1
Perioperative Nursing Annual Application
First day to submit is June 20, last day to submit is July 24 each year.
The attached materials provide an application submission guide for the Perioperative Nursing program. Please
read all of the application carefully. In order for your application to be considered, all steps must be completed
and the required materials submitted to Hawk Central Student Records office at the Pasco campus.
Perioperative nurses are Registered Nurses (RNs) with special training, knowledge, and skills in surgical patient
care. Perioperative nurses work in hospital operating rooms and surgical services departments, ambulatory
surgery centers, physician offices, and other specialty facilities providing care to patients during the course of a
surgical procedure. They work closely with surgeons, anesthesia providers, surgical technologists, and other
operating room professionals. Traditionally, the perioperative nurse may serve as either a scrub nurse or a
circulating nurse. In the scrub role, the perioperative nurse establishes and maintains the sterile field, anticipates
the needs of the surgical team, and passes instruments and supplies to the surgeon and surgical first assistant.
In the circulating role, the perioperative nurse manages the overall care of the patient and ensures patient safety
by ensuring a proper environment. The circulator also transfers and positions the patient, performs urinary
catheterization, positions the patient, performs counts of all instruments and supplies with the surgical technologist
or scrub nurse, and maintains intraoperative documentation. To be successful, perioperative nurses must develop
a strong sense of physical and environmental awareness and the ability to anticipate the patient and surgical
team’s needs. This requires in-depth knowledge of surgical anatomy, operative procedures, surgical
instrumentation and supplies, sterilization and infection control procedures, and technical specialty equipment.
CBC’s Perioperative Nursing program incorporates AORN’s PeriOp 101 program into didactic, laboratory, and
clinical study. Didactic coursework is presented using a hybrid online and classroom-based learning environment,
culminating in a 165-hour clinical experience designed to prepare students for a career in the operating room.
Program applicants must be licensed RNs meeting specific entrance criteria.
The Perioperative Nursing program is a selective admission and competitive entrance program. You must apply
to the College and also to the program. CBCs Perioperative Nursing program is a two-quarter program beginning
in fall quarter. Graduates will earn a Short-term Certificate in Perioperative Nursing.
Applications must be received as a complete package. Please read and complete all sections of the application.
Applications will be evaluated for
priority based on completion of all requirements.
Program applications must be either postmarked or hand delivered to:
Hawk Central Columbia Basin College
2600 North 20th Avenue
Pasco, WA 99301
Applications are due July 24, 2020.
For additional assistance, please contact the Health Science Center in Richland
during office hours at (509) 544-8300.
2
Perioperative Nursing Annual Application
Application Process
Minimum Entrance Requirements
A. Meet college admission criteria as stated in the College Catalog prior to applying for application into the program.
B. Complete and submit a Perioperative Nursing program application.
C. Provide proof of an unencumbered registered nursing (RN) license.
D. Submit three professional letters of reference on company or organization letter head.
E. Submit a 500-word essay describing your career and educational goals in perioperative nursing.
F. Have completed a minimum of an associate degree in nursing.
G. Apply for admission prior to the deadline.
H. Attend a formal interview with program faculty as directed (following receipt of application).
I. Prior professional nursing experience preferred but not required.
J. Submit official college transcripts to CBC Student Records office for every college attended
a. Transcripts from other colleges must be received by Columbia Basin College Student Records office as
soon as they are available. This will expedite your application to the Perioperative Nursing program.
b. Students who have taken classes at Columbia Basin College do not need to include a transcript from
CBC.
The Student Records office will provide a current copy of your transcript to accompany this
application.
General Information for Accepted Students
Once students have been accepted into the program, the following information will be helpful to guide them with other
requirements necessary to maintain enrollment.
A. Student study requirements have been found to be a minimum of three hours per week for each scheduled theory
credit hour.
B. After acceptance, you are required to submit a national criminal history search, and upload your immunization
history using the College-approved vendor. All students must provide results of a yearly tuberculin skin test by the
due date listed and comply with all program and College policies, and evidence of currency of required
immunizations.
C. All students must successfully complete required courses with a 75 percent or higher (2.0 GPA) to remain enrolled
in the Perioperative Nursing course sequence.
D. Attendance is vitally important to successfully complete the Perioperative Nursing certificate. Students must adhere
to the attendance policy.
E. Scholarships and loans may be available through the Financial Aid office or Worker Retraining programs. For more
information, contact that office and review the Columbia Basin College website (columbiabasin.edu).
F. All students are encouraged to have accident/health insurance. A student injury and sickness insurance plan is
available for purchase. Forms are available from the campus Cashier’s Office or the Health Science Center.
