AI and the Art of Nursing

Overwhelmed by burnout and stretched thin from staffing shortages, nurses face soaring patient-to-nurse ratios — but artificial intelligence (AI) could be the game changer they need.

AI has the potential to revolutionize nursing care. And nurses can use AI tools to help with everything from transcription to patient monitoring and clinical decision-making, which could have powerful impacts on patient care — when it reaches its full potential.

“There’s a lot of talk about the potential of AI and nursing and healthcare,” said Stephen A. Ferrara, DNP, associate dean of AI and professor at the Columbia University School of Nursing, New York City, and president of the American Association of Nurse Practitioners. “Where we are now isn’t necessarily where we’re going to be…it’s going to continue to develop.”

Despite being a fledgling tool, nurses are embracing AI possibilities.

A recent survey found that two thirds of nurses believed AI could improve their case workload and enhance patient care with the biggest benefits in areas like patient education, enhancing medication management, improving accurate diagnoses, and clinical decision support.

Managing administrative tasks is one of the most widespread applications for AI in nursing to date. Nurses spend up to 15% of each shift on documentation; nursing scribes, device integration, and other AI tools can help reduce this burden.

“One of the reasons we have all these [nurses] with bachelor’s degrees is we expect them to operate at the full scope of their practice and capabilities,” explained Karen Cox, PhD, RN, FAAN, president of Chamberlain University in Addison, Illinois. “Right now, a lot of nurses spend an inordinate amount of time chasing data, moving data from one place to the next.”

Evaluating the AI Landscape

Some of the nation’s largest hospitals and health systems have incorporated AI into their nursing workflow. In Boston, Mass General Brigham uses generative AI to take notes during appointments and enter them into the electronic health record (EHR). Their research found that 58% of notes required no additional editing.

Baptist Health in Jacksonville, Florida, uses a similar tool; using recorded information that is encrypted in a certified environment requires patient consent and has led to significant reductions in the amount of time nurses spend charting.

Stanford Health Care in Stanford, California, launched an AI-powered app that uses ambient voice recognition to listen to interactions between patients and healthcare providers and generate written summaries of the clinical details. Ongoing pilot programs test new AI use cases and evaluate their potential to benefit healthcare providers and patients.

“If we’re able to [manage administrative tasks] in more of this hands-free experience, there could be…a release of the cognitive burden that [affects] nurses,” said Darren Batara, MS, BSN, RN, manager of nursing innovation at Stanford Health Care. “We’re also looking to understand if it improves the patient-nurse interaction. Oftentimes, nurses document and look at the screen while the patient looks at the nurse. This is actually a whole new change in the way that we’re conducting nursing.”

Ironing Out AI Concerns

The American Nurses Association included information about The Ethical Use of Artificial Intelligence in Nursing Practice in its code of ethics, noting, “The appropriate use of AI in nursing practice supports and enhances the core values and ethical obligations of the profession.” However, nurses still have concerns about how AI is used and its potential to maintain quality patient care.

Batara and Nerissa Ambers, director of Health Informatics at Stanford Health Care, are tasked with educating nurses about the potential of AI, dispelling misconceptions, and helping them understand that AI has a role in shaping the future of healthcare. Education is a critical step because 36% of nurses report a lack of knowledge about how to use AI tools.

“AI is not going to replace [nurses],” Ambers told Medscape Medical News. “The message is that we need to start learning how to use it because it is a disruptive technology; it will disrupt the way that we work, and so the more we can learn to use it to our advantage, the better.”

Getting nurses involved in creating and deploying AI tools is critical for ensuring acceptance and adoption. Survey data show that establishing clear guidelines and regulations for AI use, soliciting nurse input into AI design, showing evidence of its effectiveness, and providing education about using AI were among the top strategies to ease doubts about incorporating AI into clinical practice.

“In general, nurses will support things when they understand the ‘why’ and are involved in making those decisions,” Cox said. “A leader in healthcare isn’t going to be the best person to make a decision about something that…translates to the bedside.”

Focusing on the Future

AI is already transforming nursing, and its impacts will continue to grow. The tools have shown potential to reduce diagnostic errors, improve emergency response times, enable remote patient care, and provide insights that can lead to better care decisions.

Ferrara notes that some health systems are already using predictive analytics within the EHR to identify trends that might be missed with manual data entry and incorporating chatbots to help triage patients into care — but there is so much unrealized potential to explore.

Increased use of remote monitoring and wearable devices that use AI to integrate data into the EHR with the goal of improving health outcomes is just one possible future use case. More information could lead to better patient outcomes, he added.

There is also a push to address possible equity issues related to AI adoption in healthcare and ensure that rural hospitals, Federally Qualified Health Centers, and other under-resourced hospitals aren’t left behind.

“We assume the larger health systems have access to more resources and more support,” Ferrara said. “We want to be very mindful of the equity issue as these tools are being deployed, so we don’t create systems where a technology-enabled health system is providing better care than one that doesn’t have access to the resources.”

It will take time to win nurses over and provide proof that AI tools can offer benefits like improved care coordination and reduced administrative burden. Batara believes that introducing AI in a “paced fashion” is key to gaining acceptance for AI as part of the nurses’ workflow.

“We need to start small and stay really focused [on] raising the proficiency and understanding that AI can be just another tool in our bucket to coordinate,” he said. “At the end of the day, that’s what matters.”

Jodi Helmer is a freelance journalist who writes about health and wellness for Fortune, AARP, WebMD, Fitbit, and GE HealthCare.