From classroom to community: How Penn State Schuylkill is building a local nursing pipeline

It’s noon on a Tuesday. At Geisinger Medical Center, Alexa Menjivar is hours into a 12-hour rotation working bedside. Her preceptor, or supervising nurse, walks her through a procedure, pauses, steps back, hands over the chart and says, “Okay, next one’s yours.”

This isn’t a simulation. The patients are real. The stakes are real. For Menjivar, so is the responsibility. One patient at a time, 12 hours a shift, three days a week.

Menjivar has known she wanted to become a nurse since kindergarten. In May, she was one of 29 students fulfilling that dream when she graduated from Penn State Schuylkill with a bachelor of science degree in nursing (BSN) from the Ross and Carol Nese College of Nursing.

Just a few years ago the program didn't exist, but now it is celebrating its third graduating class, sending new nurses into the workforce with jobs already secured. Many stay to care for the communities where they were raised.

By living at home, commuting to campus and working part-time, many also graduate debt-free. But being close to home is only part of what sets the program apart.

Hands-on training from the first rotation

Launched in 2019, the four-year program is built to move students out of the classroom and into real-life care settings early. More than 100 students are enrolled in the BSN at Penn State Schuylkill, with many coming from Schuylkill County. The campus is one of five at Penn State offering the BSN.

“Students train in hospitals, long-term care and community-based settings,” said Marianne Adam, director for Undergraduate Nursing Education at Penn State Schuylkill. “They are placed in multiple environments to meet different learning goals.”

For students like Menjivar, that was the difference between watching and doing. A clinical day involved eight students sharing one instructor, each assigned to one or two patients. The externship at Geisinger offered a dedicated preceptor, her own assignments and three 12-hour shifts per week.

“It was a full-time job,” Menjivar said. “Completely hands-on.”

By the time she returned for senior year, she added, her hands already knew what her textbooks were teaching.

That level of personalized experience is also beneficial to local hospitals.

“It can be really scary to be a new grad nurse, because it’s the first time you’re putting everything together,” said Wendy Clayton, chief nursing officer at Penn State Health St. Joseph Medical Center, who works closely with Penn State Schuylkill students during their clinical and externship placements. “The externship gives them a chance to see it firsthand with an experienced nurse, so they’re not walking in blind.”

Early exposure builds confidence and changes how new nurses show up on the floor. Instead of focusing on where to find supplies or how to navigate a unit, they’re able to focus on the patient from the start.

Lessons that don’t fit in a textbook

Menjivar saw that play out early on. During one of her first clinical rotations, she said, a patient rejected her. Every attempt to engage was met with resistance.

“I thought I was good with people,” she said. “And then I walked in and he just didn’t want me there.”

Instead of letting her switch patients, her instructor pushed her to try again. This time, Menjivar changed her approach. Less upbeat. More direct. She adjusted to meet the patient where he was.

The shift worked. The patient opened up and the interaction changed.

It was a lesson that couldn’t be taught in a lab, Menjivar said. Sometimes being a good nurse isn’t about doing more. It’s about reading the room and knowing when to adapt.

Students also take an active role in community-based programs like clothing and food drives, adult day programs, senior expos and the Schuylkill County Drug and Alcohol recovery simulation, building a deeper understanding of the realities their patients face outside of clinical settings.

What they learn in the hospital and in the community shows up right away in how they care for patients.

Where Schuylkill trains, Schuylkill hires

Menjivar’s externship turned into a formal offer at Geisinger Medical Center before her senior year began. Her two best friends are on similar paths.

At Penn State Schuylkill, that trajectory is increasingly the norm. Many students step directly into roles at the same hospitals where they trained. Radiological sciences and other health-related programs on campus also prepare students for roles inside the same regional healthcare network, creating even more opportunities beyond bedside care.

Across Pennsylvania, the nursing shortage is very real, with an estimated shortage of more than 20,000 registered nurses in the next year. But in Schuylkill County, the picture is very different.

“I only have seven RN (registered nurse) positions open right now,” Clayton said. “That’s down from having almost a 50% vacancy four years ago. Part of that is because of the pipeline that we’re growing with Penn State Schuylkill and other organizations that are close to us.”

As roles fill, students don’t just get hired, they stay to take care of the people they know. For locals like Menjivar, that connection is immediate.

“It just provides a different level of comfort when you’re taking care of people from your own community," she said.

After graduation

The BSN program is designed so that students are stepping into hospitals where they’ve already trained, bringing a level of familiarity and confidence that shortens the learning curve and strengthens retention.

Over time, those same nurses become preceptors, mentors and eventually educators, becoming the ones who train the next group coming up behind them.

“Five years from now, it’s not just about hiring new nurses,” said Clayton. “It’s about building a system that sustains itself."

Menjivar will soon start in the Critical Care Float Pool at Geisinger Medical Center, the same unit where she completed her externship. Long term, she said, she hopes to come back as a teacher.

“I’ve always had an interest in teaching, and I’d like to come back and encourage people from this area,” she said. “There’s so much opportunity; you just have to step out of your comfort zone and go for it.”

About the series

This story is part of an ongoing Penn State News series exploring the Commonwealth Campuses and their connections to the communities they serve. The series highlights how campuses across Pennsylvania contribute to education, workforce development, research and regional engagement in unique and impactful ways.