Marilyn Shuler spent 39 years as a utilization review nurse at Montefiore Medical Center in the Bronx. She read patient charts. She argued with insurance companies. She made sure doctors’ orders got covered. Then, one Sunday in July 2026, she and 11 colleagues lost their jobs.
Their roles went to software from Datavant, a company with ties to Palantir. The move followed a hard-fought contract that promised safeguards against exactly this kind of replacement. Nurses call it a betrayal. The hospital calls the claims inaccurate.
But the anger runs deeper than one Bronx facility. It touches on how hospitals chase efficiency while experienced staff watch their expertise get reduced to data points. Short sentences capture the shock. Longer ones reveal the stakes that build from bedside knowledge to insurance battles to community health in underserved areas.
Contract Victory Undone by Layoffs
Back in January 2026, more than 15,000 nurses struck at several major New York hospitals. The walkout lasted 41 days. When it ended in February, the new three-year agreements included historic language on artificial intelligence. Hospitals had to discuss AI plans with the union. The goal was patient protection. MedPage Today reported that nurses believed these provisions would prevent exactly the scenario now unfolding at Montefiore.
Yet when Shuler and her team returned after the strike, their workflow changed without explanation. No meetings. No transparency. In late May they received 45-day notices that their positions were eliminated. The New York State Nurses Association filed a class action grievance. Union leaders argue the terminations violate the contract won through that bitter strike.
“We are outraged about these layoffs because these dedicated nurses are being replaced by AI,” said Shaiju Kalathil, a Montefiore nurse and NYSNA executive committee member, in a statement. (NYSNA). “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.”
But. The hospital pushes back. Joe Solmonese, Montefiore’s senior vice president for government relations and strategic communications, told reporters the union’s framing is “inaccurate and misleading.” The health system, he said, invests in new technology to improve care and outcomes for patients. (The Guardian).
Utilization review sits at the heart of the dispute. These nurses don’t provide direct bedside care. They examine records. They push back against insurance denials. Their clinical judgment draws on decades of experience that algorithms struggle to replicate. Shuler told Futurism the work involves complicated conversations about medication changes and discharge planning. “AI should be a tool used in conjunction with the clinical expert, not to replace,” she said. “We’re not against technology. … The issue is with new tech without evidence.”
And the evidence remains thin. Nurses at a July town hall warned that dropping human review could lead to missed diagnoses or unapproved surgeries in complex cases. Algorithms process raw data. They miss context around gender, race, culture, family support. Judy Sheridan-Gonzalez, a former NYSNA president, explained in MedPage Today that patient situations often shift in ways no simple click can capture. “These algorithms just take very raw data and make a conclusion … without taking into account the patient’s gender, race, ethnicity, cultural needs.”
Concerns extend beyond accuracy. Datavant, the vendor chosen by Montefiore, maintains partnerships with Palantir. The latter firm’s work with immigration enforcement has drawn scrutiny. Nurses also pointed to the company’s history of data breaches. Private patient records, including sensitive details, could flow to a third party with those connections. The union highlighted those risks during the town hall covered in the NYSNA press release.
Shuler made her ask plain. “What we want from Montefiore is simple: stop the layoffs, keep a licensed nurse on the final review, use AI to support us instead of replacing us, and sit down with the nurses who actually do this work.” That plea, delivered at the virtual event, drew support from local officials.
City Council Member Shirley Aldebol called for an immediate halt to the displacement clock and real dialogue. State legislators echoed the sentiment. Assembly Member Amanda N. Septimo said Montefiore’s choice sides with profits over patients in a borough already facing healthcare strains. “Human compassion and medical judgments cannot simply be replaced by software,” she stated in the NYSNA release. Similar remarks came from Assembly Member George Alvarez, State Senator Nathalia Fernandez and NYSNA President Nancy Hagans, who stressed that artificial intelligence must never replace real human caring.
National Nurses United, NYSNA’s parent organization, has pushed an AI bill of rights for patients and staff. It has fought unregulated tools in care settings. Jamie Brown, NNU president and a registered nurse, noted that hospitals often cut costs first. “Nurses know from experience that hospital employers will find any opportunity to cut costs and cut corners on patient care and nurse staffing.”
This Bronx episode fits a larger pattern. Earlier this year the CEO of NYC Health + Hospitals, the nation’s largest municipal system, said he stood ready to replace radiologists with AI once legally possible. Futurism covered that comment in April 2026. Nurses had already raised alarms in late 2025 about quiet rollouts of AI tools across city facilities without frontline input. A November 2025 New York Post article detailed those complaints, including untested devices in ICUs and extra work checking an AI assistant called “Sofiya.”
Internationally the risks appear concrete. In Brazil a 32-year-old woman died after an AI bed-assignment system left her waiting five days for intensive care transfer. Such cases fuel skepticism even as vendors promise efficiency gains.
Montefiore describes the changes as limited to a nonclinical paperwork program. Yet the union sees a test case. If utilization review falls to software without nurse oversight, what follows? Documentation tasks have already shifted in some departments. The fear is gradual expansion into areas that touch patients directly.
So the grievance moves forward. So do calls for evidence before deployment. Nurses don’t reject innovation. They demand proof that new systems improve outcomes rather than erode judgment built over decades. Shuler’s pride in her longtime employer turned to disappointment. “It’s disrespectful, and it’s very disheartening, and my colleagues feel the same way as well.”
That sentiment now echoes through union halls, legislative offices and patient advocacy circles. Hospitals face pressure to show their technology investments truly serve care instead of trimming headcount. The Bronx town hall signaled that communities won’t stay silent when experienced nurses disappear from roles that once protected access to treatment.
Recent coverage reinforces the tension. The Guardian’s July 13 story framed the layoffs as a direct challenge to the post-strike contract and quoted union warnings about quality of care. Fresh reporting today from health policy outlets notes the story gaining traction on social media, with nurses nationwide watching whether the grievance produces real accountability or simply more statements about investing in technology.
The outcome at Montefiore could set precedent. Either hospitals learn to integrate AI as a support layer under human supervision, or unions will fight each deployment that sidelines licensed professionals. For now the 12 nurses wait on resolution. Their experience sits idle. The software runs on.
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