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A L E R T !

This program/curriculum guide is

revised each semester.

Please check the nursing web page for updates at

www.jefferson.kctcs.edu/nursing

Practical Nursing Program

Program/Curriculum Guide

Admission Information for Fall 2016

Accreditation:

The Practical Nursing (PN) Program of Jefferson Community and Technical College (JCTC) is approved by the Kentucky Board of Nursing (KBN). Upon completion of the program of study, the graduate is awarded a diploma of practical nursing and is eligible to write the National Licensure Examination (NCLEX – PN) to become a Licensed Practical Nurse (LPN).

Campus Location:

The Practical Nursing Program is taught on the Downtown Campus.

 Mailing address: 109 East Broadway, HSH 442, Louisville, KY 40202

 Physical address: 110 W Chestnut Street, Health Sciences Hall, Building A-South, room 442, Louisville, KY 40202.

Deadlines for submission of an application, for admission to the PN Program

October 1

,

for applying to the spring semester (classes beginning in January)

April 1

,

for applying to the fall semester (classes beginning in August)

1. Applications that are received early are very much appreciated.

2. Applications that are received late will result in placing that applicant on the alternate list. This means that we will fill the class with eligible students that have met all requirements first. If any of these accepted students decline our invitation to attend the PN program, then we will fill their seats with students from the alternate list.

Discrimination Statement:

Jefferson Community and Technical College does not discriminate on the basis of race, color, national origin, age, marital status, sex or handicap in employment, educational programs or activities as set forth in Title IX of the Educational Amendment of 1972, Title VI of the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973.

Required Psychomotor Functions:

Nursing at the technical level involves the provision of direct care for individuals and is characterized by the application of verified knowledge in the skillful performance of nursing functions. Therefore, in order to be considered for admission or to be retained in the program after admission, all applicants should possess sufficient:

1. visual acuity, such as is needed in the preparation and administration of medications and for the observation required for patient assessment and nursing care;

2. auditory perception to receive verbal communication from patients and members of the health team and to assess health needs of people through the use of monitoring devices such as monitors, stethoscopes, intravenous infusion pumps, Doppler’s, fire alarms, etc.;

3. gross and fine motor coordination to respond promptly and to implement the skills, including the manipulation of equipment required to meet health needs;

4. communication skills (speech, reading, writing) to interact with individuals and to communicate their needs promptly and effectively, as may be necessary in the individual’s interest; and,

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Table of Contents

Headings

Page

Cover page:

 Accreditation  Campus location

Deadlines for Submission of Application to the PN Program

 Discrimination Statement

Required Psychomotor Functions

1

Nursing Information Session (informal and presented by the Master Nursing Advisor)

Nursing Advising (schedule appointments well in advance of application)

3

Pre-requisites Requirements

Curriculum

PN Program Courses

PN Co-requisites Requirements (General Education Courses)

4

 Program Requirements for Admission

5 & 6

 Preference for Admission

 Admission Policy to the PN Program

6

Application to the College (Information) Submission of PN Application Instructions

Notification of Application Status (Students will be notified by mail the last week of June

when applying for the fall classes and by the last week of November when applying for the spring semester.)

 Costs and Financial Aid (Information)

7

Requirements Following Admission

 Background Check and Drug Screening

 Basic Life Support

 Immunizations and Physical Examination

 Mandatory Orientation

8 & 9

Requirements Following Graduation:

 Kentucky Board of Nursing (KBN) Requirements

9

Readmission Process to the Practical Nursing Program

10

Readmission Application to the Practical Nursing Program

Readmission application deadline at 12:00 PM-Noon on Tuesday following Finals week

11

 BLS-Basic Life Support Certification or Re-certification Information (CPR)

12

 Directory/Contact Information:

Advising and Academic Counselors

 Assessment Center

 Bookstore at JCTC (Barnes & Noble)

 Financial Aid Office

Workforce Solutions Office (to obtain information on MNA training & Testing)

 Nursing Division Office (Nursing Programs)

 Student Service Center

13

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Preliminary Nursing Information Sessions and

Scheduling Individual Nursing Advising Appointments Preliminary Nursing Information Sessions

When Nursing Information Sessions are scheduled, they are posted at www.Jefferson.KCTCS.edu/nursing Informal pre-nursing information sessions are held by the nursing advisor at approximately biweekly intervals during the fall and first half of the spring semester. Preregistration is not necessary. It is strongly recommended that potential applicants attend one of these sessions at least one full semester prior to starting the application process to the JCTC Associate Degree Nursing Program.

