A “Virtual” Attack on Our Union Voice
Earlier this year, Northwell South Shore University Hospital nurses secured a contract with provisions for nurses to review artificial intelligence (AI) technology before implementation, a first for nurses’ union contracts in New York State. Having a “real nurse” at the bedside, not AI, is a core pillar of our New York City private sector bargaining platform and will likely be a big part of upcoming contract fights.
For many who have not yet seen AI’s influence in medical settings, these provisions may seem unnecessary. I’ve even heard some nurses repeating our bosses’ line, saying that automation and virtual nursing can be solutions to our chronic overwork and understaffing. But those of us who have seen the rollout of AI and virtual nursing in the healthcare setting know this isn’t true: Technology can never replace the expertise of a real nurse at the bedside. As a union of healthcare professionals invested in safe patient care and protecting our rights at work, it is imperative that we are unified and consistent in our position for “a real nurse” at the bedside and advocate for a strong nurse voice in any decision that impacts our work.1
Nurses Are the Real Experts in Patient Care
As nurses, we have fought diligently to have the medical industry value our expertise. As our work evolves, we have taken on different types of responsibilities, but one thing remains constant: We create and maintain connections with patients that many other professionals who interact with patients do not. Our ability to directly care — to be present physically and emotionally for patients — is at the heart of what we do. As the healthcare system becomes increasingly profit-driven and the demand for efficiency cuts down on face time between medical professionals and patients, we need to do everything in our power to preserve that connection. Not only is AI stealing care away from patients and real nurses, but it is stealing what makes nursing a powerful and trusted profession. If we don’t provide direct care and we allow technology to compromise our patient interactions, nursing as we know it will end.
AI Is Already Here
Already, we are seeing these new technologies roll out in facilities across the state. At some facilities, AI tools track how long it takes a nurse to dispense a drug. Although this is done under the guise of safety and efficiency — nurses are administering narcotics that could be dangerous in high quantities — these technologies are recording interactions with patients to teach machines how to do our jobs. This is part of a long-term vision for the future of healthcare; for corporations, it may mean more profit. For the rest of us, though, this will lead to a future with fewer nurses and less compassionate and — ultimately — less real, intelligent care.
Not a New Fight
For years, the hospital industry has been automating medical decision-making, making important and often biased decisions based on boiled-down data. Now, electronic medical records companies, including ones our facilities contract with, are marketing the use of AI to scrub charts before the end of a shift.2 AI will run through charts and question nurses’ clinical judgement. However, what is potentially more dangerous is that it is also teaching AI how to perform these nursing tasks.
We are also seeing the rise of virtual care. While virtual care may address some of the systemic barriers to accessing care, particularly in rural parts of the state, it is no substitute for in-person care. The biggest telehealth companies right now are bringing in low-wage nurses from nonunion states to care for patients through a screen. This compromises the therapeutic relationship, and teaches a machine to do what only a real nurse can.
Protecting Our Union Voice
It is critical that we stay informed and demand transparency when AI, machine learning or virtual care are introduced to our facilities. There are too many attacks on healthcare and organized labor for us to stay silent on this one.
Although we welcome technology that keeps patients safe and healthy, we refuse to accept changes that can be bad for patients and bad for nurses, undermine our union voice and help lay the groundwork for a future with worse healthcare outcomes for all.
National Nurses United has put together a “Nurses and Patients’ Bill of Rights” which outlines the principles healthcare settings should follow when applying A.I. to ensure quality patient care, safety, and equity.
Read it here: bit.ly/ NNU-AI-Principles
SOURCES
1 bit.ly/2024convresolutions
2 https://www.epic.com/software/ai-clinicians/