Kaiser Nurses Say AI Is Spying on Their Calls, and It’s Hurting Patients

Part of Nurse.org’s Nursing AI Watch, our ongoing investigation into how artificial intelligence is reshaping nursing practice. 

Imagine being a triage nurse trying to talk to a patient over the phone, all while knowing that an AI robot is listening in to judge the tone of your voice, the words you use, and how long your conversation is, all in the name of evaluating your “effectiveness.” 

Nurses who staff Kaiser Permanente’s telephone advice lines are facing that exact scenario and expressing concern about a growing web of artificial intelligence and workplace surveillance. And the outcome, for both patients and nurses, is not a welcome one.

According to an investigation published July 9 by CalMatters, the constant surveillance and AI monitoring are pushing nurses to rush patients, hold back compassion, and fear discipline for doing their jobs.

Want to see more Nurse.org articles in your Google results? Add us as a preferred source.

The nurses describe software that tracks how long they spend on the phone and flags any call that runs longer than 15 minutes, no matter how serious the situation on the other end. Nurses are routinely called into “performance evaluation” meetings or criticized by management for going over 15 minutes.

The software also runs daily “predictions” on whether nurses will be unproductive or too slow to answer calls, and those metrics feed into monthly performance scores.

Union members, organizing under the California Nurses Association, say the metrics and monitoring have changed how they care for people. The CNA has taken its concerns about AI to the picket line and to lawmakers in Sacramento; “Trust nurses, not AI” has been the union’s slogan since 2024 protests in San Francisco.

The new concerns about the AI software used with triage nurses come as Kaiser staff are negotiating a new contract with the healthcare system. AI is expected to be part of the contract negotiations.  

Kaiser disputes how the metrics are used, saying its technology is deployed with patient safety in mind and does not use call length to grade individual nurses.

The dispute is one of California’s first major labor fights over AI in health care, and because Kaiser is the state’s largest private employer, how it resolves could set the tone for how the technology reshapes nursing work across the country.

Kaiser advice nurses handle calls from patients who are anxious, in pain, or in crisis.

But nurses told CalMatters they operate under productivity software that predicts their daily output, flags long calls, and during busy periods gives them as little as 30 seconds between calls, down from about 10 minutes previously. Some said they are expected to limit their guidance to two or three points per call.

Raquel Alvarez Sanchez, a Kaiser advice nurse in Vallejo since 2010 and a union steward, said she once spent more than an hour on the phone with a suicidal patient knowing it would throw off her average call time for weeks. Pa Vue, a call-center nurse and union representative, said her performance score dropped after she repeated advice to a patient with cardiac concerns. “You aren’t calling Comcast. We’re dealing with life here,” said Charlotte Capulong, a 22-year call-center veteran and union organizer, in the CalMatters report.

Nurses also described an AI tool Kaiser began testing in summer 2024 that attempted to assess empathy and tone in the voices of nurses and patients. Kaiser ended that test in November 2024. One nurse said the tool graded calls wrong frequently; another said the broader scoring pressure led her to hold back reassurance from a terminally ill patient rather than risk a hit to her monthly score.

Their frustrations echo a broader trend: a 2024 National Nurses United survey of more than 2,000 nurses found many do not trust their employers to prioritize patient safety when deploying AI. These accounts are the nurses’ allegations and have not been independently proven.

Kaiser’s Response and the Fight in Sacramento

A Kaiser spokesperson told CalMatters the health system does not use “average handle time” to assess agent performance and deploys AI responsibly, “prioritizing patient safety, privacy, and equity,” with human review and oversight.

Kaiser declined to detail its AI systems, citing security and operational reasons, and no documented evidence has yet linked the surveillance to a specific adverse patient outcome. The company has faced past scrutiny over care access, including a record $50 million fine in 2023 tied to behavioral health failures.

The clash is unfolding as the California Nurses Association negotiates contracts covering roughly 25,000 nurses, including about 1,000 call-center workers. Kaiser nurses have already struck for one day and picketed last fall over AI. It is also playing out in the Legislature, where nurses are backing bills such as AB 1883, which would prohibit employers from using AI to predict the emotional state of their employees, and AB 2575, which would protect health workers who override AI recommendations from retaliation. Lawmakers tried this before: Gov. Gavin Newsom vetoed one notification bill, SB 7, last year, and a companion measure, AB 1018, died for a third straight year amid opposition from companies including Kaiser. A successor to SB 7 is back this session as SB 947.

Contract protections like these are still rare: Nurse.org’s Nursing AI Watch found only seven of 100+ tracked health systems have union contract language addressing AI.

>>Listen to The Latest Nurse News Podcast

Algorithmic management is moving into clinical settings, from advice lines to bedside documentation, and how it is regulated will shape working conditions, clinical autonomy, and legal liability for nurses far beyond Kaiser.

The central question raised by these nurses is whether metrics built for call-center efficiency belong in decisions about patient care, and whether nurses can override an automated recommendation without risking their standing. The California bills would begin to answer that, and their outcome could become a template other states follow.

For any nurse working under productivity software or AI monitoring, the Kaiser fight is a preview of debates potentially coming to their own workplace.

🤔 If an AI system flagged one of your patient interactions as too long or lacking empathy, would you trust it, or would you push back? Share your experience in the comments.

If you have a nursing news story that deserves to be heard, we want to amplify it to our massive community of millions of nurses! Get your story in front of Nurse.org Editors now – click here to fill out our quick submission form today!