Please bring a copy of all unofficial transcripts to the session, including KCTCS/JCTC transcripts.

Nursing Advising Appointment in the Advising Center Master Nursing Advisor, Demetrius Langley Contact by email at [email protected]

Jefferson Education Center, 200 W Broadway, building F, room 606, Phone: 502-213-2196 (Located at the intersection of 2nd & Broadway, directly across Broadway from McDonalds)

For individual advising sessions, please schedule appointments well in advance of registration dates or stop by during walk-in advising on Wednesdays and Thursdays. Nursing Advisors are not available during open registration and

applications for the nursing program are taken months in advance for the upcoming semesters.

Bring the following to the advising appointment:

1) Unofficial transcripts from all other colleges you have attended. Even if official transcripts have been sent to JCTC or KCTCS, all transfer coursework transcripts should be printed out from the original school.

a) If a college is out of the Kentuckiana area, bring course descriptions for relevant courses. Proof of regional accreditation is required for any out of state colleges from which student plans to transfer course credit.

b) Transcripts from other schools must display the name of the issuing college, the name of the student, the date that it was printed, dates for the coursework grades and hours earned for the course.

c) Do not have an official transcript mailed to the Nursing Program; instead, print out an online, unofficial student transcript or have a copy mailed to you. You will need a copy to attach to the application form when you apply to the nursing program.

2) A printed copy of your JCTC or KCTCS transcript showing the classes you have taken at JCTC or other KCTCS schools, if applicable.

a) Transcripts from KCTCS colleges can be printed by going to www.Jefferson.kctcs.edu then select “Student Self-Service”. From left column, select “Self-Service”, then select “Academic Records”.

b) If transfer credit has been previously evaluated by the registrar, please include them on JCTC transcript. To do this, it may be necessary to print a separate report from your JCTC Student Self-Service by following this process: same as 2a, then select “Transfer Credit”

3) NLN RN Preadmission Exam (PAX-RN) scoring report, if you have already taken the exam and only if you intend to apply for the Associate Degree Nursing Program. This is not a requirement for the Practical Nursing Program.

4) Any previous advising information, including previous Academic Program Plans (APP), if applicable. 5) Please be on time. If you need to cancel or reschedule, please call the Advising Center at 502-213-2277. 6) The Program/Curriculum Guide at www.Jefferson.KCTCS.edu/nursingshould be reviewed before an advising

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PRE-REQUISITE REQUIREMENTS

1. High School Graduate or Equivalent

2. Verification of Computer (Digital) Literacy (with a grade of C or higher). Or IC3-Fast Track computer challenge exam with a minimum score of 750 (75%). See page 5 for details.

3. KY State Registered Nurse Aide (SRNA) Certification. Or complete HST 104-Healthcare Basic Skills Clinical with a grade of “C “or higher. See page 6 for details.

4. Students who have not had previous college courses must take FYE 105 (First Year Experience) or its equivalent.

1. For students interested in bridging to the Associate Degree Nursing (A.D.N.) Program, it is recommended that instead of taking PN co-requisites (AHS 100, BIO 135 & TEC 200), taking the following:

BIO 137 and BIO 139; PSY 110 and PSY 223; also, COM 252 or COM 181 or ENG 101 (these transfer to the A.D.N. Program)

2. If bridging to the A.D.N. program and applying to the PN program, you must have completed PSY 110 prior to enrollment in the first semester of PN courses and take PSY 223 along with the PN classes or earlier. The same is true for BIO 137 and BIO 139; you must have completed BIO 137 prior to enrollment in the first semester PN courses and take BIO 139 along with PN classes or earlier. a. BIO 135 or BIO 137 and BIO 139 must be taken within 10 years of the semester of application to the PN program.

3. Co-requisites (general education/non-NPN classes) may be taken before enrollment into the PN program. Or taken during or before the designated semester listed in the Curriculum below. Students are given preference for admission by having all pre-requisites and co-requisites completed.

CURRICULUM

PROGRAM COURSES and CO-REQUISITE COURSES

To progress through the program, students must earn a grade of C or higher in each of the following courses.

PN Program courses are bolded General Education Co-requisites are in blue font-italics. We highly recommend taking most co-requisites prior to being enrolled into the PN Program if possible.

