of nursing experience. All the prerequisites (including RNSG 1301 Pharmacology and RNSG 1215 Health Assessment) must be completed prior to admission. The Humanities/Fine Arts Elective is a co-requisite and may be taken after student receives admission to the program. Complete all admission requirements and be admitted to Blinn College (Please note that previous Blinn students who have not been enrolled in Blinn College for the previous Spring or Fall Semester must reapply to the college). All applicants must be TSI compliant. Submit a completed Associate Degree Nursing Application (LVN-Transition Option) to the ADN office. (NOTE: Admission to the ADN program is a separate process from admission to Blinn College and requires a separate application). Acceptance to Blinn College does not guarantee acceptance into the Associate Degree Nursing Program (LVN-Transition Option). Submit ALL official college/university transcripts with your nursing application to the ADN office. (NOTE: this includes Blinn College official transcripts). It is the applicant s responsibility to make sure official transcripts are also on file in the Admissions and Records Office at Blinn College. Highlight all courses on official transcripts that were listed on the Application Degree Worksheet (Page 3 of the application). You may open your official transcript in order to highlight courses. All prerequisites and co-requisites must be completed with a C or above and the minimum overall GPA for those prerequisites and co-requisites must be a 2.5. The three science courses (Anatomy & Physiology I, Anatomy & Physiology II, and Microbiology) must not be more than five years old when you submit your nursing application. Take the TEAS V for nursing (Test of Essential Academic Skills) administered by the Blinn College Testing Center. Please see the TEAS V information form in this packet for further details. The TEAS V must be completed prior to submitting nursing application and TEAS V score sheet must be included in nursing application packet. Student is ineligible for admission if ATI Academic Preparedness Level is Basic or Developmental. International Students must have passed all sections of TOEFL. Summer Admission Application due or postmarked by March 3rd (ADN Office will accept applications beginning January 4 th )

TEAS V (Test of Essential Academic Skills) for Nursing Description The Test of Essential Academic Skills (TEAS V) measures basic essential skills in the academic content area of reading, mathematics, science and English and language usage. The test is intended for use primarily with adult nursing program applicants. The objectives assessed on the TEAS V exam are those which nurse educators deemed most appropriate and relevant to measure entry level academic readiness of nursing program applicants. The time limit for the test is 209 minutes and is broken down as follows: Reading 58 minutes, Math 51 minutes, Science 66 minutes, and English 34 minutes. No calculators are allowed for the test. Preparing for the TEAS V for Nursing The following items are available for purchase from Assessment Technologies Institute (ATI) at www.atitesting.com. Learning Strategies: Your guide to Classroom and Test-Taking Success TEAS Pre-Test Study Manual TEAS Online Practice Assessments TEAS Transcripts ADN Program Instructions Applicant must take TEAS V prior to submitting your nursing application. Applicant must include your TEAS V score sheet in your application packet. Applicant may take TEAS V twice during an application period, but must test at least 4 weeks apart. All TEAS V testing must take place before nursing application due date. If applicant has taken the TEAS V for a different nursing program and wants to use those score results then applicant must make sure the test date is within twelve months of the application due date. If applicant resides out of town/state, the TEAS V may be taken at another educational institution or testing facility. The Blinn College Testing Center will no longer offer walk in testing on Saturdays. In order to register for a Saturday test students must prepay Monday Friday in Enrollment Services in Bryan only. Seating is limited! No forms of payment will be allowed on Saturday testing dates. Instructions for completing the TEAS V at the Blinn College campus in Bryan, Texas are found on the Blinn College website at http://www.blinn.edu/testing/teas.html.

