Why nurses are protesting AI

Nurses took to the streets of San Francisco this week to protest the use of artificial intelligence in healthcare. But what were their specific complaints?

In general, they said they were demonstrating against the "untested" technology and the risk it poses to patient safety, and how AI should not replace nurses.

The hundreds of nurses who protested April 22 in front of Kaiser Permanente's San Francisco Medical Center also told local media outlets which programs in particular concerned them.

Some nurses objected to a platform in the Epic EHR that determines nurse staffing based on real-time charting. Cathy Kennedy, RN, neonatal intensive care nurse at Kaiser's Roseville (Calif.) Medical Center and a nursing union leader, told the San Francisco Standard that if nurses don't log charts right away the next shift could be short-staffed. Other nurses said it might not account for their time-sensitive work that can't easily be measured, such as educating patient family members or preparing for chemotherapy treatments before a patient arrives, the San Francisco Chronicle reported.

"We are the providers at the bedside, we know how to take care of patients best," Amy Grewal, RN, an oncology nurse at Kaiser Permanente Fresno (Calif.) Medical Center, told the Chronicle. "No algorithm can tell us."

Another nurse complained about an AI chatbot at Kaiser Permanente that patients can talk to instead of a nurse, according to the Standard. But what if a patient is having a heart attack and the chatbot doesn't understand — because it wasn't trained on the correct medical terminology — when a nurse would have? "The AI might direct them to the pharmacy, not to a doctor," Michelle Gutierrez Vo, BSN, RN, a president of the California Nursing Association and registered nurse at Kaiser Permanente Fremont (Calif.) Medical Center, told the news outlet.

Melissa Beebe, RN, an oncology nurse at UC Davis Medical Center in Sacramento, Calif., lamented to the Standard that an AI tool that monitors patient vital signs often issues false alarms. A hospital spokesperson told the news outlet she was "fear-mongering," noting that the platform has been in place since May 2022. "The concern is that this [technology] will take jobs — it will not," the spokesperson said. "It will make their jobs easier."

Kaiser Permanente has an Advance Alert Monitor in place at 21 Northern California hospitals that analyzes EHR data to detect patient deterioration. The Oakland, Calif.-based health system says the tool saves about 500 lives a year, but nurses told KQED it can produce erroneous notifications or miss patients who are in decline. "There's just so much buzz right now that this is the future of healthcare. These healthcare corporations are using this as a shortcut, as a way to handle patient load. And we're saying 'No. You cannot do that without making sure these systems are safe,'" Ms. Gutierrez Vo told the news outlet. "Our patients are not lab rats."

A spokesperson for Kaiser Permanente told Becker's that its technologies "empower" nurses by allowing them to "work more effectively" and that "physicians and care teams are always at the center of decision-making with our patients."

"It's very good to have open discussions because the technology is moving at such a fast pace, and everyone is at a different level of understanding of what it can do and [what] it is," Ashish Atreja, MD, chief information and digital health officer of Sacramento-based UC Davis Health, told KQED. "Many health systems and organizations do have guardrails in place, but perhaps they haven't been shared that widely. That's why there's a knowledge gap."

"We have this mission that no patient, no clinician, no researcher, no employee gets left behind in getting advantage from the latest technologies," he added.

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