First Semester Credit hours

AHS 100-Growth & Development or PSY 223-Developmental Psychology (prerequisite PSY 110) 2-3 BIO 135 - Basic Anatomy & Physiology or BIO 139-A & P II (prerequisite BIO 137) 4

NPN 100 - Introduction to Nursing and the Health Care System 2

NPN 105 - Development of the Care Giver Role 6

NPN 110 - Pharmacology I 2__

16-17 Second Semester

NPN 201 - Child Bearing Family 3

NPN 125 - Mental Health 3

NPN 130 - Pharmacology II * 3

NPN 135 - Introductions to Health Deviations * & **** 6 15 Third Semester

NPN 200 - Medical-Surgical Nursing I ** 5

NPN 205 - Medical-Surgical Nursing II *** 5

NPN 210 - Clinical Practicum *** & ***** 4

NPN 215 - Nursing Trends and Issues 1

TEC 200--Technical Communications or ENG 101--Writing I or

COM 252--Intro to Interpersonal Communication or COM 181--Basic Public Speaking 3 18

Total Credit Hours for the Program Credit Hours 49-50

* Failure of NPN 130 will necessitate the student to withdraw from NPN 135, due to the inability of the student to meet the clinical

requirement of administering medications to patients.

** Failure in NPN 200 necessitates the student to withdraw from NPN 205 & 210. *** Failure in NPN 205 necessitated the student to withdraw from NPN 210.

**** Students will complete a mid-curricular exam as part of the course grade. Additional information will be given at the beginning of

the course.

***** Students will be required to successfully complete a standardized examination that is comprehensive of the entire

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Program Requirements for Admission:

Students seeking admission to the Practical Nursing (PN) Program must submit and/or meet the following: 1. Submit an application form for admission to the PN Program (see last page for application). Please note that

applying to the college is a separate process from applying to the PN Program (page 7).

2. Submit an official high school transcript indicating that the applicant has or will complete the high school course of study, or a passing GED official score report. This documentation is only required if you have not completed a minimum of 12 credit hours of any college level courses.

3. Submit unofficial transcripts of post-secondary work completed at any institution of higher education along with your application to the PN Program. Also, an official transcript of course work completed at another institution should be sent to the college Registrar's Office if you have not already done so. To be eligible for transfer credit, the course work must have been completed at an accredited institution, the transcript must be

evaluated by the college and the course accepted as replacement of a required course. Acceptance of general education courses is determined by the college Registrar’s office.

a. If a general education course does not have an equivalent transfer credit, please submit a copy of the course descriptions of completed courses from the catalog, of the college from which the student wishes to transfer. Determination of equivalency for nursing courses will be decided by the PN Program Coordinator. b. The course description must indicate the semester and year that the course was taken. Only transfer

credits towards the PN program need a course description.

4. Applicants must have a cumulative grade point average (GPA) of at least a 2.0 on all college work. 5. Course work to be applied toward the PN diploma must be earned with a grade of C or higher.

BIO 135 or BIO 137 and BIO 139 must be taken within 10 years of the semester of application to the PN program.

6. Applicants who have not had previous college courses must take FYE 105 (First Year Experience) or its equivalent.

7. Applicants must have documented minimum ACT composite score of 19 with subcategory scores as follows:

ACT Reading–20, ACT Mathematics–19 and ACT English–18

Or

Compass test scores at the following minimum level:

Compass Reading–85, Compass Math (Algebra category)–36, and Writing (English)–74

If the above ACT or Compass scores are not obtained, further developmental classes must be taken or retest to achieve the required scores.

8. All applicants will have to provide proof of digital computer literacy. This requirement can be met by completing CIT 105, OST 105 or equivalent, with a grade of “C” or higher.

Or students may take IC3-Fast Track computer challenge exam with a minimum score of 750 (75%). This

exam can be purchased in the JCTC Barnes and Noble Bookstore located in the Hartford Hall, building C, at 649 South 1st Street, in the lower level. You will receive a payment voucher that includes a code. Take the

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Program Requirements for Admission (continued):

9. Applicants may take HST 104-Healthcare Basic Skills Clinical class (earning a grade of C or higher) in lieu of SRNA. HST 104 includes BLS/CPR certification. HST 104 must be completed in the spring semester or

earlier, for the following fall semester’sapplication. Or completed in fall semester or earlier, for the following

spring semester’s application.

