AI Nurses: Staffing Solution for Hospitals or a Threat to Quality Care?
The next time you schedule a doctor’s appointment, the voice on the phone might not be human.
With a calm, welcoming tone, Ana, an AI-powered virtual assistant, is trained to help patients prepare for their appointments and address questions. Available 24/7 and in multiple languages, Ana is a product of Hippocratic AI, a company offering automated solutions for tasks traditionally performed by nurses and medical assistants. This marks a significant move by AI into healthcare, with hundreds of hospitals employing sophisticated programs to monitor patients, flag potential emergencies, and initiate care plans—tasks previously handled by human medical professionals.
Hospitals see AI as a way to increase nurse efficiency in high-pressure environments and address both burnout and staffing shortages. However, nursing unions raise concerns that this technology could undermine the value of human expertise and potentially compromise the quality of care. Michelle Mahon, of National Nurses United, stated, “Hospitals have been waiting for the moment when they have something that appears to have enough legitimacy to replace nurses. 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 organized numerous protests at hospitals across the country. Their focus is on securing a voice in how AI is implemented and ensuring protection for nurses who may disagree with automated advice. The union voiced new concerns in January over comments by Robert F. Kennedy Jr., then the incoming health secretary, suggesting AI nurses could provide care in rural areas “as good as any doctor.” And Dr. Mehmet Oz, nominated to oversee Medicare and Medicaid, believes AI can “liberate doctors and nurses from all the paperwork.”
Early on, Hippocratic AI promoted a rate of $9 per hour for its AI assistants, contrasted with approximately $40 per hour for a registered nurse. While the company has since adjusted its messaging, it emphasizes how thoroughly the technology has been tested and assures customers they’re getting a high-quality service.
Hospitals have used technology to improve care quality and reduce costs for years, including sensors, microphones, and motion-sensing cameras. This data is now integrated with electronic medical records to analyze patient data and predict medical issues, which sometimes directs care before a nurse even comes into contact with the patient.
Adam Hart, formerly in the emergency room at Dignity Health in Henderson, Nevada, encountered a situation where the hospital’s system flagged a new patient for sepsis. Following hospital protocol, he was instructed to administer high doses of IV fluids immediately. However, Hart recognized the patient as someone receiving dialysis, who requires controlled fluid management to prevent kidney overload. Despite his concerns, Hart was instructed to follow the protocol. Only after a physician intervened did the patient receive a slower 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 acknowledge AI’s goal to support them in monitoring multiple patients and responding quickly to urgent situations. They note, however, that this often leads to a constant stream of false alarms, potentially flagging basic bodily functions as emergencies.
Melissa Beebe, a cancer nurse at UC Davis Medical Center in Sacramento, said, “You’re trying to focus on your work but then you’re getting all these distracting alerts that may or may not mean something. It’s hard to even tell when it’s accurate and when it’s not because there are so many false alarms.”
Michelle Collins, dean of Loyola University’s College of Nursing, also highlighted the limitations of advanced technology, explaining that even the most advanced systems may miss crucial signs that nurses can easily discern, such as changes in facial expressions or odors. “It would be foolish to turn our back on this completely… We should embrace what it can do to augment our care, but we should also be careful it doesn’t replace the human element.”
Due to the COVID-19 pandemic, more than 100,000 nurses left the workforce, leading to the most substantial staffing drop in 40 years. With the population aging alongside current nurse retirements, the U.S. government estimates that over 190,000 new nursing positions will open up annually through 2032.
Given the shortage, hospital administrators see AI as filling a critical role: helping nurses and doctors gather information and connect with patients, rather than replacing their roles. At the University of Arkansas Medical Sciences, staff members make hundreds of calls each week to prepare patients for surgery, verifying details about prescriptions, heart conditions, and sleep apnea.
Dr. Joseph Sanford, who oversees the center’s health IT, explained that some patients only answer their phones in the evening, which added to the difficulty of contacting them. “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,”
Since January, the hospital has used an AI assistant from Qventus, which contacts patients and providers, sends and receives medical records, and summarizes them for human staff. Qventus reports 115 hospitals use their technology, with the aim of boosting hospital revenue through faster surgical turnarounds, fewer cancellations, and less staff burnout.
Each call starts with the program clearly 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,” said Sanford.
While some companies like Qventus focus on administrative services, others see a broader role for AI in healthcare. Israeli startup Xoltar creates human-like avatars that conduct video calls with patients. They are collaborating with the Mayo Clinic on an AI assistant that helps patients manage chronic pain and developing an avatar to assist smokers. In initial testing, patients spent around 14 minutes talking to the program, which can interpret facial expressions and body language.
Nursing experts studying AI suggest that these programs may be beneficial for those who are relatively healthy and active in their health care. However, they question the technology’s readiness for the majority of patients in the health system.
Roschelle Fritz of the University of California Davis School of Nursing. “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,”
