Artificial intelligence disrupts nurses' shifts, and they call it a safety issue

The largest hospital system in the United States, HCA Healthcare, has rolled out a scheduling tool developed with Palantir called Timpani across roughly 130 of its 190 sites over the past two years. The algorithm is supposed to match the right staff with the right experience to every shift. Nurses who spoke with WIRED describe the opposite reality: the software ignores concrete requests, strings together three 12-hour shifts in a row, and leaves critical shifts staffed only with junior personnel.

When the algorithm sets the tone

Amber Retzloff, an ICU nurse in Florida and a team lead for the union National Nurses United, requested 50 specific shifts over four months. In more than half the cases she was assigned to different shifts, often in back-to-back sequences that wore her down mentally. Human schedulers who managed the roster manually respected preferences far better, she said. Five nurses at different HCA locations repeated the same complaint, and Reddit discussions point to a broader pattern.

Experience gaps and patient risk

Nurses say Timpani produces unbalanced teams — too few nurses overall, and too few veterans in particular, especially on Sundays. Retzloff described a shift where she was the only senior nurse alongside three new graduates, and had to delay care for the sickest patients in order to guide the juniors through routine cases. "You're letting an app dictate clinical judgment," she said, "and replacing human connection with a spreadsheet."

Days off erased by a single percentage point

According to HCA, the tool schedules nurses on only 1 percent of "red days" — pre-requested days off. Lee Barker, a nurse in Missouri, says the low figure is misleading: before the tool, being scheduled on a red day was a rare-to-nonexistent event. Less than a year after implementation, nearly every nurse on her team had been scheduled on such a day. Barker canceled a scheduled medical appointment for a chronic condition after she couldn't swap a forced shift.

Management response and the gap on the floor

HCA spokesperson Harlow Sumerford emphasizes that nursing managers, not Timpani, make the final decision, and rejects the claim that the tool was designed to cut staff at the expense of safety. The goal, he said, is to match skills and experience to patient needs while accounting for preferences, and the company continues to improve the system based on feedback. Nurses on the floor, meanwhile, report more time wasted on shift swaps and appeals, and a rise in absence reports — a step that jeopardizes their jobs if repeated more than a few times a year.