Or if not taking HST 104, applicants must provide documentation of their Kentucky State Registered Nursing Aide (SRNA) licensure status. Commonly referred to as Medicaid Nurse Aide (M.N.A.) or Certified Nurse Aide

(C.N.A.). Completing the nurse aide course (with course testing) does not constitute state certification. Students must successfully complete the state certification exam in order to be placed on the state registry. Posting of state registry can take up to 30 days after the state certification exam. Validation from the

Kentucky Board of Nursing (KBN) web site must also state that the applicant is not on the abuse registry. Verification can be found on the KBN website at: https://secure.kentucky.gov/kbn/bulkvalidation/basic.aspx a. If an applicant has already tested and is awaiting inclusion on the Kentucky Nurse Aide Registry at the time

that the application to the PN Program is due, that student must include a statement of when the Nurse Aide testing was completed along with the PN Program application. Then documentation of proof of certification with inclusion on the Registry must be submitted 14 days prior to the 1st day of class. Test

scores will not be accepted.

b. Further information on classes and registering for testing dates can be obtained through the Workforce Solutions Office located at 101 W. Broadway, (building E, 2nd floor), Louisville, KY 40202.

JCTC also offers MNA training at the following campuses; please call for class schedules:

 JCTC at the Downtown Louisville Campus: 502-213-4297

 JCTC at the Carrollton Campus: 502-213-5201

 JCTC at the Shelby County Campus: 502-213-3626

Preference for admission may be given to those applicants who:

1. are veterans, active duty personnel, their spouses, and also displaced workers who qualify under the Trade Adjustment Act;

2. have completed 12 or more credit hours in the Practical Nursing approved curriculum from an accredited college or university with a cumulative grade point average (GPA) of 3.0 or higher;

3. have completed all general education pre-requisite and co-requisite classes;

4. achieve Assessment and Placement entry level scores to allow placement for college level courses (not score as still needing developmental level courses); and,

5. demonstrate above average standing in high school or on the General Education Development (GED) exam.

Admission Policy to the PN Program:

 Admission to the PN Program is by selective admission. The application process to the program is open to all qualified students. A Selective Admission’s Committee reviews application files.

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Application to the College:

Application to the college is a separate process from application to the PN Program. There is no application fee to apply to the college or the PN Program. To apply to the college, go to www.Jefferson.KCTCS.edu and select the

“APPLY NOW” link, then follow the instructions.

Submission of PN Application Instructions:

The following must be submitted when applying:

1. Application form filled out completely (see last page for application form) 2. Unofficial copies of all transcripts

3. Digital computer literacy, grade of C or higher on transcript. Or IC3 Fast-Track score of 750 or higher. 4. HST 104-Healthcare Basic Skills Clinical, grade of C or higher Or verification of Kentucky State Registered

Nurse Aide (SRNA)

5. Academic Program Plan (APP), which can be obtained by attending one of the Nursing Information

Sessions (see page 3 for details). Or by scheduling an appointment with Demetrius Langley, Master Nursing Advisor at 502-213-2277. Or contact Evelyn Lichtsteiner, Nursing Division Assistant at 502-213-2192.

Mailing Address:

Evelyn Lichtsteiner

Practical Nursing Application

Jefferson Community and Technical College 109 East Broadway, HSH 442

Louisville, KY 40202

or

Hand deliver to this Physical Address:

Evelyn Lichtsteiner

Practical Nursing Application

110 West Chestnut Street, Building A-South Health Sciences Hall (HSH), Room 442 Louisville, KY 40202

All required documents may also be scanned & emailed to [email protected] An email reply from Evelyn confirms receipt of application. It doesn’t confirm application is complete or all requirements have been met.

Notification of Admission’s Status:

Applicants will be notified in writing of their admission status to the program usually by the last week of June when applying for the fall classes and by the last week of November when applying for the spring semester. An email will also be sent to applicants letting them know the exact date letters were mailed. The admission status will not be given to applicants by phone.

 Letters will be sent to the address listed on the application. It is the applicant’s responsibility to notify the PN Program in writing or email, of any change of address. Email to [email protected]

Costs and Financial Aid Information:

1. Tuition and fees may be found on the Jefferson Community and Technical College web site at http://jefferson.kctcs.edu/en/costs_and_financial_aid/tuition_and_fees.aspx

2. A cost estimation of the PN Program can be found at www.jefferson.kctcs.edu/nursing then select Practical Nursing Program. Another window opens and under the heading of “Information Links” is the Cost Estimation of Practical Nursing Program

3. In addition to tuition, books, uniforms, skills kits and other items required in the clinical area, nursing students are responsible for transportation to the various health agencies.

4. A liability insurance fee of $11.00 will be posted to students financial accounts each semester they are enrolled in a Practical Nursing class that has a clinical component.

