Nursing has, is, and always will be a STEM field

The United States faces a well-known problem of a significant shortage of nurses, which is projected to worsen in the coming years. This complex issue stems from several factors, including an aging population requiring more healthcare, a higher burden of chronic diseases, retirements among baby boomer nurses, inadequate numbers of new graduates entering the workforce, declining admissions in Schools of Nursing and the residual impact of the COVID-19 pandemic. This shortage creates significant strain on the healthcare system, with nurses facing heavier workloads, increased stress, and burnout. This shortage of nurses negatively impacts patient care, highlighting the urgent need for solutions to attract and retain nurses and ensure a robust healthcare workforce for the future.

I learned of this nursing staffing crisis as an international student at Fairleigh Dickinson University(FDU) School of Nursing in 2004. I expected that when I graduated, hospitals would eagerly hire and retain me the US desperately needed nurses. When I graduated in 2008, during the 2007-2008 economic crisis, I felt immune to the crisis because I thought that nursing was recession-proof. However, after working for a year on my optional practical training(OPT), a temporary employment that is directly related to an F-1 student's major area of study, I discovered that I was not eligible for the STEM OPT, which allowed a 24-month extension of the 1-year OPT, ?because nursing was not designated a STEM (science, technology, engineering, and mathematics) field. I had to choose between going back to Ghana or pursuing advanced degrees. I chose the latter.

I was perplexed that nursing was not considered a STEM field because I obtained a Bachelor of Science in Nursing degree at FDU, where I completed over 60 credits of STEM-related courses, including Anatomy and Physiology, Microbiology for Health Sciences, Chemistry for Health Sciences, Pharmacology, Pathophysiology, Biostatistics, Research, and Information Technology, among others. These STEM courses provided the requisite foundation to provide healthcare to diverse populations in varied settings. I received critical thinking and analytical skills to interpret data, assess patients, and make life-or-death decisions, which prepared me to work as a cardiac nurse at Inova Fairfax Hospital.

The integration of mathematics and technology in nursing practice is without question. Nurses routinely utilize mathematics for dosage calculations, ensuring patient safety and accurate medication administration. We analyze fluid and electrolyte balance using complex calculations and use biostatistics to evaluate data and improve healthcare processes. Nurses are increasingly at the forefront of technological innovations to solve healthcare problems. We utilize and contribute to the design of electronic health records, telehealth, and medical devices in diverse settings, which further reinforces the inextricable link between nursing and technology. Indeed the American Nurse Association has noted that “Nursing integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence.

When we think of STEM fields, it is easier to conjure images of scientists, engineers, mathematicians, and technologists. Yet, a crucial health profession is often left out of this conversation: nursing. Despite the undeniable scientific foundation of nursing practice, nursing often finds itself excluded from the STEM designation. This exclusion is not only inaccurate but also detrimental to the future of healthcare. While nurses are known to provide care, we save lives every day by applying knowledge and training that is deeply rooted in science. While some may argue that the presence of non-STEM or art elements, such as communication and compassion, excludes nursing from the STEM field, I argue that caring, compassion, and STEM are not incompatible. These skills should not be exclusive to nursing but it is equally required for successful professionals in all fields, including STEM.

Recognizing nursing as a STEM field is a long overdue and critical step to expand the workforce of US-trained nurses and increase the pipeline of nurses from diverse backgrounds. There have been previous calls to action which have not translated into action-designation of nursing as a STEM field at the federal level. While the Department of Labor recognizes nursing as a STEM or STEM-adjacent field in less material capacities, the Department of Homeland Security (DHS) and U.S. Immigration and Customs Enforcement (ICE) do not recognize nursing as a STEM. This designation is the most prominent and clear definition that exists at the federal level. Fixing the problem will take the simple act of an administrative change from the Student and Exchange Visitor Program (SEVP) office under ICE. It does not require an act of Congress.

Designating nursing as a STEM field may attract more international students to join the most trusted profession. Although there are approximately one million international students in the US, less than 1% choose nursing as a career. I am part of the 1% of international students who choose nursing as a career and the 2.7% of nurses with a doctoral degree in nursing. While the US has looked to the Philippines and other low-and middle-income countries to fill gaps in staffing, this approach is fraught with ethical challenges, including unethical recruitment practices and visa backlogs.? Designating nursing as a STEM field will allow more than 8,000 international nursing students to be eligible for the 3-year OPT, which affords them more time to contribute to the US nursing workforce and adjust their status to US residents.

The STEM designation will allow us to diversify the nursing workforce to ensure that the nursing workforce reflects the growing diversity of the US population. There have been previous calls to action to diversify the nursing workforce. While 40% of the US population identifies as people of color, only 19.4% of the nursing workforce are from racial/ethnic minority groups. In the landmark report, the Institute of Medicine (IOM) called for increased racial, ethnic, and gender diversity among nurses to improve the quality of care and reduce health disparities. More than a decade later, the Future of Nursing 2020-2030 report has noted that insufficient progress has been made to diversify the nursing workforce. Thus, we must do everything we can to retain all international nursing students, especially those who have received their training in the US, to ensure a more diverse nursing workforce.

Immediate designation of nursing as a STEM field may increase funding for nursing education and research, which will foster continued innovation and improve patient outcomes. For Schools of Nursing, this designation would unlock access to the approximately 9.5 billion dollars that is awarded by the National Science Foundation to universities every year. A lack of nursing STEM designation will preclude nursing students, faculty, and nursing programs from the growing pool of STEM-designated funding opportunities.

Nurses are at the bedrock of the US healthcare system. By recognizing the true impact of nursing, and designating nursing as a STEM field, we will be implementing an overdue change that will both address the nurse staffing crisis in the near and long-term and diversify the nursing workforce. It is time to acknowledge the reality – nursing is a STEM field.

I encourage you to join the coalition: https://www.nursingisstem.org/join-our-coalition

Yvonne Commodore-Mensah, PhD, MHS, RN is an Associate Professor at the Johns Hopkins School of Nursing, President and Co-founder of the Ghanaian-Diaspora Nursing Alliance and Board Member of the Nursing is STEM Coalition

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