As the nursing shortage continues to stretch hospitals and health systems thin, some IT leaders have begun working with generative AI to see whether it can help reduce administrative burden on nurses, free them up to spend more time with patients and help ease the nursing shortage.

Jill M. Lashay is a healthcare attorney at Buchanan Ingersoll & Rooney specializing in management in areas of labor and employment law. Carly Barnes is an associate at Buchanan Ingersoll & Rooney. They both help clients deal with healthcare, technology and nursing challenges on a daily basis.

Healthcare IT News sat down with both of them to discuss what the nursing shortage means for hospitals and health systems, how technologies like ChatGPT can help address labor shortages and increasing demands on healthcare workers, and predictions for the future of AI and the nursing shortage.

Q. Please describe the nature of today's nursing shortage.

Lashay: The COVID-19 pandemic caused an unpredictable spike in patient demand. As a result, nurses became overwhelmed and resources were more limited. When COVID-19 was declared a national public health crisis, initially, nurses were celebrated by the public and the media for their response and commitment to patient care. However, over time, wellbeing suffered and nurses were left feeling unsupported.

The current state of the nursing shortage in the United States is more challenging than it has ever been. Those nurses who were close to retirement age prior to the pandemic chose to leave the profession in 2020 and 2021 in some of the largest numbers in history.

Even those nurses who are not close to retirement age often choose to begin employment at a hospital and thereafter shift to an outpatient setting. More hospital-employed nurses are sharing that they are dissatisfied in their current position, and many are looking to move on from their current roles in 2024.

They are considering other options, including working as travel nurses, taking jobs outside of direct patient care, returning to school or even leaving the profession.

Barnes: While the workforce is shrinking, the population is getting older. As a result, there will be a continued demand for healthcare. Those nurses who remain in the profession are faced with higher patient load, less time with patients and longer hours.

This results in patient safety and access to care issues. Health system financial stability also depends on adequate staffing.

Some hospitals offer large signing bonuses to help recruit nurses and in turn mitigate the shortage. Yet, overall, it is increasingly important that nurses continue to receive mental and emotional health support, are given meaningful opportunities so they feel less restricted in practice and receive sufficient technological support.

Individual intervention can lead to systematic improvement and stability.

Q. How can hospitals and health systems use generative AI and other advances in technology to mitigate these shortages?

Lashay: The healthcare industry is ripe for a once-in-a-century revolution with the introduction of AI. Patients will soon see the value of AI in lifesaving medical devices, as well as the delivery of standard medical care. This tectonic shift will directly impact the method by which nurses and other healthcare professionals perform their work.

Hospitals and health systems will likely use AI first in areas like nurse education and onboarding. This use of AI could mitigate the impact of shortages by allowing current nurse educators and preceptors more time to focus attention on actual patient care and revenue-generating tasks.

"Large language model technology, like ChatGPT, may assist nurses with management of electronic health records and other data that may be time-consuming or distracting to the nurse."

Jill M. Lashay, Buchanan Ingersoll & Rooney

Further, patient care coupled with immense documentation requirements can lead to nurse burnout. AI can be used to assist nurses with clinical documentation and administrative tasks, making their work experience less stressful and more focused on their chosen vocation – patient care. This may result in higher recruitment and retention of nurses.

Barnes: AI cannot be used to replace a nurse’s clinical experience, emotional support or medical judgment, but can be used to push out patient medication reminders, assist with scheduling and billing, and help answer medical questions. Other advances in technology can also be used to help with medication dispensation and shelf stocking.

AI can be implemented to more directly assist with staffing shortages. For example, companies have been developing healthcare apps that allow facility managers to post staffing needs. Those enrolled nurses post their availability. When there is a staffing need, local nurses receive a notification and can accept or decline a shift.

Once accepted, the facility’s schedule gets updated to reflect the filled position. Not only does this help fulfill facility needs, but also, it gives nurses more flexibility and control over their schedules, which in turn reduces burnout.

Q. How can technology like ChatGPT help address labor shortages and increasing demands on healthcare workers?

Barnes: First, by using ChatGPT, providers can access information on a variety of topics. Healthcare workers can access medical literature and treatment guidelines in real time to assist with diagnoses and treatment recommendations, which ultimately results in more informed decision-making and better patient outcomes.

ChatGPT can also be used to help recommend labs and tests and help providers check their knowledge on drug interactions upon prescribing. Healthcare workers may also dictate their notes and use ChatGPT to help accurately summarize signs, symptoms and diagnoses. Thereafter, valuable time is given back to staff to focus more attention on patient care.

Lashay: Additionally, large language model technology, like ChatGPT, may assist nurses with management of electronic health records and other data that may be time-consuming or distracting to the nurse, who simply wants to focus on patient care. It may alleviate some recordkeeping responsibilities, thus reducing the need for more nursing staff.

Data extraction requires a lot of time and attention. Healthcare workers can lean on AI to extract clinical data from EHRs and other systems. AI technology can retrieve information from multiple systems and centralize it.

Not only can the technology find standardized or structured information like name or birthdate, but also, it can help pull "unstructured" information found in clinician notes or other reports. While information is centralized, it can also be linked back to its original source so a provider can read and interpret the information in its original context to discuss the outcome and recommended next steps with the patient more confidently.

Q. What are some predictions you have for the nursing shortage and AI for 2024?

Lashay: It is not anticipated that the nursing shortage will abate in 2024. 2023 enrollment rates in nursing schools have declined from prior years and many new nurses are more transient than their senior counterparts.

Younger nurses are recognizing opportunities for travel and the financial benefits of agency, as well as recruitment bonuses offered by hospitals and health systems. This makes recruitment and retention a challenge.

Although AI may be more attractive to younger nurses, those who are over 50 years old may shy away from the technology and move to retirement. AI is also costly, and current financial challenges facing hospitals and healthcare may present obstacles for purchasing and implementing AI products to help with the nursing shortage.

Barnes: To help combat the shortages, health systems may consider developing virtual nursing teams. Although virtual programs require upfront expenses for recruitment and technology, once trained, nurses can work from an on-site command center or even work from home to handle patient admissions, discharge and transfers, review of medical history, and assessment of current symptoms.

While virtual nurses do not provide bedside care, they can play a critical continuum of care role by monitoring and educating the patient directly and corresponding with the in-person clinical team and family members to provide necessary updates. Virtual nurses also help provide an extra layer of safety monitoring.

Ultimately, the healthcare industry should continue embracing innovation. It is up to industry leaders to adopt technology that will help reduce nurse burnout. This in turn can lead to greater career satisfaction and help attract and retain talent.

Additionally, providers may consider opening dialogue with their international counterparts regarding methods that can help potentially address the shortage here. Finally, exploring partnerships with academic institutions may help grow the profession so we do not see the shortage issue persisting at such high levels in 2025 and beyond.

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