Twelve utilization nurses at Montefiore Medical Center in the Bronx were laid off Sunday and replaced with artificial intelligence software, according to the New York State Nurses Association. The move comes months after a historic 41-day strike by 15,000 nurses won contract language explicitly designed to protect against AI-driven job displacement.
A 39-year career ended by software
Marilyn Shuler, who worked at Montefiore for 39 years as a utilization nurse, was among those let go. Utilization nurses review patient charts to confirm medical necessity so insurers will cover care. "I've always, always taken so much pride in the organization that I've worked for all these years, and just to be treated this way," Shuler told The Guardian. "It's disrespectful, and it's very disheartening, and my colleagues feel the same way as well."
The union had warned earlier this month that Montefiore intended to replace nurses with AI from a company called Datavant, which has partnerships with surveillance tech firm Palantir. Palantir has drawn criticism for its work with U.S. Immigration and Customs Enforcement.
Contract safeguards tested
In January, nurses at several of New York's largest hospitals walked off the job for 41 days. The resulting three-year contract included what the union called historic protections against artificial intelligence. But when Shuler and others returned to work in February, their workflow changed without explanation. After weeks of silence from management, the dozen nurses received 45-day layoff notices in late May.
"We are outraged about these layoffs because these dedicated nurses are being replaced by AI," said Shaiju Kalathil, a Montefiore nurse and union committee member. "This is a violation of the contract that we recently won by going on strike. It should also concern every practitioner and patient who cares about the future of healthcare and the quality of care they receive."
Broader AI risks in clinical settings
The healthcare sector has seen clear signals that AI for healthcare could disrupt clinical roles. Doctors and nurses already use AI tools for clinical notes, and some clinics deploy AI to help triage patients. Shortly after the nurses' strike, the CEO of NYC Health and Hospitals, the largest municipal healthcare system in the U.S., openly discussed replacing radiologists with AI.
The transition carries documented risks. In Brazil, a 32-year-old woman died after an AI system for assigning hospital beds left her waiting five days for transfer to an intensive care unit, according to local reports.
Montefiore disputes the union's framing. "As is often the case, the claims by NYSNA are inaccurate and misleading," Joe Solmonese, senior vice-president for government relations and strategic communications at Montefiore, told The Guardian. "What is true is that we are always investing in new technology to ensure the best care and outcomes for our patients and will continue to do so for the betterment of the people we serve."
Why this matters for healthcare
For healthcare professionals, the Montefiore layoffs show that AI implementation is not a distant threat - it is happening now, sometimes in direct conflict with hard-won labor agreements. Utilization review, clinical documentation, and triage are all areas where software is taking over tasks once performed by experienced staff. The case also highlights the gap between contract language and enforcement: even explicit AI safeguards can be contested when management adopts new technology. Clinicians should scrutinize any new AI tools introduced into their workflow and push for transparency about how those tools affect staffing and patient care decisions.
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