INFORMATION & APPLICATION PACKET
2008 – 2009
PERIOPERATIVE NURSING
Certificate of Completion
CLASSES BEGIN EVERY FALL SEMESTER!
108 N 40th Street
Phoenix, AZ 85034-1704
Phone 602.286.8000
www. g a t e wa y c c . e d u
Perioperative Nursing
2
Dec 08
108 N 40th Street
Phoenix, AZ 85034-1704
Phone 602.286.8000
www. g a t e wa y c c . e d u
Dear Registered Nurse: Welcome to the GateWay Community College Perioperative Nursing Program. As a registered nurse, this program will allow you to gain skill and understanding about how to provide quality care to the patient in Pre-op Holding, the Operating Room, and the Post Anesthesia Care Unit. The foundation of this course is a ten-week hybrid format. The student will work from home. During the on-line portion of this course you will study instrumentation, medications, aseptic technique, scrubbing, gowning, gloving, opening surgical suites for a procedure, how to collaborate with team members, prepping, draping, types of procedures, how to attend to specialty populations in the operating room and much more. A lab will accompany the on-line lecture delivery for hands on experience in the O.R. setting. During this initial seven weeks you will attend a clinical day once per week. At the hospital you will gain experience with a preceptor in departments such as the SPD or Hospital Central Sterile, Decontamination, and Processing. Here you will also learn how to build case carts and a tour of the operating room with a scavenger hunt. During the last eight weeks of the program you will be in the clinical arena five days per week. This clinical experience will entail three weeks of second scrubbing with a Surgical Technician in the operating room and five weeks of second circulating with a Circulating Nurse in the operating room. As the circulator you will learn how to attend for the patient throughout the entire perioperative process. The program is taught by faculty currently working in the perioperative services. Whether you are new, returning, or currently working in this field, completion of this program will allow you to become familiar and have a working knowledge of perioperative nursing. You may register at any time throughout the year. Classes begin twice a year in the fall and spring semesters. Complete the application form in this packet and mail it or return it to Admissions and Records/Selective Admissions. Thank you for coming to GateWay Community College and learning about how the Perioperative Nursing Program will assist you in ‘Making Your Career Move’. Sincerely,
Susan Wallen
Susan Wallen, RN, MS Program Director 602.286.8515 susan.wallen@gwmail.maricopa.edu
A Maricopa Community College
Perioperative Nursing 3 Dec 08
TABLE OF CONTENTS
Information and Application Guide Student Services Policies, Rules, and Regulatory Compliance / Application Process Certificate of Completion Estimated Program Costs Application for Admission Affirmative Action Data Form Request for Official Transcripts 4 4 5 5 6 7–8 9 – 10 11
INFORMATION & APPLICATION GUIDE
Welcome to the Perioperative Nursing Program At GateWay Community College If you have any questions about the enclosed program material, please feel free to contact any of the following program contacts: Susan Wallen, RN, MS, Program Director / Phone 602.286.8515 / E-mail susan.wallen@gwmail.maricopa.edu Caroline Delgado, Health Sciences Advisor / Phone 602.286.8183 / Email: delgado@gwmail.maricopa.edu Ruth Major, Health Sciences Advisor / Phone: 602.286.8176 / E-mail: ruth.major@gwmail.maricopa.edu
STUDENT SERVICES
The following are some of the services available to students. Advising – Available in the Center for Health Education Careers, 602.286.8183 or 602.286.8176. Counseling – Academic, personal, or career counseling available. Call 602.286.8900. Financial Aid – Available for qualified students. Contact the Financial Aid Office at 602.286.8300 or visit website: http://enroll.gatewaycc.edu/FinancialAid/ApplyForFinancialAid/default.htm Tutoring Assistance – Available though the Learning Center, 602.286.8800. Employment – Upon completion of the Perioperative Nursing Program, contact the Career & Re-Entry Services, at 602.286.8500 for assistance. Assessment Center – Services include instructor makeup exams, the English, Math, and Reading ASSET or COMPASS placement tests, and selected instruments required for acceptance into the Health Science or Nursing programs. Call 602.286.8160 for specific days and times tests are available. Bookstore / Textbooks – A list of required textbooks will be given to admitted applicants with their admittance letter. All textbooks and supplies for classes are available at the college bookstore. You can call 602.286.8400 or visit their website at: www.efollett.com and selecting “College Textbooks”.
