“We understand technology is coming. We generally want it to be good for us and our patients,” said union president Laura Nilsson at a town hall in March. “But right now, there's a lot of unknowns. What we don't want technology to do is replace nursing judgment. We don't want it to take jobs.”
The use of AI has popped up in the past few years in all kinds of union negotiations, from contracts for TV writers, to tech workers, to journalists.
This winter, nurses in New York City went on strike and then won AI safeguards in their contract. At one hospital in New York last year, nurses even won the right to review AI tools before they were deployed.
And in Traverse City, nurses are now asking for provisions surrounding AI, too.
“Say we’re checking their blood pressure and the blood pressure cuff isn’t on the patient appropriately,” said Munson nurse and member of the bargaining committee James Walker. “[If] that number is just pulled into the system without verifying whether it's accurate… that value, without looking at the big picture... it could potentially lead to a wrong decision.”
The hospital hasn’t purchased any AI note-taking software or diagnostic tools for nursing yet, but Walker thinks if, or when, they do, it’s always important to have a nurse in the room.
“What frequently happens with nurses is that somebody in the management and procurement, they decide on purchasing the technology, and then this is handed down from top to bottom to the practicing nurses that are there 24/7,” said professor and nurse Maxim Topaz of Columbia University, who has studied how AI is being implemented in hospitals around the country.
“Frequently nurses are not involved in designing those technologies and thinking about how these technologies are going to be integrated into practice,” Topaz said.
He said there are very few studies that examine the accuracy of AI systems in healthcare.
But in one Stanford study from earlier this year, Topaz said, researchers showed top-performing AI models producing 12 to 15 errors per 100 cases, and the worst-performing models making mistakes in 40 out of 100 cases.
“This is exactly why nurses are concerned about … these technologies. They have to be vetted and validated, and we need to know what the error rates are,” Topaz said.
Jenn Standfest, Chief Nursing Officer at Munson, has been at the bargaining table in Traverse City. She said she does see benefits of implementing AI at the hospital.
“Really some of the things that AI is targeting, in terms of reducing administrative burden or helping support clinical decision making, those are things that are challenges in healthcare… [and] are fueling burnout,” Standfest said.
But she said that everyone at the bargaining table as they’ve negotiated a new contract has had the same goal.
“We're in the business of taking care of humans," Standfest said. "And we have well-trained and experienced clinicians, and we want to make sure that we're honoring the work and the experience that those individuals have and implementing technology where it makes sense.”
The nurses’ union and the hospital reached a tentative agreement early Wednesday morning. The details of what’s in the new contract, like their agreements about AI, or other issues on the table like staffing levels, will be announced after union members vote on the new contract.
However, in a statement Wednesday afternoon, the Michigan Nurses Association said the tentative contract includes competitive wage increases and guardrails around AI and technology.
