As AI nurses reshape hospital care, human nurses are pushing back
[March 17, 2025]
By MATTHEW PERRONE
The next time you’re due for a medical exam you may get a call from
someone like Ana: a friendly voice that can help you prepare for your
appointment and answer any pressing questions you might have.
With her calm, warm demeanor, Ana has been trained to put patients at
ease — like many nurses across the U.S. But unlike them, she is also
available to chat 24-7, in multiple languages, from Hindi to Haitian
Creole.
That’s because Ana isn’t human, but an artificial intelligence program
created by Hippocratic AI, one of a number of new companies offering
ways to automate time-consuming tasks usually performed by nurses and
medical assistants.
It’s the most visible sign of AI’s inroads into health care, where
hundreds of hospitals are using increasingly sophisticated computer
programs to monitor patients' vital signs, flag emergency situations and
trigger step-by-step action plans for care — jobs that were all
previously handled by nurses and other health professionals.
Hospitals say AI is helping their nurses work more efficiently while
addressing burnout and understaffing. But nursing unions argue that this
poorly understood technology is overriding nurses' expertise and
degrading the quality of care patients receive.
“Hospitals have been waiting for the moment when they have something
that appears to have enough legitimacy to replace nurses,” said Michelle
Mahon of National Nurses United. “The entire ecosystem is designed to
automate, de-skill and ultimately replace caregivers.”
Mahon’s group, the largest nursing union in the U.S., has helped
organize more than 20 demonstrations at hospitals across the country,
pushing for the right to have say in how AI can be used — and protection
from discipline if nurses decide to disregard automated advice. The
group raised new alarms in January when Robert F. Kennedy Jr., the
incoming health secretary, suggested AI nurses “as good as any doctor”
could help deliver care in rural areas. On Friday, Dr. Mehmet Oz, who’s
been nominated to oversee Medicare and Medicaid, said he believes AI can
“liberate doctors and nurses from all the paperwork.”
Hippocratic AI initially promoted a rate of $9 an hour for its AI
assistants, compared with about $40 an hour for a registered nurse. It
has since dropped that language, instead touting its services and
seeking to assure customers that they have been carefully tested. The
company did not grant requests for an interview.
AI in the hospital can generate false alarms and dangerous advice
Hospitals have been experimenting for years with technology designed to
improve care and streamline costs, including sensors, microphones and
motion-sensing cameras. Now that data is being linked with electronic
medical records and analyzed in an effort to predict medical problems
and direct nurses' care — sometimes before they've evaluated the patient
themselves.
Adam Hart was working in the emergency room at Dignity Health in
Henderson, Nevada, when the hospital's computer system flagged a newly
arrived patient for sepsis, a life-threatening reaction to infection.
Under the hospital's protocol, he was supposed to immediately administer
a large dose of IV fluids. But after further examination, Hart
determined that he was treating a dialysis patient, or someone with
kidney failure. Such patients have to be carefully managed to avoid
overloading their kidneys with fluid.
Hart raised his concern with the supervising nurse but was told to just
follow the standard protocol. Only after a nearby physician intervened
did the patient instead begin to receive a slow infusion of IV fluids.
“You need to keep your thinking cap on— that’s why you’re being paid as
a nurse,” Hart said. “Turning over our thought processes to these
devices is reckless and dangerous.”
Hart and other nurses say they understand the goal of AI: to make it
easier for nurses to monitor multiple patients and quickly respond to
problems. But the reality is often a barrage of false alarms, sometimes
erroneously flagging basic bodily functions — such as a patient having a
bowel movement — as an emergency.
“You’re trying to focus on your work but then you’re getting all these
distracting alerts that may or may not mean something,” said Melissa
Beebe, a cancer nurse at UC Davis Medical Center in Sacramento. “It’s
hard to even tell when it’s accurate and when it’s not because there are
so many false alarms.”
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In this photo provided by National Nurses United, nurses hold a
rally in San Francisco on April 22, 2024, to highlight safety
concerns about using artificial intelligence in health care.
(National Nurses United via AP)
 Can AI help in the hospital?
Even the most sophisticated technology will miss signs that nurses
routinely pick up on, such as facial expressions and odors, notes
Michelle Collins, dean of Loyola University’s College of Nursing.
But people aren't perfect either.
“It would be foolish to turn our back on this
completely,” Collins said. “We should embrace what it can do to
augment our care, but we should also be careful it doesn’t replace
the human element.”
More than 100,000 nurses left the workforce during the COVID-19
pandemic, according to one estimate, the biggest staffing drop in 40
years. As the U.S. population ages and nurses retire, the U.S.
government estimates there will be more than 190,000 new openings
for nurses every year through 2032.
Faced with this trend, hospital administrators see AI filling a
vital role: not taking over care, but helping nurses and doctors
gather information and communicate with patients.
‘Sometimes they are talking to a human and sometimes they’re not’
At the University of Arkansas Medical Sciences in Little Rock,
staffers need to make hundreds of calls every week to prepare
patients for surgery. Nurses confirm information about
prescriptions, heart conditions and other issues — like sleep apnea
— that must be carefully reviewed before anesthesia.
The problem: many patients only answer their phones in the evening,
usually between dinner and their children’s bedtime.
“So what we need to do is find a way to call several hundred people
in a 120-minute window -- but I really don’t want to pay my staff
overtime to do so,” said Dr. Joseph Sanford, who oversees the
center’s health IT.
Since January, the hospital has used an AI assistant from Qventus to
contact patients and health providers, send and receive medical
records and summarize their contents for human staffers. Qventus
says 115 hospitals are using its technology, which aims to boost
hospital earnings through quicker surgical turnarounds, fewer
cancellations and reduced burnout.
Each call begins with the program identifying itself as an AI
assistant.
“We always want to be fully transparent with our patients that
sometimes they are talking to a human and sometimes they’re not,”
Sanford said.
While companies like Qventus are providing an administrative
service, other AI developers see a bigger role for their technology.
Israeli startup Xoltar specializes in humanlike avatars that conduct
video calls with patients. The company is working with the Mayo
Clinic on an AI assistant that teaches patients cognitive techniques
for managing chronic pain. The company is also developing an avatar
to help smokers quit. In early testing, patients spend about 14
minutes talking to the program, which can pickup on facial
expressions, body language and other cues, according to Xoltar.
Nursing experts who study AI say such programs may work for people
who are relatively healthy and proactive about their care. But
that’s not most people in the health system.
“It’s the very sick who are taking up the bulk of health care in the
U.S. and whether or not chatbots are positioned for those folks is
something we really have to consider,” said Roschelle Fritz of the
University of California Davis School of Nursing.
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