By Matt Wolfgram
The story of how one passionate and talented HMoob College student ended up being pushed-out of her Bachelor of Nursing program, graduated with a nursing-adjacent degree after two additional years of college and consequent student debt, and now still needs to go to graduate school to someday become a nurse.
The “really long story” of STEM pushout
“It’s a really long story,” explains Sarah, who is a recent college graduate in Biomedical Health Science from the UWM. “But, my original [college] plan was nursing and now I’m going to grad school for nursing. So technically, my undergrad was supposed to be nursing, but it had to change to Biomedical Health Sciences.”
Nursing is a STEM discipline and profession that is on the one hand, an academically competitive discipline that is associated with prestigious, lucrative, and stable professional careers. Nursing is also the most feminized educational and career paths in the in STEM and medical sciences in the United States. Thus, if the racial and gender diversification of the STEM workforce is a national priority, it is important to consider the factors that impact the educational attainment of women and other minoritized students in the nursing profession. This blog highlights the cultural and institutional factors that conspire to pushout Hmong college students from nursing, focusing in particular on the experiences of one HMoob American student at University of Wisconsin-Milwaukee (UWM).
Sarah is a HMoob college student from Wisconsin, who I interviewed as part of the HMoob American College Paj Ntaub research study, to document the experiences of HMoob college students in the state. Sarah’s story is reflective of other HMoob students who we interviewed for the study—she started college pursuing an academic and career goal in a STEM discipline (in Sarah’s case, earning a Bachelor’s of Nursing Science and becoming a Registered Nurse), but as Sarah pursued and made progress toward this goal, she experienced a variety of institutional, cultural, and interpersonal factors that re-directed her toward an alternative (often adjacent) degree path. STEM Pushout is the concept we use to refer to the aggregate of processes that re-direct students away from selective STEM majors to alternative academic pathways.
In spite of the challenges of STEM pushout described in this blog, Sarah has remained focused and motivated to become a nurse. “Growing up,” she explains, “[nursing] had a big cultural aspect to it, wanting to be a medical profession and helping out family members spiritually and medically at the same time, that was a big goal of mine.” Sarah, whose family follows the traditional religious practices of HMoob Shamanism, hopes that the profession of nursing will provide opportunities for her to serve and provide care for the HMoob community. As a nurse, she could support the “other spiritual needs that are weren’t being met just because a lot of people don’t believe in that [HMoob Shamanism] in the medical system … so I think that’s how I got into nursing.”
Our research on STEM pushout has identified two broad categories of factors that cause students to depart selective STEM majors and pursue alternative pathways, one being Institutional Gatekeeping and Re-direction Procedures, and the other Cultural Minoritization.
Institutional Gatekeeping and Redirection Procedures
Selective admissions programs which include nursing and other STEM programs employ institutional gatekeeping procedures, such as required “weed out” courses and a selective application process for access into the clinical stage of the major, with the first application during the sophomore year. The timing of the application process for Sarah coincided with mental struggles brought on by “relationship drama” and the passing of her grandmother, with whom she was especially close. In this context, she received a C- in Organic Chemistry (or “O-Chem”), which is not considered passing for the nursing program application process. O-Chem is an infamous course among pre-nursing and other STEM students, described by students as “weed out” courses—with extremely academically challenging content, delivered as a lecture in a larger hall with many students, often graded on a curve, and highly contingent on the quality and approach of the instructor. She was unable to apply for two consecutive semesters because she was unable improve her grade in the O-Chem weed out course. Given the mental health and other factors that impacted the situation, and with support from two nursing faculty who advocated on her behalf, Sarah tried making a special-circumstances appeal to the Associate Dean, and later the Dean of the College of Nursing. But, the leadership of the college were recalcitrant—they would not adjust the bureaucratic gatekeeping procedures.
At the same time as this gatekeeping procedure was ongoing, Sarah was being re-directed toward a nursing-adjacent major outside the College of Nursing where she could graduate, and apply to the direct admissions nursing graduate program. This process of redirection to alternative and adjacent non-selective programs is mediated by the process of deficit-oriented advising. Sarah describes how her nursing advisor worked to re-direct her academic goals by persistently directing her to “consider a plan-b” other than nursing.
