Montefiore Medical Center in the Bronx dismissed 12 experienced nurses from its utilisation review team and intends to replace their work with artificial intelligence software, according to the New York State Nurses Association (NYSNA).
Among those affected was Marilyn Shuler, who had worked at Montefiore for 39 years, and Ajita Mathew, a registered nurse with 36 years of experience. The nurses, who reviewed patient records to determine whether hospital stays and procedures were medically necessary and covered by insurance, received termination letters in late May. Each was told their position would end within 45 days.
"So much of what we do cannot be reduced to a click," Shuler said during a media call, arguing that the role requires deep clinical knowledge that cannot easily be automated.
Judy Sheridan-Gonzalez, an emergency department nurse at Montefiore and former NYSNA president, warned that replacing human review with algorithms risks undermining patient advocacy. "These algorithms just take very raw data and make a conclusion without taking into account the patient's gender, race, ethnicity, cultural needs, physical needs, and clinical needs," she said. Only a human reviewer, she added, can identify missing information in a patient's records and follow up directly with clinical teams.
The union says the terminations violate a February agreement reached with the hospital system after a month-long strike. NYSNA argues the agreement requires any introduction of AI to be discussed with the union to protect both staff and patients. The union has filed a class-action grievance and is calling for the layoffs to be reversed.
The hospital rejected the union's claims, with spokesperson Joe Solomonese calling the accusations "inaccurate and misleading." The union said Montefiore has already begun using AI-powered software from Datavant for utilisation review tasks, saying the technology is being used to eliminate nursing positions rather than support them.
The dispute highlights growing tension in US hospitals over the use of artificial intelligence in clinical and administrative roles traditionally performed by nurses.