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POLICIES, RULES, & REGULATIONS COMPLIANCE
Policies, courses, programs, fees, and requirements may be suspended, deleted, restricted, supplemented, or changed through actions of the Governing Board of the Maricopa County Community College District. The Maricopa Community College District reserves the right to change, without notice, any materials, information, curriculum, requirements, and regulations.
APPLICATION PROCEDURES
This Packet has been designed to provide you with information and application procedures for the Perioperative Nursing Program. Read all information carefully as it is your responsibility to make sure the application is complete. Application Process: Step 1Step 2Application For Admission To The College: This is required of all new and former students. Complete and submit to the Admissions Office in the Student Services Building. PERIOPERATIVE NURSING APPLICATION: A Completed application, a photocopy of your RN License and CPR Health Provider Card should to submitted to Admissions and Records/Selective Admissions PHYSICAL EXAMINATION FORM: Non-sponsored student (s) must submit a completed health declaration form, including immunizations(s) no later than the first day of class.
Step 3-
CERTIFICATE OF COMPLETION PERIOPERATIVE NURSING
Program Notes: Students must earn a grade of "C" or better for all courses required within the program. + indicates course has prerequisites and/or co-requisites. Students with other related health care experiences not listed on the following Program Prerequisites options may request an evaluation for course competency equivalence through the Integrated Competency Assessment Network (ICAN) by calling 480.731.8924. Admission Criteria: Formal application and admission to the program is required Current Arizona Registered Nurse (R.N.) license Current Healthcare Provider CPR card Current fingerprinting clearance card Required Courses: Credits: 11 PON210+ PON212+ PON214+ PON220+ PeriOperative Principles I PeriOperative Principles II PeriOperative Laboratory PeriOperative Clinical Practice Total Credit Hours CREDITS 3.0 3.0 1.0 4.0 11.0
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ESTIMATED PROGRAM COSTS
The estimated cost for the program is approximately $1,384.95 including tuition, fees, books and liability insurance for Maricopa County residents. The student is responsible for providing transportation and uniforms. In the last semester, the student will be responsible for costs of his/her national board exam and state licensing.
Cost Breakdown: (All costs subject to change)* Tuition (May be as much as 11 credit hrs @ $71 a credit hr effective 07/01/08)* .......... Registration Fee .................................................................................................. Lab Fee ............................................................................................................... Textbooks (notebooks, pens, etc.) ...................................................................... Alexander’s Care of the Patient in Surgery (2003) ...................................... AORN 2003 Standards ................................................................................. Drug Screening ** ................................................................................................ Fingerprinting and Background check ** ............................................................. $ 781.00 15.00 125.00 200.00 79.95 75.00 44.00 65.00 $ 1,384.95
* **
Tuition and fees are set by the Maricopa Community College Governing Board and approved by the State Board of Directors for Community Colleges; all fees are subject to change. COSTS ARE APPROXIMATED AND WILL BE THE RESPONSIBILITY OF THE STUDENT.
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APPLICATION FOR ADMISSION PERIOPERATIVE NURSING PROGRAM GATEWAY COMMUNITY COLLEGE 108 N 40th St / Phoenix, AZ 85034-1704 / 602.286.8000 Please print clearly
I PLAN TO BEGIN THE PROGRAM IN: FALL SPRING
LEGAL NAME (LAST)
(FIRST)
(MIDDLE)
ADDRESS (STREET)
(CITY)
(STATE)
(ZIP)
FORMER NAME(S) which may appear on transcript
HOME PHONE NUMBER
CELL PHONE NUMBER
E-MAIL ADDRESS
SOCIAL SECURITY NUMBER
DATE OF BIRTH
PERSON TO NOTIFY IN CASE OF EMERGENCY
PHONE
ADDRESS
ARIZONA NURSING LICENSE NUMBER
LICENSE EXPIRATION DATE
NAME OF NURSING EDUCATIONAL PROGRAM
CITY & STATE
Graduated:
Year Yes
Diploma No
A.D.N.
