A U.S. hospital was recently in the spotlight after 12 nurses who were laid off said they were being replaced with artificial intelligence-powered software. The situation has raised concerns about hospitals automating and eliminating the jobs of nurses and other workers through AI.
“For a lot of us, there’s this fear of the human narrative being erased,” said Christine Rodriguez, assistant professor and associate dean of nursing impact at Yale School of Nursing.
To Rodriguez, nursing is both a science and an art. But with AI, she says the art is missing. AI can process data left and right, but nurses are the ones who center the human experience within health care. For Rodriguez, there is a role for AI within the field of nursing — to complement, not replace, the work of nurses.
“It’s about being mindful if you’re going to use the technology and what you’re going to use it for to have the maximum impact,” she said.
In a Q&A, Rodriguez explains where AI belongs in health care, the ethical implications of using this technology, and how nursing schools can prepare students for the future.
The interview has been edited for length and clarity.
How is AI changing the field of nursing?
Christine Rodriguez: One of the biggest trends we’re seeing is the use of ambient AI scribes during patient visits, which transcribe and summarize patient-provider conversations in real time. Today, when we see our primary care providers, like a nurse practitioner, physician associate, or physician, the first question we get asked has changed. Now, it’s not even an introduction or a greeting, but rather, “Is it okay if I record this visit?”
Where does AI belong in health care, and where must human expertise remain non-negotiable?
Rodriguez: For me, AI needs to remain an extension of the decisions that we make as nurses. But when we rely on AI to be moral, when we rely on AI to speak to the lived experience of us as human beings, that is where AI fails. Empathy is essential in nursing because it shapes how nurses interact with patients, and it is closely connected to the ethical principle of justice, which requires us to treat people fairly, with dignity, and without bias. AI reduces the human experience. It reduces what empathy looks like. My favorite saying that I tell folks is, “I can’t wear the boots that you wear.” I don’t fit in those boots, but I certainly can pick up a pair of boots and walk right with you. That’s essentially what we need to be doing as nurses.
AI is a tool to help us, but at the end of the day, human connection is completely different than what my connection is to an AI agent. It doesn’t know the patient in front of me, what their lived experience is, what they’re going through in life. To AI, patients are reduced to algorithmic biomedical setpoints rather than human beings. I’m trying to view the patient as a person. My big fear with this technology is that people mistake it for something morally conscious, even though it flattens people into data representations and overlooks the depth of their lived complexity and dignity
[W]hen we rely on AI to be moral, when we rely on AI to speak to the lived experience of us as human beings, that is where AI fails.
Also, the same biases that we see within us as individuals are being perpetuated by these algorithms because we are the ones training these systems. To make matters worse, the systems are not even being trained by health care professionals. Instead, the system is being driven by the industry. For these reasons and more, nurses deserve a seat at the table and should be co-creators of this technology.
What are some of the ethical implications of AI influencing things like patient care and clinical decision-making?
Rodriguez: When we rely on AI in health care, it can lead to a lot of difficulties. For one, we’re marginalizing the expertise of the clinician because we’re now basically dependent on these algorithms to do it. What about the training that nurse practitioners, physician associates, and physicians go through? What about the training registered nurses go through? Are we saying that all you have to do is put [a question] in a chatbot, and all those years of training are gone? Does this mean our work isn’t valuable? During the pandemic, everyone was clapping for nurses, remarking we are the backbone of our health care system, calling us heroes. Today, some of those same nurses are the very ones being replaced with artificial-intelligence software. So, there’s this marginalization of the clinician’s expertise.
The other big thing is that policy and decisions start changing because they prioritize efficiency over humanity. It becomes about inputs and outputs. That can lead to a further erosion and mistrust between nurse and patient. Another big piece I struggle with is the environmental degradation of these systems. Data centers are being built in the most marginalized areas and further causing erosion of trust. Here we are telling you to trust AI, but then AI within the community is leading to depletion of water as well as an increase in electricity costs for those very communities.
What are some other ways AI is being used in nursing?
Rodriguez: There is also a growing ecosystem of AI-enhanced tools that we’re seeing specifically within simulation-based education. For example, sound-modulation technologies can now alter vocal tones and cadence to approximate how someone might sound, giving learners a more immersive and empathetic encounter. Likewise, there are also high-fidelity manikins that are able to move, shake your hand, and even talk to you in basic conversation, expanding the fidelity of clinical role-play and supporting clinical skill development.
How should nursing schools be preparing students to work with AI without sacrificing critical thinking or clinical judgment?
Rodriguez: We’re seeing a lot of folks figuring out how to integrate AI into health care curriculums because AI is here to stay. It’s about understanding which AI tools we should be utilizing to best prepare students to navigate what it looks like to be a clinician in the world of AI. For example, the AI ambient scribes are helpful in taking notes for clinicians, allowing for valuable face-to-face time to be maximized. However, these notes still need to be reviewed by a clinician. We’re also seeing AI embedded within the electronic health record, where advanced algorithms and predictive analytics now help anticipate clinical trajectories and how a patient’s biomedical course might unfold.