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Transfer from another Practical N

ursing

program:

Applicants who have completed at least one semester of another Practical Nursing Program within KCTCS that teaches the same curriculum plan must:

1. Meet all admission requirements of the program in effect at the time of application;

2. Notify the Jefferson Community and Technical College’s PN Program Coordinator in writing of request to transfer, the course to which they are seeking admission and the reason for the transfer;

3. Submit official and unofficial copies of their transcript;

4. Apply for the criminal background check and take the drug screen by the deadlines listed in the letter granting approval to transfer; and,

5. Submit the Immunization and Physical Examination verification form by the deadline indicated in the letter granting approval to transfer.

Students who have attended a Practical Nursing Program that is not a member of KCTCS must meet the above listed criteria and additionally submit a copy of the course descriptions of completed courses from the catalog of the college from which the student wishes to transfer. Determination of equivalency for nursing courses will be decided by the PN Program Coordinator. Acceptance of general education courses is determined by the college Registrar’s office.

Students who have been granted approval to transfer will be required to attend the mandatory orientation for students who have been newly admitted to the PN Program. This orientation is held at a date prior to the beginning of classes for the semester and students will be notified by mail.

If more than three (3) years have elapsed since initial enrollment in the first nursing course in any Practical

Nursing Program, the applicant must repeat all nursing courses at Jefferson Community and Technical College.

Requirements following admission:

1. Background Check and Drug Screening:

a. Completion of criminal background check (instructions and a deadline date will be specified in the students’ letter of acceptance to the PN Program). If clinical placement is not possible due to a criminal record, the Program Coordinator will notify the student in writing and the student will be permitted to withdraw rather than failing the course due to the inability to fulfill course requirements.

b. Completion of required drug screen (instructions and deadline will be specified in the students’ letter of acceptance to the PN Program).

c. Failure to comply by the specified deadlines may result in the student’s removal from the class roster.

2. Basic Life Support (BLS):

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Requirements following admission (continued):

3. Immunizations:

Once the student is formally admitted to the program, they must submit a Physical Examination form and verification of immunizations, which must be signed by the health care provider.

a. Instructions and a deadline date for submission of the PN Programs Physical Examination form and verification of immunizations, will be specified in the students’ letter of acceptance to the PN Program.

b. Do not submit immunization records along with your application; they will not be processed.

c. Required Vaccinations: Influenza Vaccine during flu season, MMR (Measles, Mumps, Rubella), TB (Tuberculosis) Test-annually, T-dap (Tetanus, Diphtheria and Pertussis), Varicella (Chicken Pox), and Hepatitis B Vaccination (series of 3 doses).

d. TB Skin Test and CPR: It is the student’s responsibility to maintain current CPR certification and updated annual TB skin testing and keep a copy with them in a folder during class and clinical times.

e. No student may attend clinical orientation if above items are not current.

4. Orientation:

Students will be notified of the date, time, and location of the mandatory orientation session with the Program Coordinator or his/her designee. Attendance at the orientation is required, as vital information concerning the program is distributed. Failure to attend will result in the student’s removal from the class roster, unless documentation of an emergency situation is presented to the PN Program Coordinator prior to the date of orientation. Examples of such events include; life threatening illness of the student or immediate family member, death of an immediate family member, etc. This orientation is held at a date prior to the beginning of classes for the semester. The date will be included in the students’ letter of acceptance to the PN Program.

Requirements Following Graduation:

Kentucky Board of Nursing (KBN) Requirements: (This process will be reviewed during the third semester of the PN program.

Graduates of nursing programs must complete a computerized jurisprudence exam prior to being licensed. A study guide is available in order for graduates to prepare. Additionally, KBN may deny a nursing graduate the right to take the NCLEX- PN (licensing examination to become a licensed practical nurse) if an individual has ever been convicted of a misdemeanor or felony that involved acts that bear directly on the qualifications or the ability of the graduate to practice nursing. In addition to meeting the program’s academic requirements, graduates must conform to this requirement in order to be licensed as a practical nurse in the Commonwealth of Kentucky.

Information concerning the application process for licensure will be disseminated in a special session with the Program Coordinator prior to graduation from the program.

