New York City Nurses Say AI Is Replacing Them

Following the largest nurses strike in New York City history, Marilyn Shuler and 11 of her co-workers returned to their jobs at Montefiore Hospitals in the Bronx in February, only to find that their work environment had changed in a major way.

At the time, Shuler worked in the utilization review department, which ascertains a patient’s need for medical care and whether care is covered by insurance. The veteran nurse, who worked at Montefiore for almost 40 years, had to begin using Datavant , a tool used to abridge the process by which the hospital sends patient and care information to insurance companies. Datavant’s website refers to itself as an AI platform.

Shuler said she and other nurses thought the tool would just help process the backlog of cases created by the nurses strike. But when case volume returned to normal, the 12 nurses working in utilization review were told to continue using Datavant.

In early July, after a few months of using the tool, Shuler was laid off from the position she held for six years. Her colleagues were all laid off too. They felt they had been replaced by artificial intelligence .

Shuler’s case and that of her colleagues, she said, is far from an outlier. Hospitals will continue to automate and eliminate the jobs of nurses and other workers through AI , Shuler added.

They felt they had been replaced by artificial intelligence.

Job automation keeps nurses up at night. It was a concern raised by nurses represented by the New York State Nurses Association (NYSNA) earlier in the year, when 15,000 walked off the job demanding a new contract.

“Artificial intelligence should never replace real human caring from a nurse,” NYSNA President Nancy Hagans said in a press release issued when the 12 nurses at Montefiore lost their job.

Montefiore representatives deny having replaced workers with Datavant.

“As is often the case, the claims by NYSNA are inaccurate and misleading,” Joe Solmonese, Montefiore’s senior vice president for government relations and strategic communications, said in an email. “What is true is that we are always investing in new technology to ensure the best care and outcomes for our patients and will continue to do so for the betterment of the people we serve.”

A spokesperson for the hospital said that Datavant’s tools are a nonclinical program that helps facilitate the paperwork process, but did not address whether the program uses AI.

Shuler said the laid-off nurses did not receive proper notice from the hospital. A union representative told the nurses on May 6, National Nurses Day, that the hospital planned to eliminate the 12 utilization review positions.

“We just can’t believe that a machine can replace all the decades of … clinical judgment and knowledge that we have,” Shuler told Prism.

Job automation through AI is bound to impact nurses in other parts of the country too. Joe-Ann Fergus, the executive director of the Massachusetts Nurses Association, said her union, which is engaged in a fierce contract battle with the largest hospital network in the state, is pushing back against an AI future in which hospitals deprioritize workforce development. A future in which hospitals de-skill their workers, she said, could be disastrous for patients and hospitals alike.

“We have already begun to see that, in places where AI has been introduced around triaging,” Fergus said. “The younger, newer clinicians, the more exposure they have to AI, and the earlier exposure they have to AI, the higher the risk of them de-skilling.”

“The earlier exposure they have to AI, the higher the risk of them de-skilling.”

Fergus said healthcare workers should have a background education, but that they should also supplement that with real experience in the field and trial and error. Reading X-ray scans, Fergus said, is an example of a practice that is enhanced by AI tools. But workers should still be able to know what they are looking at.

“We will lose the skill of doctors being able to read those tools as well, and when the inevitable happens that the system goes down, then nobody’s going to know how to read the images,” Fergus said.

Using an AI system that does not account for the historical inequities of the healthcare industry, Fergus said, is also a deep concern. Fergus worries that hospitals might look to save money on the AI products they contract with and end up with a service that is not attuned to serving a diverse population.

“If there’s any issues of racism, or the system is not properly programmed for the population that it’s in, then that additional programming of the AI can amplify the disparities that already exist and can actually result in injuries,” Fergus said.

Despite hospitals onboarding AI systems as an addition to workers’ current workflows, Fergus said it is only a matter of time before hospitals look to automate jobs. She said most hospitals will likely see this as short-term savings.

But if they don’t create more staffing to maintain and continuously train the products, “then the systems become obsolete, and they become harmful to the patients,” Fergus said.

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