Working With AI and Robotic Systems While Preserving Clinical Judgement, Professional Accountability and Person-Centred Care: Critical Care Nurses' Perspectives.

BACKGROUND

The integration of AI and robotic systems into critical care necessitates examining how ICU nurses preserve clinical judgement, professional accountability and person-centred care while using these technologies.

AIMS: To explore ICU nurses' perceptions of AI and robotic systems in critical care, focusing on clinical judgement, trust, responsibility, professional roles and person-centred care.

STUDY

DESIGN

A qualitative descriptive study using scenario-based elicitation was conducted. Data were collected through seven semi-structured focus group discussions (FGDs) with 38 ICU nurses working in general, paediatric and cardiovascular surgery ICUs in two hospitals in Istanbul City. Data were analysed using reflexive thematic analysis, supported by MAXQDA 2024.

FINDINGS: Four themes were developed: negotiating trust in AI-supported critical care; preserving human authority, accountability and boundaries; protecting the human core of intensive care nursing; and reimagining AI and robotic systems as supportive partners. ICU nurses evaluated these systems through bedside verification, patient safety, professional responsibility and person-centred care. AI recommendations were useful only when nurses could question, verify, delay or override them according to the patient's current condition. Robotic systems were valuable when they reduced documentation or physical workload, but not when they replaced clinical judgement, emotional presence, reassurance or accountability.

CONCLUSIONS

ICU nurses conceptualised AI and robotic systems as acceptable only when clinically verifiable, professionally bounded and subordinate to human judgement. The findings support a model of AI- and robot-supported ICU care that is responsible, human-led and person-centred.

RELEVANCE TO CLINICAL PRACTICE: AI and robotic systems should be implemented in ways that strengthen, rather than replace, nurses' clinical judgement, accountability and bedside presence. Clear protocols are needed to verify AI outputs, define robotic task boundaries, support nurses' authority to question or override recommendations and preserve person-centred care in technologically intensive ICU environments.