Nurses need a seat at the table in using AI

Nurses have viewed AI with a mixture of enthusiasm and anxiety.

Nursing leaders see potential in AI tools to reduce the time spent on documenting patient records and other administrative tasks. They have have also been frustrated that health systems have incorporated digital products, including AI, without including nurses at the outset, leading to problems when those solutions are implemented.

Brad Goettl, chief nursing officer of American Nurses Enterprise, tells Chief Healthcare Executive® that he’s seeing more progress in healthcare organizations recognizing that nurses must be involved in helping shape AI strategies.

“Nurses need to have a seat at the table when they are deciding which technologies are going to be brought into their ecosystems,” Goettl says.

“They should really be at the table when thinking of solutions and designing solutions, and they should be a part of the governance because it's important that nurses understand how the tools are used, how the data is being used, how the models are being trained,” he adds.

The American Nurses Enterprise has received $5 million in support from Google and the Johnson & Johnson Foundation to help build AI skills in the nursing workforce. The American Nurses Enterprise includes the American Nurses Association, American Nurses Credentialing Center, and American Nurses Foundation.

Goettl spoke with Chief Healthcare Executive® about the ways AI is changing the nursing workforce, and shared insights on how health systems and healthcare organizations should be working with nurses to utilize AI.

While Goettl sees enormous potential in the use of AI, he warns that healthcare organizations need to see AI as a tool to help nurses, not to replace them.

“We've always taken the position that the AI isn't the decision-maker, but it really is a way to help add additional decision support to nurses,” Goettl says. “And so those concerns still stay true.

“And if you keep a nurse at the center of the development, the procurement, the implementation, then you're much more successful to not only pick the right solution, but to have nurses really kind of lean in and be early adopters and implement this into their everyday practice,” he says.

‘Nurses are closest to the problems’

Goettl expresses unquestionable enthusiasm about the ways that AI, if utilized properly, can help nurses deliver better patient care and have a better work experience.

“AI is not intended to take the place of a nurse, but if it can remove some of the tasks that nurses were really never intended to do to begin with, if it can help remove administrative burden, if it can help synthesize information, even support decision making, and give nurses more time back with their patients, or to be able to focus on tasks related to their patients,” Goettl says.

“We feel that, especially in areas where there's nursing shortages, or nurses are being stretched thin, or ratios are being pushed, that this type of technology will allow nurses to have some more time back in their day and maybe simplify their load,” he says.

At healthcare technology conferences, nursing leaders have consistently called on hospital executives to work with nurses in developing and deploying AI solutions. They have said at times, health systems have unveiled new tools without getting feedback from nurses, which has led to problems when those solutions are put into real-life workflows.

Goettl says he thinks more healthcare organizations are recognizing the need to get nurses engaged on AI tools from the start.

“I think system leaders are hearing the message. Nurses are more integrated into senior informatics roles where they are naturally kind of brought to the table,” Goettl says. “I'm seeing industries bring in nurse leaders either in formal roles or in an advisory capacity to help inform their products. Hospitals that deploy kind of a shared governance model tend to have an infrastructure where nurses are brought in to help kind of guide decisions with healthcare leaders.”

“Nurses are closest to the problems, so they're closest to the solutions. They know not only what they need to make their lives and days more efficient, but also what their patients need and what is right for the people that they take care of and the communities they take care of,” he adds.

Health systems looking at AI products should consider the problems they are trying to solve, and Goettl suggests organizations looking at forming an advisory team of nurses to examine the impact. They should look at testing products and can make incremental changes. And he says organizations need to be willing to take the leap with AI tools.

But he adds, “Just make sure the right people are in the room when you're making the decision.”

Why nursing can’t go away

American Nurses Enterprise advocates for more than 5 million nurses, so there are undoubtedly a wide variety of opinions on AI.

From his perspective, Goettl says it’s a “mixed bag.”

“We've started to see some advances, especially around ambient listening and reducing the documentation burden, and there's great headlines about nurses getting out on time instead of staying late to do some of those tedious tasks and catch up on charting,” he says.

He points to virtual nursing and digital tools that allow less experienced nurses to check with veteran nurses if they have questions. Such strides can reduce delays in medication administration.

But he knows that some nurses are uneasy about AI.

“I'm also hearing the skepticism a little bit, too, about patient privacy and their data,” he says. “What does malpractice look like if a clinical decision tool recommends something and I think in a different direction, or vice versa? How is all the data stored in this ambient listening?”

“I think we're working through, like I said, the legal, ethical, and governance around the use of AI within healthcare environments, and you know, the more nurses are engaged, obviously those questions get answered a lot easier,” Goettl says.

Certainly, nurses are worried about their job security, and some fear that hospitals and health systems are looking at AI to replace them. Nurses have also criticized technology companies for labeling products as “AI nurses.”

Goettl says AI can’t be viewed as a substitute for nursing.

“You can't replace the human aspect of care,” Goettl says. “So, there's never going to be a time where nursing goes away, because you can't replace human touch, you can't replace critical decision-making, you can't replace gut instinct. Those are things that technology can't do, or at least can't do well right now, and so you always have to have a human in the loop.”

“And I think it's essential that health systems, patients, nurses all remember that the human component of nursing is never going to go away,” he says.