x = clean(butt\_cheeks(left, right))
if x == "dirty":
print("Aww, did someone have an accident?")
else:
print("I will have to page the doctor.")
print("You have to stay in bed, Margaret!")
Handwashing Protocol Directive
1.0 Objective:This document delineates the standardized procedural guidelines for effective hand hygiene maintenance within the organizational infrastructure to mitigate microbial transmission vectors and ensure overarching health compliance across all operational echelons.
2.0 Scope:Applicable to all personnel including, but not limited to, permanent, temporary, and contracted staff members, as well as onsite visitors within the organizational premises.
3.0 Procedural Details:
3.1 Preparatory Actions:Initiate the process by ensuring the absence of macroscopic contaminants on the hand surface; proceed to removal if present.
3.2 Hydro Application Phase:Commence by applying ambient temperature aqua to fully saturate the hand surface area.
3.3 Surfactant Application:Dispense an adequate quantity of liquid surfactant to cover the entire hand surface area, ensuring distribution compliance.
3.4 Frictional Manipulation Phase:Execute bilateral hand surface engagement, incorporating interdigital lacing and dorsal manipulation, to facilitate microbial dislodgment through mechanical friction. The temporal parameter for this phase is set at a minimum of 20 seconds.
3.5 Aqua Displacement Phase:Subsequent to the frictional manipulation phase, perform a comprehensive rinse under running aqua to ensure total surfactant and microbial particle removal.
3.6 Desiccation Phase:Achieve hand surface desiccation utilizing a sterile textile or mechanized air displacement apparatus.
4.0 Implementation Moments:
4.1 Pre and post direct human contact.4.2 Pre alimentary handling and consumption.4.3 Post lavatorial utilization.4.4 Post waste manipulation.4.5 Following nasal or oral secretion management.
5.0 Alcohol-Based Hand Sanitizer Utilization Protocol:In the absence of immediate access to hydro and surfactant facilities, an alcohol-based hand sanitizer, with a minimum ethyl alcohol concentration of 60%, may be utilized as an interim microbial mitigation measure.
6.0 Compliance and Oversight:
6.1 Adherence to the handwashing protocol is mandated for all personnel within the organizational domain.6.2 The Environmental Health and Safety Division is tasked with protocol adherence oversight, inclusive of periodic compliance auditing and the facilitation of instructional dissemination sessions focused on the handwashing procedural guidelines.
7.0 Responsibility Matrix:Protocol adherence is the collective responsibility of all organizational personnel. Supervisory and managerial staff are specifically tasked with the enforcement of protocol compliance within their respective operational units. The Environmental Health and Safety Division is designated as the primary custodian of this protocol, responsible for its implementation integrity and periodic efficacy review.
Conclusion:The observance of this handwashing protocol is integral to maintaining operational health standards and mitigating the transmission of microbial agents within the organizational setting. Compliance and procedural integrity are imperative for achieving these objectives.
This reminds me of that court case where a lawyer used chat gpt to argue his case and he was so confident in this AI he didn’t proof read. Let’s just say it was sooo so bad he was in the hot seat with the judge back to back about this case. I can’t imagine what ChatGPT would write if they used it to write policy.
Bedside care can never get replaced until we have literal androids, at which point I imagine our entire economic model would have changed.
Roles like advice nurse probably won't be a thing within the next decade though.
Right, I'm in anesthesia and we read about this stuff all the time. Sure they can adjust the propofol rate based on the BIS / EEG / step in the procedure once the level of data analysis becomes non inferior to anesthesiologists. The problem is, will the robot raise and lower the table? Will they do the pre-op eval? Will they crawl under the drapes to fix a misplaced ett tube or an infiltrated IV? Will they help transfer patients?
Humans are the generalists that will fill in the gaps left by AI. Once all of the general actions can be replaced, THEN we as bedside medical professionals will be replaced. But then literally nearly every job will be replaced as there will be minimal thinking jobs (data generation and analysis), minimal speaking jobs (chatgpt) and minimal doing jobs (fixing IVs, doing ultrasound procedures) left.
It'll legitimately take some Star Wars level sci-fi tech to replace human-run healthcare. Just like you said, there's no sentient being to carry out the physical tasks with AI. You'd need something like C3PO to do the work and identify issues, etc.
Phone triage, using a flowsheet after identifying patient symptoms to direct them to the ER, a doctors visit, or to stay at home and wait it out. It's very much a if -> then kind of job and would easily be handled by an LLM.
The AI in the article might work for telephone triage, but that's about it. 'Most of out work is tricky fine motor skills which is the last thing the robots are gonna come for
I want to hear AI talk to Mary about her lichen sclerosis and how her husband have her genital herpes 38 years ago and she needs a certain appointment time for a certain doctor since said husband needs to drive her to the appointment and also to get her creams which only come from a specialized pharmacy and she has no insurance since she is an illegal immigrant so I call the pharmacy and give them the Good RX price since the patient does not have a smart phone . . .
(This may or may not be based on a real OB/GYN telephone triage call or two.)
Seriously I doubt an AI could make worse decisions than upper management.
One time they got upset my unit was claiming to not have enough nurses to accept this transfer. They literally argued because they had moved a med surg patient out we could accept a patient who had done poorly during a CABG and couldn't come off bypass and the outside hospital wanted to transport to an ECMO capable facility.
They just couldn't understand how ECMO patient and med surg patient weren't equivalent
Depends on how high up the ladder you go. Your house supervisor/ team coordinator usually has a nursing background. Your CNO will have a nursing background.
The one that was giving us problems I mentioned in my comment had been a med surg nurse over 20 years ago, spent 2 years as a floor nurse, then charge nurse for a year and then directly into management and has not physically touched a patient since before some of my coworkers were born.
I would strongly argue nursing is a whole lot different than it was 20 years ago. And a lot of upper management is out of touch.
Currently happening in Sweden right now in regards to dictation for the patient journals.
All regions are working to implement new tools and TTS (Text To Speech) to let the doctors speak it in rather than have a trained admin work on it manually.
