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Roberts Wesleyan CollegeDepartment of Nursing

Early Admission to the Nursing Major Application for Transfer Students

Congratulations! You meet the qualifications to be considered for early admission to the Roberts Wesleyan College summer transfer program for nursing students. Please read this packet carefully for instructions on completing your admission documents.

The primary goal of the undergraduate nursing program at Roberts Wesleyan College is to prepare nurses for professional registered nursing practice. The care of clients/patients is entrusted to the professional nurse. The members of the nursing faculty of Roberts Wesleyan College have an obligation to the profession of nursing, to the recipients of nursing care, to the students in the program, and to the society which grants nurses special privileges. This recognition of obligation includes careful selection of students for the nursing major, a well-designed program that will provide opportunity for growth of the developing professional, and assurance that the new graduate possesses the abilities required for professional practice. Preparation of a professional practitioner requires an education that includes knowledge, skills and values of a liberally educated person, the concepts, principles and skills of nursing care, and the development of a value system that is consistent with the profession's Code of Ethics and a Christian philosophy of service.

The application process is competitive. Applicants are selected on the basis of: their academic record; critical thinking and writing skills as demonstrated in their personal analysis, recommendations from faculty; and potential for success in the nursing program.

Admission decisions are made after the application deadline, and applicants are notified in writing as soon as a decision is made.

PROCEDURE FOR ADMISSION TO THE NURSING MAJOR:1. Complete an application to the nursing major (enclosed). Applications for transfer students

requesting early admission must be received by 5:00 PM on Monday, February 23, 2015. All applications must be in typewritten form. Send via email to [email protected] or postal mail to :

Roberts Wesleyan CollegeDepartment of Nursing - Traditional Nursing ProgramSmith Science Center, Suite 1112301 Westside DriveRochester, NY 14624-1997

2. When completing the Personal Analysis of Potential for Success, provide sufficient evidence of qualities and abilities identified in the list of Components of Personal Analysis. It will beneficial to outline your plan for achieving or strengthening any areas where you are weak or need improvement. Attach a wallet size physical or digital photograph of yourself.

12/14:cabg/trad/203/adm to major/2015/summer 2015 transfer preapp

mailto:[email protected]

REQUIRED DOCUMENTS/FORMS:1. Application for Admission to the Nursing Major2. Application to a Major Field of Study 3. Personal Analysis of Potential for Success Essay 4. Two recommendations using the forms provided in this packet

a. You are to fill out the upper part of the two forms and distribute to the designated persons. Select a faculty person who can evaluate your specific qualities of physical and emotional health, intellectual ability, ability to benefit from constructive feedback, communication skills, non-judgmental attitude, leadership, moral character, and responsibility and dependability. Deliver this form to the selected person (allow at least 7-10 days for completion). One recommendation must be from a faculty member. The second recommendation could be from a Faculty Member or your Academic Advisor.

b. References are to be returned to:Roberts Wesleyan CollegeDepartment of Nursing - Traditional Nursing Office – SSC2301 Westside DriveRochester, NY 14624-1997

5. Complete Admission to the Nursing Major Requirements Checklist.

6. Complete Pre/Co-Requisite Checklist :

7. Math Competency: You will be required to take a math test during the initial summer course. Mathematical ability, as evidenced by achievement of at least 80% on the Department's Math Screening test, is required for admission to the nursing major. The math test includes addition, subtraction, multiplication and division of whole numbers, fractions, and decimal numbers. The test also includes word problems to test computation skills.

8. CPR Certification/Verification: A valid CPR card and certification is required and must be valid during the entire academic calendar (must include summer sessions- if applicable).

9. First Aid Certification/Verification: A valid First Aid card showing proof of having taken a First Aid course is required.

