Nurses and AI: Seeing potential, and concerns about safety

Artificial intelligence is playing a larger role in the healthcare industry, and many nurses say they welcome the prospect of AI tools helping them do their jobs.

But nurses also are expressing some unease with AI solutions. Too often, hospitals and healthcare organizations are incorporating those tools without consulting nurses on how they should be used and how those tools mesh with the workflow.

More importantly, nurses remain concerned about the safety and accuracy of AI tools for patients.

Jennifer Mensik Kennedy, president of the American Nurses Association, says AI technologies can aid nurses by reducing time spent on documentation, which would allow them to focus on patient care.

“The utilization of AI in healthcare is vital, so we need it to come in and help us with reviewing medical records, clinical decision support, getting rid of those tasks that are mundane, that don't require the nurses,” she tells Chief Healthcare Executive®.

• Read more: Nursing leaders cite problems that aren't being fixed | Special report

But Mensik Kennedy says that many nurses are questioning the performance of AI tools designed for clinical uses.

“I think why we question it is quite often we have these technology companies who do not have nurses on staff, who do not have nurses involved in creating these technologies,” she says.

(Nursing leaders talk about AI in this video. The story continues below.)

How AI tools are labeled

A majority of nurses say they want to see more AI tools in the workplace, according to an October 2024 survey by McKinsey & Co. and the American Nurses Foundation. Nearly two-thirds (64%) of nurses surveyed said they’d like to see more AI tools available at work.

But nurses expressed some unease about AI and its impact on patient care, according to that survey. They said their top concerns are accuracy of those tools, a lack of human interaction, and insufficient guidance on using the technology.

Nurses bristle at AI tools that are touted as substitutes for nursing or solutions that have been marketed to organizations as cheaper alternatives to paying nurses. Lawmakers in Oregon have crafted legislation that would prohibit AI tools from being labeled as a “nurse.”

Vicki Good, chief clinical officer of the American Association of Critical-Care Nurses, says marketing an AI tool as a nurse is “a four-letter word.”

“I think that's one of the biggest concerns that nurses have, is sometimes they'll introduce this AI tool …, they'll tell a patient, the nurse will get a hold of you, and it's a robot basically, in the back, an AI tool that's taking on all their data and consolidating it and giving the patient a recommendation,” Good says.

Good says she knows of a health system that uses a "nurse avatar" to communicate with patients.

"That's not a nurse there. That avatar is not a licensed RN," Good says.

Mensik Kennedy also ays it’s inappropriate to label or market AI tools as nurses.

“The bigger issue is that when people say, I've got an AI nurse, what they don't realize is what nurses actually do,” Mensik Kennedy says.

“This isn't about robots,” she says. “It's about the critical thinking and the care management. So we need to be really careful about saying we're replacing nurses, but giving nurses a tool to help them be able to do what they do best, and that's caring for that patient.”

Mensik Kennedy says AI tools can be called “health agents” or something else. But she says patients need to be explicitly told if they’re communicating with an AI agent.

“It’s also important for disclosure, for patient protection, because some AI tools can be pretty good,” she says. “And someone may not be able to tell the difference between AI and a nurse if it's on a screen. So how are we also protecting a patient?”

And she adds, “What if the AI gave wrong advice?”

Lavonia Thomas, nursing informatics officer at MD Anderson Cancer Center, said nurses are most concerned about protecting patients, and that’s why nurses will ask tough questions about the efficacy of AI tools.

During a panel discussion at the ViVE conference, Thomas said in the eyes of nurses, “You have to convince me that what you're giving me is going to allow me to safely take care of my patient, and that is at the forefront.”

Jing Wang, dean and professor of the Florida State University College of Nursing, is leading the first master’s nursing program on AI in healthcare. And she said during a discussion at the ViVE conference that nurses are embracing AI’s potential.

“There are a lot of nurses who are very pro-AI,” Wang said.

But Wang said nurses want to be able to use new technology as a way to deliver more patient-centered care.

Nurses need more training in foundational knowledge of AI, Wang said. She also said that hospitals and health systems need to talk with nurses about their concerns in using those tools.

• Read more: Why AI remains a top concern for patient safety

Getting guidance from nurses

Nurses are generally enthusiastic about AI tools that reduce their time in updating patient records and in creating summaries for shift changes. Good says those tools are showing potential to ease stress on nurses and allow them to spend more time with patients face-to-face.

”If they can decrease that burden of charting, and that nurse can spend more time at the bedside, what a difference we can make for our patients,” Good says. “And so that's really the upside of it, and I've seen some of the documentation tools, and I'm like, man, I wish I had that when I was at the bedside.”

Nurses say hospitals run into problems when they aren’t getting nurses to weigh in on AI solutions before deployment, and that can actually make their work harder. “Oftentimes, someone brings that technology in, and they layer it on top of everything else, and they don't change the way things work,” Menisk Kennedy says. “And they didn't get nurses' opinions and nurses' perspectives …. Is this going to work? And how can this work for us? So it is so vital that we get nurses at the table whenever you're thinking about a product.”

“Often, the chief nursing officer might be at the table, but we really need people who are the direct caregivers, the people who work those processes and policies every day, should be involved in those decisions as well,” she adds.

Without sufficient guidance from nurses, hospitals can be pouring money into solutions that won’t bring the desired return on investment.

“You could waste a lot of money, quite frankly, by spending loads of money on these solutions,” Good says. “And then if people aren't using them, you've not gained anything.”

Mensik Kennedy says some AI solutions haven’t lived up to their billing, and tools falling short of expectations often aren’t being designed with the help of nurses.

“I've seen AI tools that were supposed to help nurses, and I've been very greatly disappointed this last year in those results and what they thought they were helping with,” Mensik Kennedy says.

“So I think there's a lot to learn, and nurses should be at the table, every single table, when it comes to where we need the AI help and what the AI should be doing,” she says. “Because there's a lot to be done. Let's focus on the areas that nurses tell any developer to say, hey, here's what we really need to improve health care, and this is what's going to really help nursing if you want to help us.”