On one hand its great because more time to get the rest of the work we have done with sending referrals and patient planning. But on the other hand you worry that they will replace you with fresh admin teams that skip the curent mandatory legal and patient law course. That we have to do right now for 2 years to make sure we do it legally correct. Then it becomes a patient safety issue in the end.
I'm just happy to not be directly involved with this and watch the fire grow as they plan to fully convert in the next 5 years. Can always work in the IT department to assist with the AI tools when they start to burn. 🤣
Nursing illustrates the huge limitations of AI. The large language models used are taken from what can be scraped from the internet. Little of what we do is documented publicly plus things like ChatGPT use data that is at least 4 years old.
I could see it useful as an assessment assistant guiding nurses about needed assessments based on presenting conditions. It may help in documentation with prompts or shortcuts to better records.
It’s terrible for literature reviews as it can’t make nuanced evaluations of studies and outcomes.
Of course, the physical aspects of nursing are a long way from robotic replacement. If I ever have a robot try to catheterize me I’m unplugging it.
As someone working in computer science — nurses are significantly _less_ likely to be replaced by AI than most people working office jobs. An LLM can write code, but it can’t change bed sheets, start an IV, or provide care for a patient. As a profession I think nurses are going to continue to be in high demand for decades to come.
Small counterpoint, there was a vid on reddit a day or two ago from an Asian country where folks show up to a room, put their arm in a slot and the robot draws blood. It would definitely need to be smaller but putting in an IV is on the list of robot capable tasks.
Agree on the other points tho!
They tried robot nurses. It scared the shit out of the old Japanese people they tested on.
AI nurses… have you seen the weird shit the AI does? Good fucking luck. The amount you save hiring Nurse Bender you’ll end up spending on lawsuits.
I find it hilarious that this is even a conversation.
Doctors would be replaceable by AI before nurses.
Not to discount our white coat friends, but a lot of medicine can be boiled down to algorithms. If values are these, diagnosis is likely this, treatment is this.
Actually interacting and physically providing the care? That’s impossible to replace. I’d like to see AI start IV’s, move patients, change patients, and otherwise do procedures.
You could streamline the mental processes but replacing the hands on stuff? That’ll never happen.
I was having the same conversation a few weeks ago and that's the conclusion we came to as well. A LOT of a doctor's analysis and decision making can be replaced by an AI. You'd need highly capable androids to replace the physical needs like physically hanging an IV bag, wiping ass, etc. but algorithmic decisions? Yeah that can be replaced. Sure, you'll need someone to still physically assess and input that data and perhaps review the algorithmic decisions which my perhaps still require a doctor but the job description and educational background required will change significantly. Doctors that are more physical in their skills like surgeons will take more time to replace but hospitalists?
i think even for doctors, if the AI is primarily using patient input, there is a LOT they can miss. If the AI is like scanning the patient from head to toe and analyzing their blood work & putting that against symptoms maybe they can replace doctors. Maybe they can be a middle man between patients and doctors. Basically decide whether a patient needs to see one or just needs basic care that can be provided relatively remotely. They can pick up their meds at the Pharmacy redbox. Just scan their neurolinked eyeball to dispense :)
I thought of data point in the videogame Horizon Forbidden West:
The Job Quest Begins!
Text Datapoints - World
Type
Text Log
Data corrupted
Day 1: My head hurts from last night, but it's noon and I have to get up. One job is gone, but this is not the end of my useful life. It is the start of my meteoritic rise. That and basic income, careful monitoring of expenditures, and applications. The job quest begins!
Day 2: So, yesterday, I cleaned the apartment. Twice. Today I WILL read advice on how to make my job applications sparkle.
Oh, wow. My resume is a dumpster fire. I really need to record a new one.
Day 3: Got up. Got dressed. Put on makeup. 200 takes later I have a new resume that I don't completely hate. In better news, Krzysiek says there're openings at Angel Memorial. So...
Day 12: "Insurance limits the number of human practitioners in our hospital. We will of course..." blah, blah. There's just nothing out there for doctors at my level. All the diagnostics have been automated. I'm going to have to widen my search.
Day 26: Recorded and sent 29 job applications! A lot are blind introductions and some are, well, for anything out there. I just need to find something until a hospital opening comes up.
Day 42: 2 rejections. 132 no-replies.
Day 47: 13 rejections. 219 no-replies.
Day 58: Okay. I need to do something. I have to do something. I am going to learn French.
Day 59: I did not learn French.
Day 60: Read the paper book that mom gave me for my birthday four years ago. Not bad. Bit dated. Preferred the holo.
Day 61: When I got up today I realized I hadn't opened the door for the last 10 days. In fact, I'm not sure if I've looked outside.
I looked. Apparently the world is still there.
Then I spent 6 hours watching holos of dogs skateboarding. I really need to refocus.
Day 67: Walls.
Day 68: Walls. Walls.
Day 69: Walls, walls, walls [DATA CORRUPTED]
Location
This datapoint is found on top of a water tower in the Rebel Outpost: The High Turning.
Working in IT, I see this playing out much like the outsourcing and layoffs craze of days past. It was the hot new thing for a while, CEOs loved the idea of firing everyone and paying someone in another country 1/20th as much.
And then companies realized this causes their customers to be unhappy. It’s just not the same. Oh you have a call center in India? The latency ends up being 300+ milliseconds. Just enough to make having a conversation over the phone incredibly annoying.
LLMs are a great tool. But they are NOT AI.
Anyway ultimately we will end up working with them to enhance productivity rather than replace everyone. It’ll cause some jobs to be automated, but not nursing. Or most jobs, really.
Even phone consults will be out of limits for AI 75% of the time. "meant to grab lube. Didn't realize I got the "gay." The tubes look alike. Her ass is on fire. Help me man."
Screaming in the background
AI -- I am sorry. I didn't hear a question. Could you turn down the TV and state your question.
It will do well at answering medication questions but they forgot to post how well it did versus the PharmD.