10. Health Forms: Evidence of current physical examination and up-to-date immunizations must be on record with the Student Health Services before admission to the major. The health form in your admission packet should be filled out by your primary health provider and returned to the Department of Nursing Office before your application will be processed. In your junior and senior years, as stated in the Handbook for Traditional Nursing Students (available on the Intranet), the clinical prerequisite policy is as follows: Annual physical and TB screening must be completed at the start of each fall semester regardless of original dates of exam or certification. It must be current within the 2nd week of May of the beginning of the school year until at least the 2nd week of May the end of the school year.

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ROBERTS WESLEYAN COLLEGE DEPARMENT OF NURSING

APPLICATION FOR EARLY ADMISSION TO THE NURSING MAJOR

Anticipated Graduation Date

Student Date

Campus/LocalAddress Cell Phone

(City) (State) (Zip code)

Permanent Address Home Phone

(City) (State) (Zip code)

Date of Birth Age

Marital Status Student ID # (if available)_________

Transfer students: RWC Athlete

College Attended Dates GPA

College Attended Dates GPA

Career goals include:

I have had the following experiences as a volunteer or in paid employment, which I believe helped, prepare me for my future career: __________________________________________

I hereby make application to the major. I present the following reasons for deciding to enter this program: __________________________________________________Note: Criminal checks may be required as part of your student nurse and/or RN licensing procedures.

______________________________________________________________________________

Signature of Student Date


Application for Admission to a Major Field of StudyPlease CLEARLY TYPE all of your responses.

Name Date

Student ID#

1. I hereby apply for admission to the Nursing major, in partial fulfillment of the requirements for a Bachelor of Science (BS) Degree.

2. I also plan a second major in . (If so, a separate form must be filed. If none, state none.)

3. Minor: or Concentration .

4. My nursing faculty advisor is (if assigned an advisor) .

5. I hereby authorize the release of any information deemed necessary for the consideration of this application.

________________________________________________

Student’s Signature

FOR THE DEPARTMENT USE ONLY:

Date of Department Action

Decision: □ Approved

□ Disapproved Date Student Notified

□ Conditional Approval

Signature

Send to Registration when complete


Admission to the Nursing Major Requirements and Checklist

Name: ___________________________________ Semester Requesting Admission________________

All nursing students requesting admission to the Nursing Major must complete the following checklist. The Department of Nursing will not review an application with an incomplete or illegible checklist. It is the student’s responsibility to show evidence that they have completed all the pre-requisites to be eligible for entry into the first clinical course (NSG 203: Basic Human Needs).

Instructions: Please complete each section as outlined. If you have taken required coursework outside of Roberts Wesleyan College, please note on the appropriate line that below. Please attach a copy of your unofficial transcript from any College/University where you have taken courses required for the major if you have not already submitted an official transcript. It is also the student’s responsibility to have an official transcript sent to the Registrar (if not already done). Please identify if any courses are pending or in progress at the time of your application.

The following courses are considered pre-requisites and/or co-requisites to NSG 203 and are required for Full Admission to the Nursing Major.

YOU MUST SUBMIT THE COMPLETED GRID WITH YOUR APPLICATION TO THE MAJOR.

Pre/Co-requisites*required to be considered for early admission

Semester/YearName of College

Grade Transcript Attached (√ if appropriate)

NSG 101: Intro to Nursing* (this is the first course taken in the summer for summer transfers) NSG 102: Intro to Community (graduation requirement for summer transfers)

NSG 202: Nutrition *

NSG 207: Group Process (taken during the spring semester of the junior year for transfer students) PSY 201: Developmental Psych Across Lifespan *BIO 101: General Biology (graduation requirement for summer transfers)CHM 114: Intro Organic & Biochemistry *

BIO 201: A&P I and Lab *

BIO 202: A&P II and Lab *

BIO 301: Microbiology *


GPA REQUIREMENT:

Please document the following GPA’s. Students must have a minimum overall GPA in each of these areas of 3.50 or greater to be eligible to apply to the major (refer to the Nursing Handbook).**If you have a GPA in any of these areas less than a 3.50, please meet with your nursing advisor prior to submission of your Admission to the Major Application. Science GPA:

NSG GPA:

