Nurses push to shape clinical AI decisions
MASSACHUSETTS, UNITED STATES — Forty-one percent of nurses say their views are rarely or never reflected in artificial intelligence (AI) decision-making at their institutions, compared to 19 percent of physicians, as healthcare workers at two major United States health systems take labor action to demand a voice in how clinical AI tools are selected and deployed.
Labor actions target clinical AI expansion
Montefiore Hospital in the Bronx laid off 12 utilization review nurses in July 2026, replacing them with AI software from Datavant.
According to STAT News, the New York State Nurses Association (NYSNA) said the move allegedly violates AI-protection language from the union’s 41-day strike contract and warned that removing licensed nurses from final insurance reviews creates patient safety risks.
At Kaiser Permanente in California, roughly 1,000 call center nurses face algorithmic monitoring of call times and, in one test phase, AI assessment of empathy and tone, as STAT News reported. The California Nurses Association (CNA) placed AI governance at the center of Kaiser contract talks this summer.
“I’m not against the use of AI as long as it’s beneficial to the patient, but in this particular use it’s to increase productivity and improve efficiency and cut costs,” said Pa Vue, a Kaiser Permanente call center nurse and union representative.
National Nurses United (NNU), representing more than 200,000 nurses, calls for institutions to bear the burden of proving any AI tool is safe.
Global survey reveals nurse AI exclusion
The Elsevier Clinician of the Future 2026 report, a fifth-annual survey of 2,757 clinicians across 118 countries, found 49 percent of clinicians now use AI at work, up 23 percentage points from 2024. Among nurses, just 41 percent use AI regularly compared to 57 percent of physicians.
“AI has the potential to make a real difference in how we deliver care, but there is a clear lack of AI tools designed specifically with nurses in mind,” said Amy Hall, professor and dean of nursing at Franciscan Missionaries of Our Lady University.
Sixty-one percent of nurses predict AI will improve care quality in five to ten years, higher than physicians, suggesting their resistance centers on governance, not the technology.
As hospitals accelerate AI across clinical and administrative workflows, outsourcing providers increasingly deliver clinical documentation, prior authorization, and healthcare outsourcing functions.
Offloading back-office work to healthcare business process outsourcing (BPO) partners frees administrators to invest in the AI governance structures nurses are demanding.
Health systems that treat nurse involvement as optional face growing risk from regulatory scrutiny and labor action. The Montefiore and Kaiser cases are prompting attorneys and union negotiators to revisit AI-protection contract language, with implications for how BPO partners support clinical workflow transitions.
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