National Nurses United

4 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G J U LY | A U G U S T | S E P T E M B E R 2 0 2 6 NEW YORK L ast winter's historic strike sent a clear signal to management that New York's registered nurses are serious about the wages, benefits, and staffing levels needed to keep patients and nurses safe. For nurses in the New York City private sector, including Montefiore Hospital, one win was language requiring member input when introducing new technology like artifi- cial intelligence (A.I.). Unfortunately, no sooner did members at Montefiore return to work than utilization review nurses reported concerns with workflow changes. Utilization review nurses advocate for patients to insurance companies to make the case for coverage to pay for hospital stays, lifesaving surgeries, medications, and other important care. Often, patients are dealing with multiple comorbidities, and the nurses' years of experience help them under- stand the nuances that come with treating such complex cases. When the nurses raised with Montefiore management their concerns about how technology has changed their workflow, management instructed them to just keep working. Then in May, the unthinkable hap- pened: Montefiore announced a plan to lay off the 12 utilization review nurses and replace them with a software program from Datavant, a private equity-backed company that utilizes A.I. in its reports. To put this in perspective, Montefiore opted to lay off a group of nurses with the decades of bedside experience and clinical judgement needed to responsibly advocate for insurance approvals for patient care and treatment in the name of using A.I. to cut costs. The nurses had 45 days to find new positions. Although technology has encroached on nursing practice before, this is the first time that A.I. has replaced New York State Nurses Association (NYSNA) nurses. "Mon- tefiore gutted a department of veteran nurses months after we successfully struck and negotiated language to protect our posi- tions from being outsourced to A.I.," said Marilyn Shuler, RN, who lost her position in the utilization review department and was moved to the case management unit. NYSNA, which represents the nurses, hosted a virtual town hall on July 1 to push back on Montefiore's plan. Over 200 mem- bers, news reporters, and elected officials—including New York State Senator Nathalia Fernandez and Assembly Members Karines Reyes, Jeffrey Dinowitz, and Amanda Septimo—joined the town hall. New York City Council Member and Labor Chair Shirley Aldebol also joined the call and demanded Montefiore reverse the lay- offs, calling the use of A.I. "unproven technology that could compromise patient care." News outlets Gothamist, WNYC, and Crain's covered the town hall. Montefiore serves a diverse and vulnera- ble patient population, with many in the community already facing barriers to accessing care. In today's political climate, protecting patients' sensitive personal and medical information is more important than ever. Patients deserve to know who has access to their information, how it is being used, and what safeguards are in place to protect it. A data breach or misuse of sensi- tive information could have consequences far beyond a violation of privacy—it could expose patients to discrimination, harass- ment, or other serious harm. "It's not just that there is no real data on the use of A.I. in utilization review that's so bothersome; it's also that Datavant is known for partnering with Palantir, another private equity-backed company with a history of data breaches," said Laurel Carlin-Leclerc, RN, a former utilization review nurse who was forced to retire early. Working in uti- lization review allowed her to work from home, where she oversees care for her sick husband. "Our patients trust us to handle their incredibly sensitive data with care, and we have a responsibility to keep that data secure." Both Shuler and Carlin-Leclerc stress that technological advances are an impor- tant part of providing care. But there's a difference between using software to assist with charting and scheduling and allowing it to replace actual workers. Shuler and Carlin-Leclerc, like others in their department, each have over 40 years of nursing experience. Their years in the pro- fession enable them to understand clinical context, ask follow-up questions, and directly advocate for patients in ways A.I. simply cannot. They fear that the untested technology will increase patient denials, resulting in missed surgeries; reduced access to lifesaving medications; and denial of other patient claims, resulting in tragic outcomes. NYSNA has filed a grievance on the workers' behalf and is continuing to advo- cate for members whom the layoffs impacted by enforcing the contract and pushing for Montefiore to open positions so that no nurse is displaced. The A.I. threat will only increase in facili- ties and around the country. Union nurses will continue to raise awareness through the media and work with health care partners and elected officials on policy solutions to create more safeguards for patients and nurses' practice. —Staff report NEWS BRIEFS Montefiore nurses fight A.I. Software replaced utilization review nurses

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