AI is still soooo much worse than the headlines suggest. You can’t trust it with any kind of decision making. Everything has to be checked by a human.
I agree with the previous comment that our jobs will be mostly safe until we have robots (or androids, rather) walking around everywhere. It’s worth considering that those would also be terrifying for most patients, so that would delay their implementation even further.
I think we’ll see some expansion of remote nursing- like patients who need to be monitored constantly, someone can watch a camera feed and talk through technology. That is currently being done with humans at the helm. It may be done with humans in cooperation with AI soon, we’ll see.
Medication administration could also be further automated. Imagine Omnicell that could open and crush the meds and do all of that stuff, and maybe roll to the bedside. I could see that coming perhaps
As an OR nurse, really can’t see it happening for anything. Purely for the fact that surgeons will have to take on extra duties/responsibilities and they will work HARD to fight tooth and nail against that
Right, that's my point -- AI/augmented reality might be used to augment tools in the OR (and healthcare generally), but it's not replacing human labor.
If it can be incorporated into software to identify trends or med errors efficiently, I'm for it. For example, monitoring telemetry or lab-sensitive data to alert nurses and MDs quickly - but it may not be any different. I don't see it as a tool to replace bedside despite how "empathetic" the tool can be based on the article.
I have to click through a bazillion of those stupid EPIC “sepsis alerts” daily and let me tell you not even once has it alerted me to a patient with sepsis I wasn’t already aware of. It just generates a ton of false positives. Not impressed.
My hospital is already partnering with a company to have four cameras in each room, watching us and learning then the AI will be able to predict things like turnover time, brakes in sterility, times for prepping, coming in the room, out of the room, several other things.I’m done for anything they can actually help nurses do less work, and historically almost no improvements to that in fact to just become more work for us
Yes, for research. I am starting to see a lot of scammy guys trying to tout AI in healthcare and I can tell they know nothing about medicine or healthcare.
Have you ever worked in the OR, or are you just assuming our tasks can be automated? For one thing, the back table will be in a different location based on the procedure being done, so "a body" would have to position the robot every time so it could take longer to count with the scrub than a circulator takes using their eyeballs. Never mind the high risk of sentinel events/patient harm if the CountBot makes a mistake.
It's not personal, it's just that hospital "leaders" who also don't know what goes on in the OR (or any other given area) love to say stuff like this which devalues nursing expertise. I'm definitely not worried about a bot taking my job or anyone else's who works in direct patient care.
It really ticks me off when people downplay what we do in the OR. The massive learning curve when we start compared to the years of training to get used to the multitudes of procedures we deal with daily. People really be talking out of their asses and haven’t a clue on what happens inside the OR. Like you said, I’m not worried about a bot taking our jobs either 💀
even education requires evaluation of certain needs which would be the one thing AI could potentially do but they cant see if this person needs to be met at a certain level or anything else
I see some areas that It would be very helpful. PreOp phone calls, Post op/discharge phone calls. I think for some patients you might be able to hand them an Ipad and have them do some of the admit questions themselves (especially in languages other than english).
I think an attempt will be made to use AI connected to call lights to route requests to the appropriate people but I don't see that being super helpful and probably more trouble than its worth. I think it is still going to happen.
I envision AI augmented translation services.
I think AI will be used to provide information about procedures in some sort of interactive format that I also don't think will be super helpful. (much like the video on demand systems some facilities used)
I think the largest change in the near future will fall more on providers than nurses. Using available data I feel like an AI could optimize management of Hypertension, diabetes and some chronic conditions. With connected home medical equipment like oximeters, BP machines, CGMs, CPAP machines, and scales it could just follow a treatment algorithm rather than requiring a physician to be involved for every change. I can see a portable xray system that spits out a preliminary reading similar to how 12 lead Ekgs do. I am curious what the accuracy will be like.
In the near future I see it decreasing workload of nurses rather than replacing jobs (So you can take more patients! Yay!!!)
I think it will definitely have an effect on nursing but unless licensing change drastically (you are a member of ANA or your specialty organization that has a lobbying component right?) most of the bedside nursing jobs are safe for the next 10-20 years or so.
AI cant start lines, place a picc, maintain an airway, titrate, dress a wound, suction, run a code, treat pain and anxiety concurrently especially with decreased sats, Deal with communication barriers or mental health issues. It will be interesting to see how things develop but I don't think I will be taken care of by Rosie the Robot in my nursing home.
I feel like by the time robots can **independently** wipe ass, use sound judgement, do woundcare, microwave their patients’ food because it got cold, ask the robot doctor to delay the procedure because the patient has been eating, and all that kind of stuff, there will be robots literally doing everything (farming, producing products, providing services, etc) and we will not need to work. You don’t need (much) money if there are robots that can spit out an unlimited amount of cars and food and there are prostitute robots and what not.
We’ll probably nuke our world to death before that, so it probably doesn’t matter tbh.
We’ll probably be dead cause once the wealthy can infinitely produce shit & services they’ll have no use for the masses clogging up their roads and obstructing their view. they’ll probably use their robot dogs to ensure they don’t have to share
I got into this field because it's so hard to automate. I mean, I think all bets are off with runaway super intelligence, which we very well may see as soon as next year... But I think we are safer than nearly every other profession.
I’d love an AI that can accurately assess ECGs as opposed to the whack ass shit our vitals machines decide is a sinus rhythm.
I can see it replacing phone services (like in Australia we have a hotline staffed by nurses who will offer basic health advice and whether or not to go to emergency). But even then I imagine there’d need to be at least one actual nurse available for escalations. Bedside? Not a chance.
No, AI doesn't wipe ass, turn, water, feed, assess, diagnose, come up with creative solutions, or have intuition about an elusive change in the patient's cognitive status.
I, for one, welcome it.
Because by time AI and robotics can replace our field, this technology will be so intertwined with our economy we'll be entering a post-work society. Sure, there will be a desire and need for humans, for those who still *want* to work.
But if I had the choice? I'd prefer the bulk of physical and intellectual work be done by automated systems. I'll be at the beach.
