July 13, 2026, (Inside AI) — Twelve registered nurses at Montefiore hospital in the Bronx were laid off on Sunday after their roles were replaced by AI-powered software, according to the New York State Nurses Association. The union says the move violates a contract won after a January 2026 strike that included safeguards against artificial intelligence.
The layoffs affect utilization review nurses, a specialized role that involves reading patient charts and communicating with insurance companies over coverage. Marilyn Shuler, a 39-year veteran in the department, said she and her colleagues were blindsided.
"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 said.
"It's disrespectful, and it's very disheartening, and my colleagues feel the same way as well."
The union says it is one of the first AI-related layoffs it has handled, marking a flashpoint in the growing tension between healthcare workers and hospital automation. National Nurses United, the parent union, has been campaigning for an AI bill of rights and pushing for contractual protections.
"NNU nurses, like the nurses at Montefiore, have been on the frontlines of fighting hospital employers' efforts to force unregulated and untested AI into patient care settings," said Jamie Brown, a registered nurse and president of NNU.
"Nurses know from experience that hospital employers will find any opportunity to cut costs and cut corners on patient care and nurse staffing."
The layoffs follow a massive nurses strike across several New York City hospitals in January 2026. New contracts included language meant to protect nurses from being replaced by technology. But Shaiju Kalathil, a union executive committee member at Montefiore, said the hospital broke that agreement.
"We are outraged about these layoffs because these dedicated nurses are being replaced by AI," said Kalathil in a statement.
"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."
Shuler described a confusing sequence of events. When she and her team returned to work in February after the strike, their workflow had changed without explanation. After notifying the union, they emailed management but received no response until May 28, when all 12 nurses got 45-day layoff notices.
"We were shocked and definitely disappointed because we repeatedly asked for transparency," Shuler said.
She emphasized that her job involves nuanced tasks—medication changes, discharge planning, and complex insurer negotiations—that AI cannot reliably handle. "AI should be a tool used in conjunction with the clinical expert, not to replace," she said. "We're not against technology. There are several advances in healthcare utilizing technology. The issue is with new tech without evidence."
Montefiore hospital pushed back, saying the technology is used only in a nonclinical paperwork program. "As is often the case, the claims by NYSNA are inaccurate and misleading," said Joe Solmonese, senior vice-president for government relations and strategic communications at Montefiore, in an email.
"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."
The dispute highlights a broader industry trend. Hospitals nationwide are adopting AI for administrative tasks like prior authorization and clinical documentation. But unions argue that without evidence-based guardrails, AI can erode care quality and eliminate jobs that require human judgment.
Legal experts note that contract language around AI is still rare and largely untested. The Montefiore case could set a precedent for how such clauses are interpreted. If the union prevails, it may embolden other healthcare workers to demand stronger protections. If not, it could accelerate the use of AI to replace certain nursing functions.
The National Nurses United's AI bill of rights calls for transparency, accountability, and the right for nurses to override automated decisions. It also demands that AI not be used to replace nurses or reduce staffing levels. These principles are now being tested in real time at Montefiore.
The union has filed a grievance and is considering legal action. For Shuler, the fight is personal. "I've dedicated my life to this hospital and to my patients," she said. "To be replaced by a machine without any discussion—it's a betrayal."
