Protecting the Title ‘Nurse’: The Nurse Practice Act and the Rise of So-Called AI ‘Nurses’

As technology continues to transform healthcare, the boundaries between human and artificial intelligence (AI) in patient care are blurring. However, one boundary remains firmly protected by law: the use of the title "nurse." Across the United States, Nurse Practice Acts (NPAs) strictly reserve the title "nurse" for individuals who are licensed and have met rigorous educational, ethical, and professional standards. This legal protection is more relevant than ever in the face of emerging AI technologies branded as "nurses."

The Legal Foundation: What the Nurse Practice Act Says

The Nurse Practice Act is a set of state laws that governs the practice of nursing, outlining the requirements for education, licensure, and scope of practice for nurses. One of its core functions is to protect the public by ensuring only qualified individuals can use the title "nurse."

For example, Florida law states that only those holding a valid nursing license may use the titles "Registered Nurse" (RN), "Licensed Practical Nurse" (LPN), or any similar designation. This restriction applies to all forms of advertising, professional representation, and practice. Similar language is found in at least 35 states, including New York and North Carolina, which prohibit anyone who is not licensed from using the title "nurse" or any abbreviation that implies authorization to practice nursing.

According to the American Nurses Association, "Restricting use of the title 'nurse' to only those individuals who have fulfilled the requirements for licensure as outlined in each state's nurse practice act is a protection for the public against unethical, unscrupulous, and incompetent practitioners."

The restriction on the use of the title "nurse" is not merely a matter of professional pride—it is a critical safeguard for public safety and trust. The NPA ensures that individuals who call themselves nurses have met rigorous standards in education, clinical training, and ethical conduct. This protects patients from harm and confusion, ensuring that those providing nursing care are competent and accountable.

The New Challenge: AI and the "Nurse" Title

With the rapid development of AI in healthcare, some companies and products are being marketed as "AI nurses." These systems may offer symptom triage, health advice, or even virtual companionship. While AI has the potential to support healthcare delivery, it cannot replace the human judgment, empathy, and professional accountability that licensed nurses provide.

Allowing AI systems to use the title "nurse" poses significant risks:

• Public Confusion: Patients may mistakenly believe they are receiving care from a licensed professional, when in fact they are interacting with a machine.
• Accountability: AI systems are not subject to the same ethical codes, licensure requirements, or disciplinary actions as human nurses.
• Patient Safety: Only licensed nurses are trained to provide holistic, evidence-based care and respond to complex clinical situations.

The NPA’s title protection ensures that the public can trust that anyone using the title "nurse" is a qualified, licensed human professional—not an algorithm or chatbot.

State-Level Challenges and Legislative Action: Oregon Leads the Way

States are responding to the rise of AI in healthcare with new legislation to protect the nursing profession and patient safety. Oregon is leading the way with House Bill 2748, which prohibits nonhuman entities, including AI, from using the title "nurse" or related designations.

Championed by State Representative Travis Nelson, a registered nurse, the bill addresses concerns that AI programs marketed as "nurses" could mislead patients and undermine the profession's integrity. The Oregon Nurses Association and other nursing organizations strongly support the bill, emphasizing that only licensed humans possess the essential clinical judgment and empathy for nursing.

By restricting nursing titles to licensed human practitioners, Oregon aims to preserve clarity and trust in patient care, setting a precedent as other states consider similar measures.

Defending the Title "Nurse" in the Age of AI: What Every Nurse Needs to Know

The ANA’s Code of Ethics underscores the duty of nurses to maintain professional integrity and protect the public from misleading or unsafe practices. Nurses must advocate for clear distinctions between licensed professionals and AI tools, ensuring that technology augments—but never replaces—the essential human elements of nursing care.

Nurses have a professional and ethical responsibility to:

• Educate patients and the public about the meaning and value of licensure and the unique role of nurses.
• Advocate for strong enforcement of title protection laws, especially as new technologies emerge.
• Engage with policymakers to ensure that the Nurse Practice Act keeps pace with technological change and continues to protect both the profession and the public.

The Nurse Practice Act’s restriction on the use of the title "nurse" is more than a legal technicality—it is a cornerstone of public trust and patient safety. As AI continues to evolve, nurses must remain vigilant in defending the integrity of their title and the profession it represents. Only licensed nurses—never machines—can truly be called "nurse".

 

🤔 Nurses, what does your state’s Nurse Practice Act stipulate and what do you think about AI using the “nurse” title? Share your thoughts in the discussion forum below.