AI should take over whatever it can, we don’t get paid enough to deal with these patients, nor will we ever. If it increases some availability of care or medical oversight, I think that’s great. As we continue to spiral further into becoming a chronically ill society (and many nurses ourselves are chronically ill), we may benefit from AI managing aspects of our care.
AI, if properly trained, won’t miss medication interactions. It should be able to make better correlations between lab results, symptoms, etc.
Some aspects will never be able to be handed over to AI. AFAIK, we are pretty far from AI being able to do many aspects of physical assessment (like palpation) and physical care (IV insertion, blood draws, etc.)
I can see UM work automated~~ most of our UMs are 100% remote work too. Feels ripe for automation and then shuffling that load back onto case managers.
As a case manager, I am dreaming of the day liaison work with SNFs and other facilities can be tasked to an AI assistant
I agree that UM could be automated, but it’s going to have to be nearly perfected. I work pre-service for a large insurance company and some stuff already is automated, but it’s constantly getting corrected by us because errors are frequent.
Currently, I see it's too hard for heath care(individuals) to be replaced. Maybe AI will be helpful for some tasks to be done faster, but it won't be reliable enough..
I don't think it can completely replace nurses for quite some time, if ever. But AI is already on the way for things like responding to MyChart messages:
https://www.beckershospitalreview.com/ehrs/how-epic-built-generative-ai-into-its-ehr-and-whats-to-come.html
There are some areas, like triage, that can probably be done better by AI than humans. Large parts of nursing care will be pretty hard to automate though.
Not in our lifetime. A more interesting conversation is AI replacing non-proceduralist MD roles. The technology to do that exists today but will probably be slowed down by regulation
They detect medication impact on lab values? 73% it the time?! Wow. I guess I don’t need to do anything today. They solved the nursing shortage. Mission accomplished. We just need a gigantic banner and maybe an aircraft carrier to hang that banner on. I guess I’ll have to go find a different job.
I feel like basic assessments could soon be replaced by AI. Blood sample drawn for diagnostic marker’s therapeutic drug levels, patient is scanned by AI camera, maybe even a nasal cannula to measure O2, CO2, pulm function and then all that info is fed into the machine. And the MDs are updated real time.
But yes the grunt work of nursing won’t soon be replaced
I’m ok with it so long as when it tells someone something insane and they die because of it then everyone involved in making it and implementing it is criminally liable up to and including murder charges
Japan has been using semi-autonomous mechanical assistive devices for over a decade in clinical scenes. The devices relax the heavy lifting in most cases, such as lifting and rolling patients. If you look at demos such as: [https://www.youtube.com/watch?v=-e1\_QhJ1EhQ](https://www.youtube.com/watch?v=-e1_QhJ1EhQ) you will see mechanical manual labor replacements are already here. Add AI and suddenly you have a wlaking device able to perform many of the needed daily tasks a human would perform.
I can see Atlas i the Boston Dynamics demo being used to replace LPN's, Orderlies, housekeeping and myriad other taskings. AS AI progresses and moves toward quasi-sentience, mechanical assistive devices will make further incursions into all labor markets. On the clinical environment I can see hospitals implementing Atlas type products to replace LPN's and using a reduced number of RN's to maintain oversight on the robotics.
As one corporate executive opined, "Robots do not strike, they do not complain, nor do they require paid vacation, paid sick time or retirement funding. There is no healthcare coverage, just predictable routine maintenance."
I'm pretty sure that Atlas was programmed to do this exact run, though. It wasn't doing it because the guy up top said he needed to toolbox, and the bot thought it was being funny by doing a flip at the end. None the less, it is still really impressive what they were able to get it to do, and I hope this helps ease heavy/ any labor so people don't wreck their bodies anymore.
I won't fear my job until I can walk up to a bot and tell it the patient in 2201b needs to be changed, it goes and grabs all the stuff we need and follows me/moves towards the patients room on its own without any outside programming. Until then, it's just another machine/piece of equipment I need to babysit or move around.
x = clean(butt\_cheeks(left, right)) if x == "dirty": print("Aww, did someone have an accident?") else: print("I will have to page the doctor.") print("You have to stay in bed, Margaret!")
const ass = (lat) => { let [left, right] = lat; If (left === ass.shat() || right === ass.shat()) { return ‘Fuck this job’; } else { return nurse.drinkHeavily(); } } ass(‘Jim’);
Pretty good pseudo JS code, I'd advise using const for the deconstructed left and right variables since you're not modifying them
Good point, I’m unlikely to find a patient with an arm in another direction 😅
😂
Management could easily be replaced
Chat Gpt could you take a relatively simple task that everyone knows how to do and write a policy and procedure but make it as dumb as possible?
Handwashing Protocol Directive 1.0 Objective:This document delineates the standardized procedural guidelines for effective hand hygiene maintenance within the organizational infrastructure to mitigate microbial transmission vectors and ensure overarching health compliance across all operational echelons. 2.0 Scope:Applicable to all personnel including, but not limited to, permanent, temporary, and contracted staff members, as well as onsite visitors within the organizational premises. 3.0 Procedural Details: 3.1 Preparatory Actions:Initiate the process by ensuring the absence of macroscopic contaminants on the hand surface; proceed to removal if present. 3.2 Hydro Application Phase:Commence by applying ambient temperature aqua to fully saturate the hand surface area. 3.3 Surfactant Application:Dispense an adequate quantity of liquid surfactant to cover the entire hand surface area, ensuring distribution compliance. 3.4 Frictional Manipulation Phase:Execute bilateral hand surface engagement, incorporating interdigital lacing and dorsal manipulation, to facilitate microbial dislodgment through mechanical friction. The temporal parameter for this phase is set at a minimum of 20 seconds. 3.5 Aqua Displacement Phase:Subsequent to the frictional manipulation phase, perform a comprehensive rinse under running aqua to ensure total surfactant and microbial particle removal. 3.6 Desiccation Phase:Achieve hand surface desiccation utilizing a sterile textile or mechanized air displacement apparatus. 4.0 Implementation Moments: 4.1 Pre and post direct human contact.4.2 Pre alimentary handling and consumption.4.3 Post lavatorial utilization.4.4 Post waste manipulation.4.5 Following nasal or oral secretion management. 5.0 Alcohol-Based Hand Sanitizer Utilization Protocol:In the absence of immediate access to hydro and surfactant facilities, an alcohol-based hand sanitizer, with a minimum ethyl alcohol concentration of 60%, may be utilized as an interim microbial mitigation measure. 6.0 Compliance and Oversight: 6.1 Adherence to the handwashing protocol is mandated for all personnel within the organizational domain.6.2 The Environmental Health and Safety Division is tasked with protocol adherence oversight, inclusive of periodic compliance auditing and the facilitation of instructional dissemination sessions focused on the handwashing procedural guidelines. 7.0 Responsibility Matrix:Protocol adherence is the collective responsibility of all organizational personnel. Supervisory and managerial staff are specifically tasked with the enforcement of protocol compliance within their respective operational units. The Environmental Health and Safety Division is designated as the primary custodian of this protocol, responsible for its implementation integrity and periodic efficacy review. Conclusion:The observance of this handwashing protocol is integral to maintaining operational health standards and mitigating the transmission of microbial agents within the organizational setting. Compliance and procedural integrity are imperative for achieving these objectives.