Additionally, KBN requires that students complete a minimum of 120 contact hours of patient care within the third semester of the PN program’s curriculum. Students who delay taking a required general education

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Readmission Process to the Practical Nursing (PN) Program:

In the event that an applicant withdraws from, or is unsuccessful in a nursing course and desires to be readmitted the following semester, the information listed below must be submitted to the PN Program Coordinator no later

than noon on the Tuesday following finals week (month of May when applying for readmission to the fall

semester and month of December for spring semester readmission):

1. application for readmission to the Practical Nursing Program is located on the next page;

2. a letter written by the student, to the committee explaining the circumstances or factors that lead to the student’s withdrawing from or being unsuccessful in the course and the plan for resolving the issues that lead to unsuccessful completion of the course;

3. the student must ask two (2) Practical Nursing instructors for letters of recommendation. At least one of the 2 letters of recommendation must be from an instructor that taught in the class that the student had failed, if applicable. In the case where a student had to withdraw due to a reason other than failure, any PN instructor may write the letter of recommendation.

4. evidence of remedial work (referral) as recommended by the faculty of the course not completed, if applicable; 5. confirmation that the student is currently or was previously listed on Kentucky Board of Nursing’s register as State

Registered Nurse Aide (SRNA) or student has received a grade of C or higher, in HST 104-Healthcare Basic Skills Clinical, listed on their KCTCS transcript;

6. confirmation that BLS certification is current (CPR card must say Healthcare Provider or Professional Rescuer); and,

7. additional immunization and health record form completed by a physician or nurse practitioner if the initial form was submitted over 1 year previously.

Any student that has sat out more than one semester, who is readmitted to the PN Program, must submit

confirmation of an additional negative drug screen prior to the beginning of the class to which the student is seeking readmission. Detailed information will be included in the acceptance letter to be readmitted.

There is no guarantee for re-admission. The decision to re-admit an applicant is made by the Selective

Admissions Committee based upon one or more of the following factors: recommendation of the faculty, review of transcripts and previous course grades, performance in the lecture /lab/ clinical areas and/or availability of space in the class.

An applicant may be eligible for readmission to the PN Program one timepending the student’s submission of sufficient evidence of remedial study, additional preparation or resolution of the factors contributing to unsuccessful course completion. Only under extreme circumstances would a second readmission be considered. Examples of such circumstances would be life threatening illness and hospitalization of the student, loss of housing due to a natural disaster, etc.

If more than three years have elapsed since the initial enrollment in the first nursing course of any practical

nursing program, the applicant must repeat all nursing courses.

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RE-ADMISSION APPLICATION

Downtown Louisville Campus

Use this form only to apply for re-admission if you withdrew or failed from JCTC’s Practical Nursing course/s. Application DEADLINE: due no later than noon on Tuesday following finals week, to apply for the following semester.

Today’s Date: _______________________________

Semester reapplying for: Fall (August)

[ ]

or Spring (January)

[ ]

and Year:

_________

Names (Last): First: Middle:

Previous Names/Maiden Name: Student ID#:

Street Address:

City: State: Zip Code:

Main Phone

or Cell: 2

nd Phone

or Cell:

Email (REQUIRED):

Are you a veteran, active duty personnel, spouse of a veteran or active duty personnel, or a displaced worker who qualifies under the Trade Adjustment Act? No [ ] or Yes [ ]

Demographics (used for statistical analysis only and not for discriminatory purposes) Gender: [ ] Female [ ] Male Ethnicity: [ ] Caucasian [ ] African American [ ] Hispanic

[ ] Asian [ ] Native American [ ] Pacific Islander [ ] Unknown

[ ] Other (specify, optional): _______________________________ Date of Birth (MM/DD/YYYY):

___________________________

Check each course you are reapplying for, within the 1st or 2nd or 3rd semester: 1st semester ___ NPN 100 ___ NPN 105 ___ NPN 110 2nd semester ___ NPN 125 ___ NPN 130 ___ NPN 135 ___ NPN 201 3rd semester ___ NPN 200 ___ NPN 205 ___ NPN 210 ___ NPN 215 Remember to include the following and see previous page for details:

[ ] Letter of explanation for withdrawal & plan for future success in PN classes.

[ ] Verification that you are/had been KY State Registered Nurse Aide or [ ] HST 104 grade C or higher on transcript [ ] Yes or [ ] N/A Submit additional immunization and health record form completed by a physician or nurse practitioner

if the initial form was submitted over one (1) year previously.

Mailing Address:

Evelyn Lichtsteiner

Practical Nursing Application

Jefferson Community and Technical College 109 East Broadway, HSH 442

Louisville, KY 40202

or

Hand deliver to this Physical Address:

Evelyn Lichtsteiner

110 West Chestnut Street, Building A-South Health Sciences Hall (HSH), Room 442 Louisville, KY 40202

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Basic Life Support/CPR Class Information

Certification or Re-certification

(JCTC has no affiliation with any of the individuals/organizations on this list.)