Overall GPA at RWC: (if applicable)

MATH REQUIREMENTS:

Score on NSG 101 Math Test (if taking NSG 101 in summer – please note that here)

VERIFY and CHECK THE FOLLOWING ARE COMPLETE AND SUBMIT WITH APPLICATION

For Office Use Only - Date & Initial

CPRcopy attached Date taken

BASIC FIRST AIDcopy attached Date taken

REFERENCES COMPLETED

HEALTH FORM/IMMUNIZATIONSPhysical

Date received

PPDDate received

Flu ShotDate received

Student Signature: Date Submitted:

Student Name/Please type/print:


COMPONENTS OF PERSONAL ANALYSIS OVERVIEW

Certain criteria are perceived as important for admission to the major. Your advisor, the Traditional Program Director, the Dean of Students and other faculty members will assist you in assessing your qualifications, and the degree to which you meet the criteria, and will help you develop plans to grow as a professional and to strengthen weak areas. The following represent the major but are not all-inclusive guidelines that will be used in assessing a student's readiness and capacity to undertake the professional nursing major. The components are organized according to the College’s core values of scholarship, spiritual formation, and service.

1. Physical and emotional health. Nursing is a demanding profession and a measure of good health is a requisite to effective practice. However, some individuals with physical disabilities or limitations are very capable of meeting the demands of nursing practice and will not be exempted solely for physical reasons. In working closely with the client's problem, one needs emotional maturity and stability to be able to cope with the emotional stresses that are common in helping professions.

2. Academic Achievement and Ability. A minimum GPA of 2.50 (after two semesters for freshmen and one semester for transfers) is required for eligibility to apply for admission to the nursing major. A GPA of 3.5 is required to be considered for early admission to the major. Other evidence to be considered include high school record, other college work, if any, and scholastic aptitude tests that will aid in determining long range potential for completing the program, passing State Board examinations and being successful as a professional. Average grades of C or higher in all nursing courses and Anatomy and Physiology class and laboratory are required. A minimum science GPA of 2.50 will be required for admission and progression in the major. Thus, the average of the required biology (A&P I & II, General Biology, Microbiology) and chemistry (CHM114) courses will need to be 2.50.

3. Intellectual Ability. Related to academic achievement, problem-solving, analytical ability and creative thinking are conceptual skills required for effective practice. Complex individual, family, group and community problems require nursing majors to be able to think clearly and logically in a systematic manner and to use the decision-making process if problems are to be ameliorated and resolved.

4. Self - confidence and assertiveness . One needs to have these attributes in sufficient degree to work effectively with clients, groups, one's professional peers and other members of the health care team. These qualities are especially important to promote optimal interprofessional collaboration and promote patient safety and quality care.

5. Ability to accept constructive feedback. Nursing is a profession that requires life-long learning and a practice that always has room for improvement. An individual who is not open to learning from clients, supervisors, teachers, administrators, or employers should seek to enter a field other than nursing. Defensiveness may block learning.

6. Communication skills. Both oral and written skills in communication are vital in nursing as well as a good grasp of the English language. Awareness of verbal and nonverbal communication will be an important factor in understanding needs and responses. Basic knowledge of a foreign language such as Spanish or French is a definite asset if one wishes to work in urban areas, in missions or other foreign services. A foreign language will also help in using medical terms that often have roots in Latin or in foreign languages.


7. Ability to form and maintain positive relationships. Nursing is a person focused profession, which demands rapport and therapeutic relationships with clients, families, and groups that involve providing support and giving and receiving challenges that will provide growth for the client. A working relationship with peers, colleagues, and others will be necessary to ensure appropriate care for the patient and/or a group of patients. Self-acceptance is basic to building relationships with others.

8. Moral principles and a sound value system. In nursing, one has considerable influence upon clients, families, and groups; therefore it is essential that one be of good moral character. One should be aware of one's own values and be able to integrate into one's professional value system the values reflected in the profession's Code of Ethics.