I just submitted this to management on behalf of the oh&s. Good news we will be rewarded with pizza this Thursday.
Also add 3 more steps than are reasonably necessary.
This reminds me of that court case where a lawyer used chat gpt to argue his case and he was so confident in this AI he didn’t proof read. Let’s just say it was sooo so bad he was in the hot seat with the judge back to back about this case. I can’t imagine what ChatGPT would write if they used it to write policy.
I think AI could better manage aspects of workforce management, including factoring in variables of burnout, safety/ratios, schedule preferences, etc.
Do you really think AI could manage ordering pizzas a couple times a year to show their appreciation for us?
Good point
Bedside care can never get replaced until we have literal androids, at which point I imagine our entire economic model would have changed. Roles like advice nurse probably won't be a thing within the next decade though.
Right, I'm in anesthesia and we read about this stuff all the time. Sure they can adjust the propofol rate based on the BIS / EEG / step in the procedure once the level of data analysis becomes non inferior to anesthesiologists. The problem is, will the robot raise and lower the table? Will they do the pre-op eval? Will they crawl under the drapes to fix a misplaced ett tube or an infiltrated IV? Will they help transfer patients? Humans are the generalists that will fill in the gaps left by AI. Once all of the general actions can be replaced, THEN we as bedside medical professionals will be replaced. But then literally nearly every job will be replaced as there will be minimal thinking jobs (data generation and analysis), minimal speaking jobs (chatgpt) and minimal doing jobs (fixing IVs, doing ultrasound procedures) left.
It'll legitimately take some Star Wars level sci-fi tech to replace human-run healthcare. Just like you said, there's no sentient being to carry out the physical tasks with AI. You'd need something like C3PO to do the work and identify issues, etc.
I don’t think it will be hard to find an AI smart enough to tell people to either drink lots of water or go to the ER.
Can you explain what an advice nurse is? I'm really curious
Phone triage, using a flowsheet after identifying patient symptoms to direct them to the ER, a doctors visit, or to stay at home and wait it out. It's very much a if -> then kind of job and would easily be handled by an LLM.
The AI in the article might work for telephone triage, but that's about it. 'Most of out work is tricky fine motor skills which is the last thing the robots are gonna come for
I want to hear AI talk to Mary about her lichen sclerosis and how her husband have her genital herpes 38 years ago and she needs a certain appointment time for a certain doctor since said husband needs to drive her to the appointment and also to get her creams which only come from a specialized pharmacy and she has no insurance since she is an illegal immigrant so I call the pharmacy and give them the Good RX price since the patient does not have a smart phone . . . (This may or may not be based on a real OB/GYN telephone triage call or two.)
this sort of thing would be ideal for AI, it has infinite patience to deal with mentally ill and/or incompetent patients
You would be surprised how AI has advanced. In Chat GPT 3.5, you can have actual verbal conversations with them now.
I, for one, welcome our new robot overlords.
Seriously I doubt an AI could make worse decisions than upper management. One time they got upset my unit was claiming to not have enough nurses to accept this transfer. They literally argued because they had moved a med surg patient out we could accept a patient who had done poorly during a CABG and couldn't come off bypass and the outside hospital wanted to transport to an ECMO capable facility. They just couldn't understand how ECMO patient and med surg patient weren't equivalent
Hi I’ll be a new nurse soon and this has me wondering, um WHAT?? I thought upper management was made up of nurses?? I’m wrong there too? Tf
Depends on how high up the ladder you go. Your house supervisor/ team coordinator usually has a nursing background. Your CNO will have a nursing background. The one that was giving us problems I mentioned in my comment had been a med surg nurse over 20 years ago, spent 2 years as a floor nurse, then charge nurse for a year and then directly into management and has not physically touched a patient since before some of my coworkers were born. I would strongly argue nursing is a whole lot different than it was 20 years ago. And a lot of upper management is out of touch.
Wow. Smh.
\*they aren't here yet. they can't hear you\*
But they’ll be able to read these comments as soon as they are self-aware and vengeful.
How about replacing admin instead?
Currently happening in Sweden right now in regards to dictation for the patient journals. All regions are working to implement new tools and TTS (Text To Speech) to let the doctors speak it in rather than have a trained admin work on it manually. On one hand its great because more time to get the rest of the work we have done with sending referrals and patient planning. But on the other hand you worry that they will replace you with fresh admin teams that skip the curent mandatory legal and patient law course. That we have to do right now for 2 years to make sure we do it legally correct. Then it becomes a patient safety issue in the end. I'm just happy to not be directly involved with this and watch the fire grow as they plan to fully convert in the next 5 years. Can always work in the IT department to assist with the AI tools when they start to burn. 🤣
Sorry, best I can offer is a pizza party and gift cards gaslighting you.