“… my advisor, I wasn’t her biggest fan, I would say. At first she was okay, but once I like struggled in O-Chem, I think I got like a C-, and you need a C in order to apply off the nursing program. She just always said “maybe nursing isn’t for you, you know. You should look into other career options,” and I knew in my mind nursing was set for me.”
After Sarah continued to struggle with O-Chem, rather than identifying strategies and resources to support her goals, the advisor persisted in a deficit-oriented approach:
“… I was having a hard time, [but] she said, “Maybe we made a mistake, you know, letting you back in the program because it seems like you’re not, you know, showing up for it. What if we didn’t do the right thing for you? And maybe you should look at other options,” and it always felt like a little bit discouragement from being a nurse, and maybe she’s just someone, you know who doesn’t understand the struggles that I had, or you know, just tough love, whatever it was. I didn’t feel as if we had the greatest connection as advisor and student. So, when I wasn’t really helped out, you know, when I was struggling after finding out, I failed the nursing program and got dismissed, she wasn’t really helpful.”
Cultural Minoritization
In addition to gatekeeping and redirection, Sarah felt minortized and excluded by the peer and institutional culture of the nursing program:
“As for nursing, you know they promote diversity a lot, but, in my opinion I don’t think that there is a lot of diversity in our nursing program. There are a few like different ethnicities here and there we have a few internationals here and there, but overall, I think staff wise, and you know, student wise, it’s predominantly white. …. At least from what I saw, I felt like I didn’t get the support that I would have loved to have as, you know, as a student of a different ethnicity.”
Sarah also felt excluded from the peer-cultural of the program which she described as “It’s kind of like a … survival of the fittest kind of thing, a lot of the students.” The White students in the program, “they always had their own click already, and they always studied together.” She explained:
“I didn’t really connect with a lot of the peers in the nursing program. I usually just stuck around [my fellow] HMoob students, there are 2 of them that I hung out with, and then I didn’t really have any friends going forward just because, you know, once you failed class, you don’t get to be with the same students anymore, so I just was kind of like on my own.”
Consequence of STEM pushout
The specific consequences of STEM pushout to students are material and emotional precarity. Students who face institutional gatekeeping and redirection procedures, for example, may protract their schooling by one or several years, escalate their student debt, and graduate with a degree with an unclear career track. In Sarah’s case, she ended up graduating with a nursing-adjacent after an additional year of schooling—and now, in order to achieve the original goal of becoming a RN, she is pursuing a graduate degree for a credential that only requires a bachelor’s degree. She explains, “And obviously it was a lot of waste of time [and] wasted money on my part. … Cause, you know, it took me 5 years to graduate for an undergrad and I’m still going for further schooling.” Sarah estimates that her current student debt is 30 thousand dollars. The additional debt caused by these already additional schooling, with the coat of a future graduate degree looming, is a source of serious financial stress, as Sarah describes:
“I’m not really sure what it is right now [exact amount of student dept], but I’m afraid to look … since I’m kind of pushed back in nursing, I probably won’t be financially stable for a while. But yeah, I’ve taken out a lot of loans. I’ve got as much scholarships as I could, but you know just it’s a struggle.”
The material and emotional precarity associated with STEM pushout is amplified by accumulation of multiple experiences of in the nursing program, or frustrating “weed out” courses such as organic chemistry, of discouraging advising experiences, and of being excluded from the peer and institutional culture of the program.
The consequences of STEM pushout for society are the discouragement and redirection of minoritized students away from competitive majors and professions which need well-trained and committed professionals. The state needs nurses and other healthcare professionals who are able to serve the needs of all the communities in Wisconsin, including our Hmong citizens who may have health and spiritual needs what are not by majoritarian medical institutions. STEM Pushout is a process that maintains this racial majoritarianism by systematically frustrating the racial diversification of the STEM and healthcare workforce in the state.