G. All students are required to have malpractice insurance; this is not accident/health insurance. The fee for
malpractice insurance will be included with registration.
H. Students will have regularly scheduled class sessions throughout the Perioperative Nursing program. During winter
quarter, students will be required to attend clinical sessions. Clinical sessions will be scheduled as clinical space is
available. Students need to be flexible during the clinical sessions to accommodate the rigorous clinical schedule. A
minimum of 165 clinical hours must be completed.
I. Students must attend a formal program orientation prior to the start of the Perioperative Nursing program.
For additional information or assistance related to these entrance requirements, please contact the Health Science Center
office.
Health Science Center, MS-R2
Columbia Basin College
2600 North 20th Avenue
Pasco, WA 99301
(509) 544-8300
I have read all of the criteria and requirements for the CBC Perioperative Nursing program.
I certify my information contained within this application is accurate and complete to the best of my ability.
Applicant Signature Date
3
Perioperative Nursing Annual Application
No P
rogram Fee
First day to submit is June 20, last day to submit is July 24 of each year
Last Name
First
Middle
Previous Name(s)
Address
City
State
Zip
Phone
Alternative Phone Birth Date CBC Student ID Number
Email Address
Have you earned a minimum of an associate
degree in nursing?
Yes No
If yes, complete the following:
Name of School City, State
Programs or Degrees Completed
Additional Education and Credentials
(list any other healthcare credentials and degrees below)
Admission Checklist
(attach a copy of each)
Do you possess an unencumbered
registered nursing license?
Yes No
_______________________________________________________________________________
License Number State
Do you have 3 professional letters of
reference on company or organization letter
head?
Yes No
Have you submitted educational transcripts
demonstrating completion of a minimum
associate degree in nursing?
Yes No
_______________________________________________________________________________
Highest degree earned School name and location
Did you write a 500-word essay describing
your career and educational goals in
perioperative nursing?
Yes No
Do you have previous professional
experience as a registered nurse?
Yes No
_______________________________________________________________________________
Position and location Number of years
Do you have a current Basic Life Support
certification issued by the American Heart
Association (AHA)?
Yes No
Expiration date: ___________________________________________________________
I have read all of the criteria and requirements for the Columbia Basin College Perioperative Nursing program and certify the information
contained within this application is accurate and complete to the best of my ability. I understand this
application must be delivered
before the close of the business day by the due date listed above.
Applicant Name (Printed) Email Address
Applicant Signature Date
Demographic
Information
Prior
Educa
tion
9
Perioperative Nursing
Program Expenses
ESTIMATED PERIOPERATIVE NURSING PROGRAM EXPENSES 2019-2020
*** All stated costs are subject to change. However, the following figures may be used as a general
guideline to assist applicants in preparing for the costs associated with the CBC Perioperative Nursing
program.
Tuition per quarter with fees (WA Resident) *
Fall 9 cr. $1,190
9 cr.
$1,190
Total
$2,380 ***
Fees*
Malpractice (per Quarter)
$7.50
$7.50
x 2 qtrs. $15 ***
Books
$410
Scrubs
$100
Shoes (one pair, black)
$100
Background Check
$110
Total Estimated Program Cost
$3,115
Additional Costs:
Washington State HIV/AIDS Bloodborne Pathogens training which may be obtained from Biologix
Solutions for $35
AHA BLS training and certification fees vary by training center
Immunization costs will vary depending on what shots are needed
Student Injury and Sickness Insurance Plan is available for approximately $570 per
quarter for students who do not have
insurance
Costs as of November 2019
Columbia Basin College complies with the spirit and letter of state and federal laws, regulations and executive orders pertaining to civil rights, Title IX, equal opportunity and affirmative action. CBC
does not discriminate on the basis of race, color, creed, religion, national or ethnic origin, parental status or families with children, marital status, sex (gender), sexual orientation, gender identity or
expression, age, genetic information, honorably discharged veteran or military status, or the presence of any sensory, mental, or physical disability, or the use of a trained dog guide or service animal
(allowed by law) by a person with a disability, or any other prohibited basis in its educational programs or employment. Questions or complaints may be referred to the Vice President for Human
Resources & Legal Affairs and CBC’s Title IX/EEO Coordinator at (509) 542-5548.Individuals with disabilities are encouraged to participate in all college sponsored events and programs. If you have a
disability, and require an accommodation, please contact the CBC Resource Center at (509) 542-4412 or the Washington Relay Service at 711 or 1-800-833-6384. This notice is available in
alternative media by request.
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