R.B. TURNBULL JR., MD SCHOOL OF WOC NURSING (Onsite Program) Ann Goldstein Online School of WOC Nursing (Online Program) 9500 Euclid Ave | HS1-500 | Cleveland, Ohio 44195 Phone: (216) 444-5966 FAX: (216) 445-6343 Email: [email protected] www.clevelandclinic.org/wocschool Website: Program Prerequisites, Application, and List of Required Enrollment Documentation Prerequisite: Applicants must be currently licensed as a registered nurse with a baccalaureate degree, and a minimum of one years’ RN clinical nursing experience. Enrollment Application & Required Documentation: 1) Complete and submit your WOC online enrollment application via the link below. WOC Application: http://survey.clevelandclinic.org/TakeSurvey.aspx?SurveyID=84027n5M 2) The documents listed below must be submitted to support your enrollment application. Enrollment applications will not be processed, approved, or finalized without receipt of these documents. Fax documents(to 216445-6343 or scan and email to [email protected]. DO NOT SUBMIT DOCUMENTS ALL AT ONE TIME; SUBMIT AS YOU ACQUIRE EACH DOCUMENT. Classes fill quickly and seating is limited and on a first come, first served basis. Thus, a class seat cannot be secured until all documentation has been submitted to finalize your application. These documents must be received in our office before your class registration deadline date as identified in the class schedule (refer to Step 1 above). • • • • • • • Official, sealed college transcripts sent directly from the university. If your university utilizes an online electronic clearinghouse for transcript submissions, then send to [email protected]. If by postal mail, then send to WOC Nursing Education, 9500 Euclid Avenue, HS1-500G, Cleveland, OH 44195. (It is vitally important to include the HS1-500G mail code.) Copy of your current nursing license from the Nursys verification site: https://www.nursys.com/LQC/LQCTerms.aspx Copy of your current resume or CV Negative TB test (2-step Mantoux or QuantiFERON TB Gold test) or chest X-ray within one year before the start of the clinical rotation with annual updates while in the clinical portion of education Appropriate immunizations within the last 10 years for measles (Rubeola), German measles (Rubella), chicken pox (Varicella); Tdap Tetanus, Diptheria, Pertussis booster Hepatitis B vaccine/immunity or signed waiver assuming the risk of exposure Proof of professional RN liability insurance must be submitted and maintained during the program. Students must provide proof of professional liability insurance with coverage limits of not less than $1,000,000 per occurrence and $3,000,000 annual aggregate. (If state or national laws restrict coverage to less than the $1,000,000/$3,000,000 limits, proof of professional liability insurance at state or national levels is required along with a copy of the law stating the limits of coverage.) You may obtain more • • information on purchasing this insurance from the Nurses Services Organization, www.nso.com, 159 E County Line Rd., Hatboro, PA 19040, phone (800) 247-1500. If you are covered by your employer’s insurance policy, your Human Resources representative will need to provide a signed letter verifying that you are covered while a student enrolled in the program and state the coverage limits. Proof of personal health care coverage which must be maintained for the length of the program. A copy of your health care insurance card (both front and back sides) is required. Statement of overall good health from primary care physician. A note written on a prescription pad from a MD/NP stating that you are physically able to complete this course, signed by them, and dated is acceptable. • • • • • • • Proof of active American Heart Association Basic Life Support (BLS) healthcare provider course must be submitted. Active BLS status must be maintained while completing clinicals. Two letters of professional reference evidencing support of your enrollment in this WOC program. Signed Cleveland Clinic Background Information Release Form. After the Clinic’s onsite police department processes the background check, the report must not evidence any prior criminal history. (This form will be emailed to you within five business days upon receipt of your enrollment application.) Signed Cleveland Clinic On-Site Facility Waiver and HIPAA Confidentiality Statement Form. (This form will be emailed to you within five business days upon receipt of your enrollment application.) Copy of I-94 card issued with a United States Visa (international students only) as evidence of your criminal background check. Students who complete an onsite practicum at Cleveland Clinic’s between October 1 and March 31, must remit evidence of an annual flu vaccine. A religious or medical exemption can be requested; forms are available from our school’s office. Please contact us at 216-444-5966. All international students residing outside the U.S. are required to take a TOEFL test and achieve a minimum score of 60 on the internet based test or 500 on the paper based test. The TOEFL test measures the ability of the applicant to comprehend and speak the English language spoken in the classroom setting. (Refer to the TOEFL section in this packet for more information.) Additional WOC Program Requirements: • A final acceptance letter will be issued to you upon our receipt of your completed WOC enrollment application, the aforementioned required WOC enrollment documents, and your preceptor’s application and required documents (if applicable). The acceptance letter will outline online learning modules that must be completed in the Cleveland Clinic’s COMET education system. All WOC students must complete these mandatory learning modules before the first day of class. Examples of education modules include hand hygiene, universal precautions, safety, and other clinical policies and procedures regarding your practicum site. • Cleveland Clinic is committed to providing a drug-free work environment. Accordingly, Cleveland Clinic will not tolerate the unlawful or unauthorized use, manufacture, possession, sale or transfer of illegal or controlled substances of abuse or unauthorized use of alcohol on or around Cleveland Clinic property. Additionally, Cleveland Clinic maintains a smoke-free environment at its facilities and smoking is prohibited on all clinical site premises. • Students must abide by the applicable policies, procedures, rules and regulations of Cleveland Clinic and the clinical site at which they are trained and follow all directives of its staff. • Students, who complete clinicals onsite at our facility, shall wear the appropriate regulation white nurses’ uniform with a white (long or short) lab coat, and identifying Cleveland Clinic student ID badge. • Students assume the risk of exposure to patients who may carry a contagious or infectious disease. In the event any student is exposed to blood from a patient who is a carrier of a contagious or infectious disease or a patient who is, in the judgment of the clinical site, at risk of being a carrier of a contagious or infectious disease, the clinical site will, with the consent of the student, either refer the student to an emergency room or administer immediate precautionary treatment consistent with current medical practice. Initial screening tests or prophylactic medical treatment shall be paid for by the student’s own medical coverage. The clinical site shall have no responsibility for any further diagnosis, medication, or treatment.