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With her calm, warm demeanor, Ana is trained to put patients at ease — like many nurses across the U.S. Unlike them, she is available to chat 24-7 in multiple languages, from Hindi to Haitian Creole.

That's because , but an created by Hippocratic AI, one of a number of new companies offering ways to automate time-consuming tasks usually performed by nurses and medical assistants.

Hundreds of hospitals use to monitor patients' vital signs, flag emergency situations and trigger step-by-step action plans for care — jobs previously handled by nurses and other health professionals.

Hospitals say AI is helping their nurses work more efficiently while addressing burnout and understaffing.

However, nursing unions argue that this poorly understood technology is overriding nurses' expertise and degrading the quality of care.

"Hospitals have been waiting for the moment when they have something that appears to have enough legitimacy to replace nurses," said Michelle Mahon of National Nurses United. "The entire ecosystem is designed to automate, de-skill and ultimately replace caregivers."

Mahon's group, the largest nursing union in the U.S., helped organize more than 20 demonstrations at hospitals across the country, pushing for the right to have say in how AI can be used — and protection from discipline if nurses decide to disregard automated advice.

The group raised new alarms in January when , the incoming health secretary, suggested AI nurses "as good as any doctor" could help deliver care in rural areas. Earlier this month, , nominated to oversee Medicare and Medicaid, said he believes AI can "liberate doctors and nurses from all the paperwork."

Hippocratic AI initially promoted a rate of $9 an hour for its AI assistants, compared with about $40 an hour for a registered nurse. It since dropped that language, instead touting its services and seeking to assure customers that they were carefully tested. The company did not grant requests for an interview.

Hospitals experimented for years with technology designed to improve care and streamline costs, including sensors, microphones and motion-sensing cameras. Now that data is being linked with electronic medical records and analyzed in an effort to predict medical problems and direct nurses' care — sometimes before they've evaluated the patient themselves.

Adam Hart was working in the emergency room at Dignity Health in Henderson, Nevada, when the hospital's computer system flagged a newly arrived patient for sepsis, a life-threatening reaction to infection. Under the hospital's protocol, he was supposed to immediately administer a large dose of IV fluids.

Hart determined he was treating a dialysis patient, or someone with kidney failure. Such patients have to be carefully managed to avoid overloading their kidneys with fluid. He raised his concern with the supervising nurse but was told to follow the standard protocol. Only after a nearby physician intervened did the patient instead begin to receive a slow infusion of IV fluids.

"You need to keep your thinking cap on— that's why you're being paid as a nurse," Hart said. "Turning over our thought processes to these devices is reckless and dangerous."

Hart and other nurses say they understand the goal of AI: to make it easier for nurses to monitor multiple patients and quickly respond to problems. The reality is often a barrage of false alarms, sometimes erroneously flagging basic bodily functions as an emergency.

"You're trying to focus on your work but then you're getting all these distracting alerts that may or may not mean something," said Melissa Beebe, a cancer nurse at UC Davis Medical Center in Sacramento. "It's hard to even tell when it's accurate and when it's not because there are so many false alarms."

Even the most sophisticated technology will miss signs nurses routinely pick up on, such as facial expressions and odors, notes Michelle Collins, dean of Loyola University's College of Nursing. But people aren't perfect either.

"It would be foolish to turn our back on this completely," Collins said. "We should embrace what it can do to augment our care, but we should also be careful it doesn't replace the human element."

More than 100,000 nurses left the workforce during the COVID-19 pandemic, according to one estimate, the biggest staffing drop in 40 years. As the U.S. population ages and nurses retire, the U.S. government estimates there will be more than 190,000 new openings for nurses every year through 2032.

Faced with this trend, hospital administrators see AI filling a vital role: not taking over care, but helping nurses and doctors gather information and communicate with patients.

Qventus' AI assistant contacts patients and health providers, sends and receives medical records and summarizes their contents for human staffers. Qventus says 115 hospitals use its technology, which aims to boost hospital earnings through quicker surgical turnarounds, fewer cancellations and reduced burnout.

Israeli startup Xoltar specializes in humanlike avatars that conduct video calls with patients. The company is working with the Mayo Clinic on an AI assistant that teaches patients cognitive techniques for managing chronic pain. The company is also developing an avatar to help smokers quit. In early testing, patients spend about 14 minutes talking to the program, which can pickup on facial expressions, body language and other cues, according to Xoltar.