Tests and Immunizations Required by Associate Degree Nursing Program The following is a list of tests and immunizations required by students who are accepted into the Associate Degree Nursing Program (LVN-Transition Option). All ADN applicants must provide documented proof of each requirement below in order to receive full admission into the nursing program. These documents will be required once student has been notified they are accepted into the program. Tuberculosis skin test should be done within 30 days of program start date. (NOTE: Hepatitis B testing and immunization can take several months and applicant needs to plan in advance to meet requirement). All documentation of the requirements below will be uploaded by each student to CertifiedBackground. CertifiedBackground is a company that serves as a repository for student medical records. Once a student pays a fee and sets up their student profile with CertifiedBackground they will be able to upload their medical records and then view those records. The program director and administrative assistant will also be able to view the medical records for each student to verify they have completed the requirements. Tuberculosis Skin Test (PPD-TB Test) OR Chest X-Ray (required if skin test is positive) MANDATORY: (skin test or x-ray must be within 6 months of program start date) Recommend student gets PPD test within 30 days of program start date. Student is required to receive PPD test annually while in the nursing program. Tetanus, Diphtheria, Pertussis (TDAP) MANDATORY: One Tdap Booster (within 10 years) Measles (Rubeola) MANDATORY: Those born on or after January 1, 1957, must show proof of either: A. Serologic test positive for measles antibody/immunity OR if necessary, without serologic evidence of immunity or prior vaccine: B. Two doses of MMR Vaccine at least 4 weeks apart Mumps MANDATORY: Those born on or after January 1, 1957, must show proof of either: A. Serologic test positive for mumps antibody/immunity OR if necessary, without serologic evidence of immunity or prior vaccine: B. Two doses of MMR Vaccine at least 4 weeks apart Rubella MANDATORY: Those born on or after January 1, 1957, must show proof of either: A. Serologic test positive for rubella antibody/immunity OR if necessary, without serologic evidence of immunity or prior vaccine: B. Two doses of MMR Vaccine at least 4 weeks apart Varicella (Chicken Pox) MANDATORY: must show proof of A. Serologic test positive for varicella antibody/immunity OR if necessary, without serologic evidence of immunity or prior vaccine B. Two doses of varicella at least 4 to 6 weeks apart Hepatitis B Immunity MANDATORY: There is potential of exposure to Hepatitis B during clinical assignments. All students must have had the Hepatitis B series of vaccinations. The CDC recommends (and we require) serologic testing for all Health Sciences Students, except Vet Tech students. Specifically, we require a quantitative Hepatitis B surface antibody (anti-hbs) to document immunity. If the test comes back with a protective concentration of less than 10 miu/ml, student needs to be revaccinated with 3 doses (over 4-6 months). This is followed by another serologic test for immunity 1-2 months after the third dose. Influenza MANDATORY: All healthcare providers and students in these professions will receive annual vaccination against influenza. One dose of influenza vaccine annually, live inactivated injectable influenza vaccine IM or live attenuated influenza vaccine (LAIV) intranasally (ONLY for non-pregnant, healthy HCP aged 49 or younger). Meningococcal (Meningitis) Vaccine (MCV4): MANDATORY FOR ALL NEW STUDENTS <22 YEARS OF AGE WHEN THE ACADEMIC TERM BEGINS. VACCINE MUST BE ADMINISTERED AT LEAST 10 DAYS PRIOR TO THE START OF THE SEMESTER. All students must follow Blinn s policy regarding the Bacterial Meningitis requirements. Go to www.blinn.edu/immunization.html for all information.

ASSOCIATE DEGREE NURSING Contact Information If you wish to mail your application, the mailing address is: Blinn College Associate Degree Nursing Texas A&M Health Science Center Clinical Building 1, Suite 2500 8441 State Highway 47 Bryan, Texas 77807 If you wish to deliver your application in person the address is: Blinn College Associate Degree Nursing Texas A&M Health Science Center Clinical Building 1, Room 3536 8441 State Highway 47 Bryan, Texas 77807 Contact Information: Phone: 979-691-2012 Fax: 979-691-2410 Email: timmye.posey@blinn.edu

ASSOCIATE DEGREE NURSING (LVN-Transition Option) APPLICATION CHECKLIST (Must be included with application) Please initial each item below and submit this checklist with the application packet. Submit the completed Application packet in the following order. 1. Application Checklist 2. Employment History 3. Completed Associate Degree Nursing Program Application (LVN-Transition Option) (3 pages) 4. TEAS V Score Sheet 5. Official Transcripts from Colleges/Universities with courses highlighted 6. Proof of current Texas licensure Please submit application packet in brown 9 x 12 envelope with your name on the envelope. Summer Admission Application due or postmarked by March 3rd (ADN Office will accept application beginning January 4 th ) I have read and understand all the requirements and pre-requisites for the Associate Degree Nursing Program (LVN-Transition Option). Applicant Printed Name Applicant Signature Date

Employment History (as an LVN) (Begin with the most recent years) Employer Name: Address: City: State: Zip: Phone Number: Employment Dates: From: To: Job Title: Job Responsibilities: Reason for Leaving: Address: City: State: Zip: Phone Number: Employment Dates: From: To: Job Title: Job Responsibilities: Reason for Leaving: Employer Name: Address: City: State: Zip: Phone Number: Employment Dates: From: To: Job Title: Job Responsibilities: Reason for Leaving: Employer Name: Address: City: State: Zip: Phone Number: Employment Dates: From: To: Job Title: Job Responsibilities: Reason for Leaving: Printed Name Signature

PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE Blinn College Health Sciences Programs Student Application NOTE: YOU MUST MAKE APPLICATION TO BLINN COLLEGE FOR CONSIDERATION FOR ANY OF THE HEALTH SCIENCES PROGRAMS Select the program of your choice: Associate Degree Nursing Licensed Vocational Nurse Transition to ADN Bryan Campus Vocational Nursing Physical Therapist Assistant Schulenburg Campus Dental Hygiene Radiologic Technology Paramedic Academy Veterinary Technology APPLICANTS WILL BE TESTED FOR DRUGS AND A CRIMINAL BACKGROUND CHECK WILL BE CONDUCTED. SPECIFIC PROGRAM REQUIREMENTS CAN BE ACCESSED FROM EACH PROGRAM S WEB-SITE AT www.blinn.edu/twe. Name Last First Middle Maiden Name Previous Name Mailing Address Number Street Apt. # City State Zip E-Mail Social Security No. - - Telephone ( ) Cell Phone ( ) Permanent Address Number Street Apt. # City State Zip Blinn ID# HAVE YOU PREVIOUSLY APPLIED TO A BLINN COLLEGE HEALTH SCIENCE PROGRAM? Which one? When? PREVIOUS EDUCATION Provide official transcripts from every College/University you have attended with this application (Including Blinn). It is your responsibility to also provide Blinn Admissions with an official transcript. You must also be a high school graduate or have obtained a GED to be admitted to any Health Sciences Program. Type of School Name of School Location (Complete Mailing Address) High School or GED College Number of Years/Hrs. Completed Major & Degree Is your Hepatitis B series complete? Yes No In Progress? Yes No Must have documentation of immunity for Hepatitis B (>10mIU/mL).

Name of employer Address City, State, Zip Code Phone Number Name of employer Address City, State, Zip Code Phone Number Name of employer Address City, State, Zip Code Phone Number Name of employer Address City, State, Zip Code Phone Number EMPLOYMENT (other than as an LVN) (Begin with the most recent years or attach a resume.) Employment Dates From To Employment Dates From To Employment Dates From To Employment Dates From To MAY WE CONTACT YOUR PRESENT EMPLOYER? Reason for Leaving Reason for Leaving Reason for Leaving Reason for Leaving PLEASE LIST TWO CONTACTS IN CASE OF EMERGENCY Name Relationship Telephone: (Home) (Cell) (Work) Name Relationship Telephone: (Home) (Cell) (Work) SIGNATURE I certify that the information, provided in this application, is correct and complete. I understand that omission or falsification of information is grounds for exclusion and dismissal. If accepted into the program, I agree to meet all entrance requirements and to conform and abide by the letter and spirit of the rules, regulations, and procedures of Blinn College and this program. Signature: Date: Please indicate the manner in which you found out about this program:

BLINN COLLEGE ASSOCIATE DEGREE NURSING (LVN-TRANSITION OPTION) APPLICATION DEGREE WORKSHEET STUDENT: BLINN ID # STUDENT PHONE #: NOTE: Please provide the necessary information in the blanks below. Attach official transcript(s), highlighting courses and grades to show where each grade was obtained. Indicate classes in progress by placing the current semester and year in the Sem/Yr column. COURSE # DESCRIPTION SEM/YR CREDIT SUBSTITUTED GRADE COLLEGE/UNIVERSITY COMPLETED HOUR COURSE # PREREQUISITES BIOL 2420 Microbiology for Non- Science Majors BIOL 2401 Anatomy & Physiology I BIOL 2402 Anatomy & Physiology II RNSG 1301 Pharmacology RNSG 1215 Health Assessment ENGL 1301 or 1302 Composition & Rhetoric PSYC 2301 General Psychology PSYC 2314 Lifespan Development RNSG 1513 Foundations for Nursing Practice 5 Satisfied by current unrestricted LVN/LPN License CO-REQUISITE *Humanities/Fine Arts Elective Literature, Philosophy, Art, Drama, Music, (Select one from list below) ** BONUS: Pathophysiology HPRS 2301 *Humanities/Fine Arts Elective (choose one from the following): (ENGL 2322, 2323, 2327, 2328, 2332, or 2333; ARTS 1301, 1303, or 1304, PHIL 1301 or 2306, DRAMA 1310, 2361, 2362, or 2366; MUSI 1301, 1306, 1308, or 1310). **BONUS: Applicant will receive 1 bonus point in total point calculation for admission if they have taken HPRS 2301 Pathophysiology (3 credit hour) and made a B or higher. Grade will not be calculated in total GPA for Prerequisites and Co-requisites above. Any proposed course substitutions on this degree worksheet are subject to review and verification by the appropriate Program Director & Vice President of Health Sciences. Institutions Attended Transcripts Sent to Blinn College Admissions Yes No Yes No Yes No FOR OFFICE USE ONLY: TSI Initiative: Reading TOEFL Writing (International Students only) Math