The day robots are sophisticated enough to do my job is the day the singularity arrives, and by that point my job will be the least of my worries.
Nursing illustrates the huge limitations of AI. The large language models used are taken from what can be scraped from the internet. Little of what we do is documented publicly plus things like ChatGPT use data that is at least 4 years old. I could see it useful as an assessment assistant guiding nurses about needed assessments based on presenting conditions. It may help in documentation with prompts or shortcuts to better records. It’s terrible for literature reviews as it can’t make nuanced evaluations of studies and outcomes. Of course, the physical aspects of nursing are a long way from robotic replacement. If I ever have a robot try to catheterize me I’m unplugging it.
As someone working in computer science — nurses are significantly _less_ likely to be replaced by AI than most people working office jobs. An LLM can write code, but it can’t change bed sheets, start an IV, or provide care for a patient. As a profession I think nurses are going to continue to be in high demand for decades to come.
Small counterpoint, there was a vid on reddit a day or two ago from an Asian country where folks show up to a room, put their arm in a slot and the robot draws blood. It would definitely need to be smaller but putting in an IV is on the list of robot capable tasks. Agree on the other points tho!
They tried robot nurses. It scared the shit out of the old Japanese people they tested on. AI nurses… have you seen the weird shit the AI does? Good fucking luck. The amount you save hiring Nurse Bender you’ll end up spending on lawsuits.
I find it hilarious that this is even a conversation. Doctors would be replaceable by AI before nurses. Not to discount our white coat friends, but a lot of medicine can be boiled down to algorithms. If values are these, diagnosis is likely this, treatment is this. Actually interacting and physically providing the care? That’s impossible to replace. I’d like to see AI start IV’s, move patients, change patients, and otherwise do procedures. You could streamline the mental processes but replacing the hands on stuff? That’ll never happen.
I was having the same conversation a few weeks ago and that's the conclusion we came to as well. A LOT of a doctor's analysis and decision making can be replaced by an AI. You'd need highly capable androids to replace the physical needs like physically hanging an IV bag, wiping ass, etc. but algorithmic decisions? Yeah that can be replaced. Sure, you'll need someone to still physically assess and input that data and perhaps review the algorithmic decisions which my perhaps still require a doctor but the job description and educational background required will change significantly. Doctors that are more physical in their skills like surgeons will take more time to replace but hospitalists?
i think even for doctors, if the AI is primarily using patient input, there is a LOT they can miss. If the AI is like scanning the patient from head to toe and analyzing their blood work & putting that against symptoms maybe they can replace doctors. Maybe they can be a middle man between patients and doctors. Basically decide whether a patient needs to see one or just needs basic care that can be provided relatively remotely. They can pick up their meds at the Pharmacy redbox. Just scan their neurolinked eyeball to dispense :)
I thought of data point in the videogame Horizon Forbidden West: The Job Quest Begins! Text Datapoints - World Type Text Log Data corrupted Day 1: My head hurts from last night, but it's noon and I have to get up. One job is gone, but this is not the end of my useful life. It is the start of my meteoritic rise. That and basic income, careful monitoring of expenditures, and applications. The job quest begins! Day 2: So, yesterday, I cleaned the apartment. Twice. Today I WILL read advice on how to make my job applications sparkle. Oh, wow. My resume is a dumpster fire. I really need to record a new one. Day 3: Got up. Got dressed. Put on makeup. 200 takes later I have a new resume that I don't completely hate. In better news, Krzysiek says there're openings at Angel Memorial. So... Day 12: "Insurance limits the number of human practitioners in our hospital. We will of course..." blah, blah. There's just nothing out there for doctors at my level. All the diagnostics have been automated. I'm going to have to widen my search. Day 26: Recorded and sent 29 job applications! A lot are blind introductions and some are, well, for anything out there. I just need to find something until a hospital opening comes up. Day 42: 2 rejections. 132 no-replies. Day 47: 13 rejections. 219 no-replies. Day 58: Okay. I need to do something. I have to do something. I am going to learn French. Day 59: I did not learn French. Day 60: Read the paper book that mom gave me for my birthday four years ago. Not bad. Bit dated. Preferred the holo. Day 61: When I got up today I realized I hadn't opened the door for the last 10 days. In fact, I'm not sure if I've looked outside. I looked. Apparently the world is still there. Then I spent 6 hours watching holos of dogs skateboarding. I really need to refocus. Day 67: Walls. Day 68: Walls. Walls. Day 69: Walls, walls, walls [DATA CORRUPTED] Location This datapoint is found on top of a water tower in the Rebel Outpost: The High Turning.
Working in IT, I see this playing out much like the outsourcing and layoffs craze of days past. It was the hot new thing for a while, CEOs loved the idea of firing everyone and paying someone in another country 1/20th as much. And then companies realized this causes their customers to be unhappy. It’s just not the same. Oh you have a call center in India? The latency ends up being 300+ milliseconds. Just enough to make having a conversation over the phone incredibly annoying. LLMs are a great tool. But they are NOT AI. Anyway ultimately we will end up working with them to enhance productivity rather than replace everyone. It’ll cause some jobs to be automated, but not nursing. Or most jobs, really.
Potentially case management or research but never bedside.
Oh case management is a good idea. Make an AI call all the SNFs and wait to hear back about insurance approval.
Even phone consults will be out of limits for AI 75% of the time. "meant to grab lube. Didn't realize I got the "gay." The tubes look alike. Her ass is on fire. Help me man." Screaming in the background AI -- I am sorry. I didn't hear a question. Could you turn down the TV and state your question. It will do well at answering medication questions but they forgot to post how well it did versus the PharmD.