B.S.N.
Are you currently enrolled in college? If “YES”, where?
PLEASE RETURN YOUR APPLICATION and TRANSCRIPTS TO: GATEWAY COMMUNITY COLLEGE ADMISSIONS AND RECORDS 108 N 40th ST / PHOENIX, AZ 85034-1704
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APPLICATION FOR ADMISSION PERIOPERATIVE NURSING PROGRAM (cont’d)
PREVIOUS COLLEGES OR TECHNICAL SCHOOLS ATTENDED: NAME OF INSTITUTION CITY AND STATE DATE OF ENTRANCE DIPLOMA OR DEGREE RECEIVED NAME OF INSTITUTION CITY AND STATE DATE OF ENTRANCE DIPLOMA OR DEGREE RECEIVED NAME OF INSTITUTION CITY AND STATE DATE OF ENTRANCE DIPLOMA OR DEGREE RECEIVED DATE OF LEAVING COLLEGE MAJOR DATE OF LEAVING COLLEGE MAJOR DATE OF LEAVING COLLEGE MAJOR
Attach separate sheet if additional space is needed
LIST ALL HEALTH EXPERIENCE RELATED EMPLOYMENT: STARTING WITH MOST RECENT AND WORKING BACK, LIST EMPLOYERS:
OCCUPATION EMPLOYER ADDRESS NAME OF SUPERVISOR REASON FOR LEAVING OCCUPATION EMPLOYER ADDRESS NAME OF SUPERVISOR REASON FOR LEAVING OCCUPATION EMPLOYER ADDRESS NAME OF SUPERVISOR REASON FOR LEAVING FROM TO FROM TO FROM TO
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AFFIRMATIVE ACTION DATA FORM PERIOPERATIVE NURSING PROGRAM
Based upon Federal Reporting requirements, with which Gateway Community College is attempting to comply, we are requesting that you provide us with the information requested below. This information will be used for statistical purposes only and will be retained independent of your application, In this regard, this information will be used in the review of materials for selection. It will neither change nor impede your receipt of favorable consideration. Although you submission of the requested information is optional, your cooperation in this manner will be most helpful to Gateway Community College. Please return this form with your application to the program for which you are applying.
NAME:
PROGRAM APPLYING FOR (Please check One): Medical Radiography Respiratory Technician Respiratory Therapist Pharmacy Technology Surgical Technology Hospital Central Service Perioperative Nursing
SEMESTER (Please Check One): YEAR APPLYING FOR:
Fall /
Spring
PLEASE CHECK ALL ITEMS, WHICH APPLY TO YOU: (Optional) Female / White Native American Other (Please Specify) Male Black Asian or Pacific Islander Hispanic
Handicapped (Nature of Handicap)
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REQUEST FOR OFFICIAL TRANSCRIPT
DATE
TO
Name of School
Please send one (1) OFFICIAL copy of my transcript to: AD M I S S I O N S AN D R E C O R D S GateWay Community College 108 N 40th Street Phoenix, AZ 85034-1704
I am enclosing $
LEGAL NAME ADDRESS FORMER NAMES SOCIAL SECURITY NUMBER STUDENT'S SIGNATURE
to cover costs.
DATES ATTENDED
DATE
TO
Name of School
Please send one (1) OFFICIAL copy of my transcript to: AD M I S S I O N S AN D R E C O R D S GateWay Community College 108 N 40th Street Phoenix, AZ 85034-1704
I am enclosing $
LEGAL NAME ADDRESS FORMER NAMES SOCIAL SECURITY NUMBER STUDENT'S SIGNATURE
to cover costs.
DATES ATTENDED
May Copy as Necessary.
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