Note: According to law, individuals who wish to take the NCLEX exam to gain RN licensure and who have committed a felony will have their cases brought before the State Board of Nursing. This State Board of Nursing will make a decision whether or not the individual will be permitted to sit for the licensure exam.

9. Non - judgmental attitude . The ability to relate meaningfully with people from different races, ethnic backgrounds or religions are essential for all health professionals. This includes being able to relate to people having unusual problems without being judgmental. It means relating to persons of the opposite sex or persons who are of diverse ages or of different lifestyles because people of diverse backgrounds will be encountered in the nursing profession.

10. Interest in and motivation in nursing as a career. Nursing must be viewed as a lifetime commitment for immediate and long-range success. Clear goals and sustained motivation is essential to professional development and success in academia and in the profession. A willingness to set aside lesser goals and to assume responsibility for one's own learning are signs of maturity and may be basic to success. Vocational interest tests and volunteer experiences may provide some clues to the degree of interest in a helping profession such as nursing.

11. Leadership qualities. Nurses often assume positions of leadership with the nursing team or client groups, and after staff experiences may become clinicians, clinical supervisors, teachers, administrators, or consultants. The basic components include skills in decision-making, relating to others, influencing, and facilitation of the individual or groups toward a goal.

12. Responsibility and dependability. Evidence of ability to carry responsibility, to follow-through on any type of assignment, to keep appointments, and to be responsible for one's own learning are all traits that will not only ensure completion of this program but express maturity and accountability.


YOUR PERSONAL ANALYSIS OF POTENTIAL FOR SUCCESS*

Please address the following points and include your plans to strengthen weak areas. Your analysis should be typed and well written. Thoughtful and honest analysis in itself is an important indication of your ability to assess your own strengths and weakness and devise a plan for reaching goals. The selection committee will evaluate your analysis for completeness, grammar and critical thinking.

1. Physical and emotional health

2. Academic achievement and ability

3. Intellectual ability

4. Self-confidence and assertiveness

5. Ability to accept constructive feedback

6. Communication skills

7. Ability to form and maintain positive relationships

8. Moral principles and a sound value system

9. Non-judgmental attitude


10. Interest in and motivation in nursing as a career

11. Leadership qualities

12. Responsibility and dependability

13. List activities, membership and offices held, sports, musical ability, hobbies and other personal interest, that contribute to the person you are.

College

High School

Church

Other/Community

Personal interests/awards or special recognition


ROBERTS WESLEYAN COLLEGE DEPARMENT OF NURSINGRECOMMENDATION FORM FOR ADMISSION TO THE NURSING MAJOR

Student Name Date

Local Address Cell Phone

(City) (State) (Zipcode)


(City)_______________________________(State) _________ (Zipcode) ___________________I give my permission for release of information as requested below and hereby waive Or do not waive my legal right to review this recommendation.

Date Student Signature ******************************************************************************Perceptions of strengths/weaknesses from course work taken (decision-making skills, problem-solving, class participation, assertiveness, effort):

Perceptions of strengths/weaknesses for probable success in the program (decision-making, leadership, initiative, assertiveness, reliability: ___________________

Observations and recommendations:

___________________ Highly recommend for admission

Recommended for admission

Not recommended for admission

Recommended for additional screening

Date Signature

Title

Please return to:Roberts Wesleyan CollegeTraditional Nursing Program, Department of Nursing- SSC 2301 Westside DriveRochester, NY 14624


ROBERTS WESLEYAN COLLEGE DEPARMENT OF NURSINGRECOMMENDATION FORM FOR ADMISSION TO THE NURSING MAJOR

Student Name Date

Local Address Cell Phone

(City) (State) (Zipcode)


(City) (State) (Zipcode)I give my permission for release of information as requested below and hereby waive Or do not waive my legal right to review this recommendation.