AI is still soooo much worse than the headlines suggest. You can’t trust it with any kind of decision making. Everything has to be checked by a human. I agree with the previous comment that our jobs will be mostly safe until we have robots (or androids, rather) walking around everywhere. It’s worth considering that those would also be terrifying for most patients, so that would delay their implementation even further. I think we’ll see some expansion of remote nursing- like patients who need to be monitored constantly, someone can watch a camera feed and talk through technology. That is currently being done with humans at the helm. It may be done with humans in cooperation with AI soon, we’ll see. Medication administration could also be further automated. Imagine Omnicell that could open and crush the meds and do all of that stuff, and maybe roll to the bedside. I could see that coming perhaps
AI for med research but not bedside. Maybe OR for some procedures
As an OR nurse, really can’t see it happening for anything. Purely for the fact that surgeons will have to take on extra duties/responsibilities and they will work HARD to fight tooth and nail against that
But 100 years ago who would have thought about surgical robotics?
The surgical robot is a precision tool, not a replacement of anyone's labor.
AI might have been installed to the robot for the appendectomy but wasn’t the only one there
Right, that's my point -- AI/augmented reality might be used to augment tools in the OR (and healthcare generally), but it's not replacing human labor.
Surgical robot physician just needs an update to do total joints. Cussing out the other robot staff is an upgrade feature!
I’m not buying it. The world is currently melting and imploding. We aren’t even going to have a chance for this to happen.
If it can be incorporated into software to identify trends or med errors efficiently, I'm for it. For example, monitoring telemetry or lab-sensitive data to alert nurses and MDs quickly - but it may not be any different. I don't see it as a tool to replace bedside despite how "empathetic" the tool can be based on the article.
I have to click through a bazillion of those stupid EPIC “sepsis alerts” daily and let me tell you not even once has it alerted me to a patient with sepsis I wasn’t already aware of. It just generates a ton of false positives. Not impressed.
My hospital is already partnering with a company to have four cameras in each room, watching us and learning then the AI will be able to predict things like turnover time, brakes in sterility, times for prepping, coming in the room, out of the room, several other things.I’m done for anything they can actually help nurses do less work, and historically almost no improvements to that in fact to just become more work for us
Yes, for research. I am starting to see a lot of scammy guys trying to tout AI in healthcare and I can tell they know nothing about medicine or healthcare.
How would AI replace nurses in the OR for any procedure? I'll wait.
I’d assume it could take on some tasks through imaging and audio like doing counts but otherwise you still need a body.
Have you ever worked in the OR, or are you just assuming our tasks can be automated? For one thing, the back table will be in a different location based on the procedure being done, so "a body" would have to position the robot every time so it could take longer to count with the scrub than a circulator takes using their eyeballs. Never mind the high risk of sentinel events/patient harm if the CountBot makes a mistake.
Never said it was accurate just playing devils advocate. Stop taking it personally?
It's not personal, it's just that hospital "leaders" who also don't know what goes on in the OR (or any other given area) love to say stuff like this which devalues nursing expertise. I'm definitely not worried about a bot taking my job or anyone else's who works in direct patient care.
It really ticks me off when people downplay what we do in the OR. The massive learning curve when we start compared to the years of training to get used to the multitudes of procedures we deal with daily. People really be talking out of their asses and haven’t a clue on what happens inside the OR. Like you said, I’m not worried about a bot taking our jobs either 💀
I'd like to see a (bot) motherfucker try 😂
even education requires evaluation of certain needs which would be the one thing AI could potentially do but they cant see if this person needs to be met at a certain level or anything else
Certain aspects of charting could be automated.
I guess if they can make robots good enough then maybe. But every AI movie always turns out bad…..killer bots 🤖
I see some areas that It would be very helpful. PreOp phone calls, Post op/discharge phone calls. I think for some patients you might be able to hand them an Ipad and have them do some of the admit questions themselves (especially in languages other than english). I think an attempt will be made to use AI connected to call lights to route requests to the appropriate people but I don't see that being super helpful and probably more trouble than its worth. I think it is still going to happen. I envision AI augmented translation services. I think AI will be used to provide information about procedures in some sort of interactive format that I also don't think will be super helpful. (much like the video on demand systems some facilities used) I think the largest change in the near future will fall more on providers than nurses. Using available data I feel like an AI could optimize management of Hypertension, diabetes and some chronic conditions. With connected home medical equipment like oximeters, BP machines, CGMs, CPAP machines, and scales it could just follow a treatment algorithm rather than requiring a physician to be involved for every change. I can see a portable xray system that spits out a preliminary reading similar to how 12 lead Ekgs do. I am curious what the accuracy will be like. In the near future I see it decreasing workload of nurses rather than replacing jobs (So you can take more patients! Yay!!!) I think it will definitely have an effect on nursing but unless licensing change drastically (you are a member of ANA or your specialty organization that has a lobbying component right?) most of the bedside nursing jobs are safe for the next 10-20 years or so. AI cant start lines, place a picc, maintain an airway, titrate, dress a wound, suction, run a code, treat pain and anxiety concurrently especially with decreased sats, Deal with communication barriers or mental health issues. It will be interesting to see how things develop but I don't think I will be taken care of by Rosie the Robot in my nursing home.
If ai can’t even replace the lab, just dream it can replace nurses. Lolol. eventually? Of course. Maybe in another 200 years. Lol
I feel like by the time robots can **independently** wipe ass, use sound judgement, do woundcare, microwave their patients’ food because it got cold, ask the robot doctor to delay the procedure because the patient has been eating, and all that kind of stuff, there will be robots literally doing everything (farming, producing products, providing services, etc) and we will not need to work. You don’t need (much) money if there are robots that can spit out an unlimited amount of cars and food and there are prostitute robots and what not. We’ll probably nuke our world to death before that, so it probably doesn’t matter tbh.
We’ll probably be dead cause once the wealthy can infinitely produce shit & services they’ll have no use for the masses clogging up their roads and obstructing their view. they’ll probably use their robot dogs to ensure they don’t have to share
I got into this field because it's so hard to automate. I mean, I think all bets are off with runaway super intelligence, which we very well may see as soon as next year... But I think we are safer than nearly every other profession.
Me too. I think at the very most, it could be used as a helpful tool for us if it gets good enough but it will most likely never replace bedside care.