Required CPR course must include instruction on one-man and two-man CPR, obstructed airway,

Automated External Defibrillator (AED), and variations for infants, children and adults. Important: Your CPR card needs to reflect that you are certified for Professional Rescuer or Health Care Provider, depending on where you take your course. Courses taken at the student’s place of employment are acceptable if they meet all the requirements stated above.

Contact information and costs are subject to change without notice:

AMERICAN RED CROSS: for pre-registration go to www.Louisville-RedCross.org Select “Take a Class-CPR, First Ade, More” then select “Professional Responders”, then select “Professional rescuers” and follow the instructions to register for the class.

AMERICAN HEART ASSOCIATION: Contact by going to www.CPRLouisvilleKY.com or calling 502-804-6132

BEATRICE AISTROP: Contact Ms. Aistrop at 502-835-0699 and leave a voicemail with a return phone number (repeat your phone number, please). Phone calls will be returned after 4:00 p.m. M-F. This Basic Life Support class is for the Health Care Provider from the American Heart Association and classes are held at the U of L Hospital in the Community Conference Room. The cost is $30 for new certification and $25 for recertification. Books are an extra fee of $20;

however, a copy of the book with pertinent information can be provided free of charge. Classes will only be held on Saturdays or Sundays from 1:00 p.m. to 5:00p.m. All payments must be paid the day of class by Cash or Money Orders only. No checks or credit cards will be accepted. CARDIAC PROGRAM RENEWALS: Contact Beth Comstock for an appointment at

502-937-0229. Cost is $75 for certification and $50.00 for recertification.

CLARK MEMORIAL HOSPITAL: 1220 Missouri Avenue, Jeffersonville, IN,

Phone 812-283-2079, between 8:00 AM and 4:30 PM, Monday through Friday for your reservation and to obtain dates. Cost is $60.00 for certification and $45.00 for

recertification. Again, be sure to indicate Healthcare Provider or Professional Rescuer.

KENTUCKIANA CPR 7 ACLS: For more information, please call 812-725-1281 or go to their website at www.kentuckianacpr.com

LOUISVILLE FIRE & RESCUE: 1135 West Jefferson. Please call 502-574-4277 or for more information, please go to their web site: www.louisvilleky.gov/louisvillefire Classes are every Friday from Noon to 4:00 PM. Registration must be made in person by 4:00 PM, one day before training.

TERESA L. WHITFIELD, RN (Health Promotion Consultant): Phone 502-773-3441 or email [email protected] for appointment and/or price.

NOTE: This list is provided as a convenience to students who must meet the CPR requirement upon admission to the Associate Degree Nursing (A.D.N.) Program and the Practical Nursing (PN) Program at Jefferson

Community and Technical College (JCTC). JCTC has no affiliation with any of the individuals/organizations on this list and is not responsible for the certification of the courses they offer. Students are responsible to verify that the CPR program they take meets the requirements for the A.D.N. and P.N. Program at JCTC.

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DIRECTORY

The Divisions of Allied Health & Nursing Main Phone: 502-213-4050 www.Jefferson.KCTCS.edu/nursing

Advising and

Academic Counselors

Demetrius Langley, Master Nursing Advisor

Jefferson Education Center, Building F, room 600 200 W Broadway, Louisville, KY 40202

[email protected]

502-213-2196

Assessment Center

COMPASS testing Jefferson Education Center, Building F at 2nd & Broadway, Louisville, KY 40202 Angie Henes: 502-213- 2297 Bookstore-JCTC:

Barnes and Noble

Hartford Hall, Building C (Lower level) 649 South 1st Street, Louisville, KY 40202

(intersection of 1st & Gray Street)

502-213-2150

Financial Aid Questions (KCTCS) [email protected] 502-213-2137 JCTC WORKFORCE SOLUTIONS OFFICE

Nurse Aide Program to become

Kentucky State Registered Nurse

Aide (SRNA)

Commonly referred to as M.N.A. or C.N.A.

