Revised 3/7/18
Associate Degree of Nursing Admissions Application
Nursing Essential Skills and Functional Abilities
The Associate Degree of Nursing Program is a discipline with cognitive, sensory, affective and psychomotor performance
requirements. Based on these requirements, the following list highlights the Nursing Essential Skills and Functional Abilities that
have been developed. Each standard has an example of activities which a student will be required to perform, with or without an
accommodation, while enrolled in the ADN program at Manhattan Tech. The Nursing Essential Skills and Functional Abilities should
be used as a guide to assist applicants in determining whether or not accommodations or modifications are necessary in order to
meet program participation requirements. Applicants who identify potential difficulties with meeting the Program Performance
Standards should communicate their concerns to the Director of Nursing. If the concern is related to a documented disability,
applicants are responsible for contacting the Student Services. Determination of reasonable and appropriate accommodation will
be made on an individual basis in consultation with the Student Services Office. Additionally, applicants should assess their
aptitude and ability to perform professional duties by reviewing the Program Performance Standards below and discussing them
with their healthcare provider.
Critical Thinking
Critical thinking sufficient for clinical
Competent assessment of patient in timely
manner; correct interpretation of assessment;
readily respond with appropriate treatment plans;
ability to work alone and to make
correct independent decisions as needed.
Interpersonal abilities sufficient to
interact with individuals, families and
groups from a variety of social,
emotional, cultural, and intellectual
Life and death situations; working with families
stressed by the condition of a loved one; working
with other healthcare providers in stressful
Communication abilities sufficient for
interaction with others in verbal and
written form.
Ability to follow verbal and/or written instructions.
Must communicate patient response to therapy
with others; document therapeutic procedures
performed on patient; consult with other
healthcare providers in a professional manner.
Physical abilities sufficient to move
from room to room and walk in
hallways; maneuver in small spaces;
Includes the strength necessary to lift
patients as needed.
Walking to and from departments to patient
rooms; walking room to room to take care of all
patients on a team; assisting in patient transport.
Tactile and
Motor Skills
Gross and fine motor abilities
sufficient to safely and effectively
perform nursing care. Tactile ability
sufficient for physical assessment and
to provide nursing intervention.
Perform vital signs, CPR, transporting patients,
physical assessment, manipulating equipment.
Perform palpation; give injections; intravenous
initiation; provide sterile and non-sterile dressing
changes; urinary catherization; assist patient with
daily activities.
Auditory ability sufficient to monitor
and assess health needs.
Auscultation of BP, breath sounds, heart sounds,
bowel sounds; hearing alarms in units, call bells,
telephones, and conversing with patients, family,
and staff.
Visual ability sufficient for observation
and assessment.
Reading patient charts/flow sheet/monitors;
drawing up and administering medications;
assessing patient skin color; reading thermometers.
Revised 3/7/18
Associate Degree of Nursing Admissions Application
Health Care Provider Signature Form
Instructions for completion of Health Care Provider Signature Form:
A health care provider must sign the Health Care Provider Signature Form between February 3, 2020February 3, 2021
and indicate whether the applicant will be able to function as a nursing student. Health care providers who qualify to sign
this declaration include a licensed physician (M.D., D.O.), a nurse practitioner, or physician’s assistant.
(Please Print)
Applicant Name: Student ID Number:
It is essential that nursing students be able to perform a number of physical activities in the clinical portion of the program. At a
minimum, students will be required to lift patients, stand for several hours at a time and perform bending activities. Additionally,
nursing students must be able to sit for long periods of time in a classroom environment. Students who have a chronic illness or
condition must be maintained on current treatment and be able to implement direct patient care. The clinical nursing experience
also places students under considerable mental and emotional stress as they undertake responsibilities and duties impacting
patients’ lives. Students must be able to demonstrate rational and appropriate behavior under stressful conditions. Individuals
should consider the mental and physical demands of the program prior to submitting application.
I have reviewed the Manhattan Tech Nursing Essential Skills and Functional Abilities. I believe the applicant:
WILL WILL NOT be able to function as a nursing student as described above.
If not, explain:
Licensed Healthcare Examiner (M.D., D.O., N.P., P.A.):
Print Name: Title:
Signature: Date:
Zip Code:
Phone Number:
This form will need to be completed and uploaded at the time of submitting the online ADN application.
click to sign
click to edit