Date Student Signature ******************************************************************************Perceptions of strengths/weaknesses from course work taken (decision-making skills, problem-solving, class participation, assertiveness, effort):

Perceptions of strengths/weaknesses for probable success in the program (decision-making, leadership, initiative, assertiveness, reliability:

Observations and recommendations:

Recommended for admission

Not recommended for admission

Recommended for additional screening

Date Signature

Title Please return to:Roberts Wesleyan CollegeTraditional Nursing Program, Department of Nursing- SSC2301 Westside Drive Rochester, NY 14624


Nursing Physical EvaluationHISTORY (PLEASE PRINT)

Name________________________________________ Grade _____________ Sex_____ Age_____ Birthdate

Explain “Yes” answers below: Yes No

1. Have you ever been hospitalized?...........................................................................................................................

Have you ever had surgery?.....................................................................................................................................

2. Are you presently taking any medications or pills?...................................................................................................

3. Do you have any allergies (medicine, bees, or other stinging insects)?...................................................................

4. Have you ever been dizzy or passed out during or after exercise?............................................................................ Have you ever had chest pain during or after exercise?............................................................................................ Have you ever had high blood pressure?.................................................................................................................. Have you ever been told that you have a heart murmur?.......................................................................................... Have you ever had racing of your heart or skipped heartbeats?................................................................................ Has anyone in your family died of heart problems or a sudden death before age 50?................................................

5. Do you have any skin problems (itching, rashes, acne)?.........................................................................................

6. Have you ever had a head injury?...........................................................................................................................

Have you ever been knocked out, unconscious, or had a seizure?............................................................................

7. Have you had UTI?..................................................................................................................................................

8. Do you have trouble breathing or do you cough frequently?....................................................................................

9. Do you use any special equipment (pads, braces, neck rolls, mouthguard, eye guards, etc.)?................................

10. Have you had any problems with your eyes or vision?.............................................................................................

Do you wear glasses, contacts, or protective eyewear?.............................................................................................

11. Ever had sprained/strained, dislocated, fractured, broken, repeated swelling, or other problems of bones/joints?...... Head Shoulder Thigh Neck Elbow Knee Chest Forearm Shin/Calf Back Wrist Ankle Hip Hand Foot

12. Have you had any other medical problems (such as infectious mononucleosis, diabetes, etc.)?.............................

13. Have you had a medical problem or injury since your last evaluation?.....................................................................

14. Any concerns with your menstrual period? .............................................................................................................

15. Health Promotion

Do you do SBE / TSE monthly? ..............................................................................................................................

Do you exercise three or more times a week?.........................................................................................................

Do you wear your seatbelt?.....................................................................................................................................

Do you eat less than 30% fat & five servings of fruits and vegetables daily?...........................................................

Explain “Yes” answers (#1-14):

Any medical problems relevant to clinical practice:

I hereby state that to the best of my knowledge my answers to the above questions are correct.

Signature Date


NURSING PHYSICAL EXAMINATION Student’s Name _____________________________________________

Height Weight BP / R Pulse

Vision: R 20 / L 20 / Corrected: Y N Pupils ________ UA _____ Hct/Hbg ________


Area Normal Abnormal findings Initials

Head

Ears

Eyes

Nose/Sinus

Throat

Pulse

Heart

Lungs

Skin

Abdominal

Genitalia/Urinary

Musculoskeletal

Neck

Shoulders

Elbows

Wrists

Hands

Back

Knees

Ankles

Feet

Neurological

OtherTUBERCULIN SCREENING (PPD Mantoux required within past 12 months OR

Chest x-ray date _____________ Results: Negative ____ Positive ____PPD test administered (date) ___________________ given intradermally into _____ forearmPPD read (date) ____________________ Results: Negative ____ Positive ____ ______mm indurationHepatitis B series #1 ______________ #2 _______________ #3 ______________Hepatitis B Titer Results: Positive ____ Negative ____ Date of Titer Test _______________Flu Vaccine _________________

PHYSICAL STATUS Cleared Not cleared due to

Comments

Name of Provider: Date:

Address:

Signature of Provider: Phone:


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