JCTC, Downtown Louisville Campus Workforce Solutions Office 101 W Broadway, Building E, room 203

(intersection of 1st & Broadway)

502-213-4297 JCTC at the Carrollton Campus (Sandie Banks) 502-213-5201 JCTC at the Shelby County Campus 502-213-3626

Nursing:

Associate Degree Nursing Program

(to become a Registered Nurse-RN)

Health Sciences Hall (HSH), Building A-South, Room 442

Connie Adams

Program Coordinator [email protected]

Ronci Johnson

Administrative Assistant to the A.D.N. Program

502-213-2397

[email protected]

Nursing: Bridge Course - LPN to RN

(Campus-Based, Summer Semester)

Jennie Gittings, Course Leader

Building A-South, Room 413

502-213-2355

[email protected]

Nursing: Practical Nursing Program (to become a Licensed Practical Nurse-LPN)

Health Sciences Hall (HSH),

Building A-South, Room 442

Debra Terry,

Program Coordinator [email protected] 502-213-4232 Evelyn Lichtsteiner

Division Assistant Supervisor, includes PN Program

502-213-2192

[email protected] Nursing Division Office

110 W Chestnut Street Health Sciences Hall (HSH),

Building A-South, Room 442

Sonia Rudolph,

Nursing Division Chair [email protected]

Student Service Center

To assist students with passwords, financials, Blackboard, Learn-on-Demand and more.

http://help.Jefferson.kctcs.edu

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Application to the Practical Nursing Program

Downtown Louisville Campus

Today’s Date: ___________________________

Semester applying for: Fall (August)

[ ]

or Spring (January)

[ ]

and Year:

___________

Names (Last): First: Middle:

Previous Names/Maiden Name:

Student ID#: If no Student ID, then list last 4 digits of Social Security #:

Street Address:

City: State: Zip Code:

Main Phone or cell: 2 nd Phone or cell KCTCS Email: Personal Email:

Are you a veteran, active duty personnel, spouse of a veteran or active duty personnel, or a displaced worker who qualifies under the Trade Adjustment Act? No [ ] or Yes [ ]

Demographics (used for statistical analysis only and not for discriminatory purposes) Gender: [ ] Female [ ] Male Ethnicity: [ ] Caucasian [ ] African American [ ] Hispanic

[ ] Asian [ ] Native American [ ] Pacific Islander [ ] Unknown

[ ] Other (specify, optional): _______________________________ Date of Birth (MM/DD/YYYY):

__________________________

1. Have you attended another college or post-secondary school? No [ ] or Yes [ ] (if yes, attach unofficial transcript if courses are not already listed on KCTCS transcript)

2. If yes to #1, has student requested a transcript evaluation by JCTC Records Office? No [ ] or Yes [ ]

3. The following must be included with this application or it will not be reviewed by the Selective Admissions Committee. (check all that apply):

[ ] Academic Program Plan (APP). This is generally obtained when attending a Nursing Information Session (dates posted at www.jefferson.kctcs.edu/nursing). If you do not have an APP, please email [email protected]

[ ] Unofficial copies of all transcripts

[ ] Digital computer literacy, grade of C or higher on transcript. Or [ ] IC3 Fast-Track score of 750 or higher. [ ] Verification that you are/have been KY State Registered Nurse Aide (SRNA). Or [ ] HST 104 grade C or higher. Mailing Address:

Evelyn Lichtsteiner

Practical Nursing Application

Jefferson Community and Technical College 109 East Broadway, HSH 442

Louisville, KY 40202

or

Hand deliver to this Physical Address:

Evelyn Lichtsteiner

110 West Chestnut Street, Building A-South Health Sciences Hall (HSH), Room 442 Louisville, KY 40202

All required documents may also be scanned & emailed to [email protected] An email reply from Evelyn confirms receipt of application. It doesn’t confirm application is complete or all requirements have been met.

References

Related documents

1) Unofficial transcripts from all other colleges you have attended. Even if official transcripts have been sent to JCTC or KCTCS, all transfer coursework transcripts should

Return your ADN “packet” (application, curriculum work sheet, official transcripts from all colleges attended, including Temple College if you took courses here and HESI A2 score)

You must submit with your application unofficial transcripts from Merced College and/or official transcripts from other colleges/universities attended that reflect program

 Although students are required to input coursework from ALL colleges attended, including international transcripts, it is not a guarantee which courses UC’s will accept

• Copies of your official transcripts of diplomas and grades from all academic institutions of higher education you have attended and their translations into English if

b) Unofficial transcripts for all prerequisite courses, successful completion of the Nursing Program Information Tutorial Test. c) Two official transcripts from

Another important step in the application process is to ensure that all official transcripts from every college/university you have attended since high school are sent directly to

€ Completed Wayne State University Graduate application and fee € Completed program application.. € Official transcripts from all colleges/universities attended € Copy of your