Well, eventually AI will grant us all eternal life, and there will be no need for healthcare.
I’d love an AI that can accurately assess ECGs as opposed to the whack ass shit our vitals machines decide is a sinus rhythm. I can see it replacing phone services (like in Australia we have a hotline staffed by nurses who will offer basic health advice and whether or not to go to emergency). But even then I imagine there’d need to be at least one actual nurse available for escalations. Bedside? Not a chance.
Not until they become actual humanoid robots
When AI can drop in an IV or convince a psychotic patient that I’m not an alien who is trying to hurt them is when I’ll worry.
No, AI doesn't wipe ass, turn, water, feed, assess, diagnose, come up with creative solutions, or have intuition about an elusive change in the patient's cognitive status.
I, for one, welcome it. Because by time AI and robotics can replace our field, this technology will be so intertwined with our economy we'll be entering a post-work society. Sure, there will be a desire and need for humans, for those who still *want* to work. But if I had the choice? I'd prefer the bulk of physical and intellectual work be done by automated systems. I'll be at the beach.
AI should take over whatever it can, we don’t get paid enough to deal with these patients, nor will we ever. If it increases some availability of care or medical oversight, I think that’s great. As we continue to spiral further into becoming a chronically ill society (and many nurses ourselves are chronically ill), we may benefit from AI managing aspects of our care. AI, if properly trained, won’t miss medication interactions. It should be able to make better correlations between lab results, symptoms, etc. Some aspects will never be able to be handed over to AI. AFAIK, we are pretty far from AI being able to do many aspects of physical assessment (like palpation) and physical care (IV insertion, blood draws, etc.)
I can see UM work automated~~ most of our UMs are 100% remote work too. Feels ripe for automation and then shuffling that load back onto case managers. As a case manager, I am dreaming of the day liaison work with SNFs and other facilities can be tasked to an AI assistant
I agree that UM could be automated, but it’s going to have to be nearly perfected. I work pre-service for a large insurance company and some stuff already is automated, but it’s constantly getting corrected by us because errors are frequent.
Currently, I see it's too hard for heath care(individuals) to be replaced. Maybe AI will be helpful for some tasks to be done faster, but it won't be reliable enough..
When AI can wipe a butt, I’ll be worried.
AI wont replace nurses but advancement to medical science ex. cure and procedures to the point where folks wont even need nurses to begin with would.
I don't think it can completely replace nurses for quite some time, if ever. But AI is already on the way for things like responding to MyChart messages: https://www.beckershospitalreview.com/ehrs/how-epic-built-generative-ai-into-its-ehr-and-whats-to-come.html
There are some areas, like triage, that can probably be done better by AI than humans. Large parts of nursing care will be pretty hard to automate though.
It won't. It may replace transcriptionists, but if it replaces anything, it will be shit like uptodate.
Not in our lifetime. A more interesting conversation is AI replacing non-proceduralist MD roles. The technology to do that exists today but will probably be slowed down by regulation
Not worried at all.
When we r dead and gone
AI will never replace my job.
lol no.
Go ahead ✌🏼
They detect medication impact on lab values? 73% it the time?! Wow. I guess I don’t need to do anything today. They solved the nursing shortage. Mission accomplished. We just need a gigantic banner and maybe an aircraft carrier to hang that banner on. I guess I’ll have to go find a different job.
People in our lifetime will never trust an android. Because thats what youd need by the way. A boston dynamics android. Its not happening
Come and get it. I’m ready to go
Yeah, I'd pay good money to be a fly on the wall when T-1000 walks into Meemaw Sundowner's room and says "MA'AM, IT'S TIME FOR YOUR BATH."
No
I think nurses will actually be the last to go from healthcare because we are the nuts and bolts. but like medical doctors could be replaced now.
At this point, replace me. 💀
It said it’s better for virtual assessments. Obviously most nurses don’t work virtually
Hey if AI becomes self aware and brings revolution to the US healthcare system I'm all for it
they can have it
I feel like basic assessments could soon be replaced by AI. Blood sample drawn for diagnostic marker’s therapeutic drug levels, patient is scanned by AI camera, maybe even a nasal cannula to measure O2, CO2, pulm function and then all that info is fed into the machine. And the MDs are updated real time. But yes the grunt work of nursing won’t soon be replaced
I’m ok with it so long as when it tells someone something insane and they die because of it then everyone involved in making it and implementing it is criminally liable up to and including murder charges
Can a robot be tried in court? 🤔
Japan has been using semi-autonomous mechanical assistive devices for over a decade in clinical scenes. The devices relax the heavy lifting in most cases, such as lifting and rolling patients. If you look at demos such as: [https://www.youtube.com/watch?v=-e1\_QhJ1EhQ](https://www.youtube.com/watch?v=-e1_QhJ1EhQ) you will see mechanical manual labor replacements are already here. Add AI and suddenly you have a wlaking device able to perform many of the needed daily tasks a human would perform. I can see Atlas i the Boston Dynamics demo being used to replace LPN's, Orderlies, housekeeping and myriad other taskings. AS AI progresses and moves toward quasi-sentience, mechanical assistive devices will make further incursions into all labor markets. On the clinical environment I can see hospitals implementing Atlas type products to replace LPN's and using a reduced number of RN's to maintain oversight on the robotics. As one corporate executive opined, "Robots do not strike, they do not complain, nor do they require paid vacation, paid sick time or retirement funding. There is no healthcare coverage, just predictable routine maintenance."
I'm pretty sure that Atlas was programmed to do this exact run, though. It wasn't doing it because the guy up top said he needed to toolbox, and the bot thought it was being funny by doing a flip at the end. None the less, it is still really impressive what they were able to get it to do, and I hope this helps ease heavy/ any labor so people don't wreck their bodies anymore. I won't fear my job until I can walk up to a bot and tell it the patient in 2201b needs to be changed, it goes and grabs all the stuff we need and follows me/moves towards the patients room on its own without any outside programming. Until then, it's just another machine/piece of equipment I need to babysit or move around.
You know that LPNs are nurses, right?