Tired of documentation overload and fragmented care processes, nurses are becoming the most active users of digital technologies, from telecare to AI-driven predictive analytics. They co-design and test tools in real clinical settings, adopt what works, and discard what does not, making their practical engagement a key driver of AI adoption. The European Specialist Nurses Organization (ESNO) underlines this in a recent policy brief, arguing that digital health delivers value only when it is developed with nurses and embedded in real clinical workflows.
Once seen as support staff, today they drive innovation
Nurses – not the doctors – are often the primary users of electronic health records. They document patient assessments, care plans, medication administration, and outcomes. In many hospitals, they are also the ones who improve how these systems work. In early hospital IT deployments, nurses led efforts to optimize workflows and reduce the documentation burden, often more actively than physicians.
Today, their role extends into clinical decision support and data use. Nurses use telecare platforms; they are the first to verify alerts, such as sepsis warnings; they educate patients on how to use continuous blood sugar monitoring; they work with dashboards that track patient outcomes; and they contribute to adoption of new AI tools. In fact, they translate data into action at the bedside, which makes them central to how digital systems influence care delivery.
Remote care is already largely nurse-led. Nurses conduct telemonitoring, triage patients via phone or video, and manage chronic disease programs. In the United Kingdom, nurse-led telemedicine hubs connect care homes with acute care teams around the clock, allowing most patients to remain at home rather than be admitted to the hospital.
These activities are supported by a growing ecosystem of digital tools. Nurses use mobile apps for patient education, digital platforms to coordinate virtual wards, and remote monitoring systems that feed continuous data into care pathways. Their role is both operational and strategic, as they decide how these tools are used in real clinical settings.
Digital tools are expanding nurses’ clinical authority
Digitalization has directly contributed to the expansion of nursing roles. In 13 European countries, nurses have legal authority to prescribe medicines. These prescriptions are issued through the same electronic systems used by doctors, which improves speed and continuity of care.
Nurses are also taking on tasks that previously required physician involvement. In many countries, they perform ultrasound examinations, manage remote monitoring devices, and use clinical decision tools in chronic care. The shift is visible in daily workflows. Nurses coordinate virtual wards, use mobile applications to guide patients through treatment, and monitor adherence remotely. They also integrate technologies such as infusion pumps, alert systems, and robotics into care delivery.
Nurse information officers know best where old processes and information flow fail
This expansion has been formalized through the creation of new roles in nursing informatics. In the United Kingdom, hospitals and regional systems have introduced Chief Nursing Information Officers at the executive level. Their task is practical: align digital systems with clinical workflows and ensure they are actually used in care delivery.
In the United States, nursing informatics is a recognized specialty with defined roles such as nurse informaticist, clinical informatics specialist, and data analyst. These professionals implement electronic health records, design decision support tools, and analyze patient outcomes. In the Netherlands and Nordic countries, similar functions exist in practice, with nurses acting as “super users” or digital champions who train colleagues and adapt systems on the ground.
These roles extend beyond system implementation. Nurses coordinate telehealth services, oversee digital triage tools, and manage virtual care pathways. Others focus on data quality and analytics, using clinical data to identify safety risks and improve outcomes. This places nurses in a position to shape not only how care is delivered but also how it is measured and improved.
Their involvement increasingly reaches into innovation. Nurses contribute to the design of digital products, work with industry partners, and participate in artificial intelligence projects, helping to train and validate algorithms against real clinical scenarios. Their input determines whether these tools function in practice or fail at the point of care.
Education is adapting to support this shift. Postgraduate programs in digital health and informatics are expanding, and continuous training now includes data literacy and system design. Digital competence is becoming a core requirement for modern nursing practice rather than an additional skill.
Policy is starting to catch up
International organizations are now explicitly calling for stronger nursing involvement in digital health. The World Health Organization recommends integrating digital competencies into nursing education, including telehealth, informatics, and artificial intelligence.
The International Council of Nurses states that nurses must be involved in planning, designing, testing, and implementing digital systems. It also calls for investment in nurse leadership to drive digital transformation. These positions reflect a shift from viewing nurses as users of technology to recognizing them as co-designers.
The European Specialist Nurses Organization (ESNO) goes further, arguing that digital health will only deliver value if it is developed with nurses and embedded in real clinical workflows. Its position paper stresses that nurses must act as designers, integrators, and innovators, not just end users, and that technology has value only when it strengthens clinical practice, protects time for care, and improves patient experience.
ESNO also highlights a structural problem in Europe: many digital solutions fail because they are developed outside clinical reality and do not align with workflows, professional roles, or patient needs. As a result, systems remain underused or never move beyond pilot phases. Involving nurses early in development is presented as a condition for adoption, safety, and long-term sustainability.
AI enthusiasm among nurses is huge
The debate on artificial intelligence is still largely framed around physicians, even though nurses face the same pressures from electronic health records and fragmented systems. They are also better positioned to adopt tools that directly address these problems. AI scribes can reduce time spent on documentation, and predictive systems can support earlier detection of patient deterioration.
In practice, these tools are already being integrated into clinical workflows. In some hospitals, AI systems alert both nurses and physicians when a patient’s condition worsens, enabling faster intervention and more coordinated care. This shared visibility strengthens decision-making, but it is often nurses who act first on these signals, translating alerts into immediate clinical action.
At the same time, AI introduces new responsibilities. Nurses must verify outputs, identify errors, and ensure that algorithms are used safely. For AI to support rather than burden them with more data and alerts, nursing skills must evolve alongside these technologies, with a stronger focus on digital literacy, critical evaluation, and safe use of AI in clinical practice.
AI is also changing patient expectations. Patients increasingly arrive with information generated by digital tools, which requires nurses to interpret, validate, and respond to these inputs. This adds a new layer to communication and reinforces the need for digital literacy in everyday practice.
Nurses must lead digital transformation, or it will fail in practice
Nurses are the ones who use digital technologies continuously across shifts, settings, and patient journeys. They see immediately when a tool supports care and when it slows it down. That proximity gives them a level of insight no other group has, and it puts them in a position to shape how digital care actually works.
Their role has already moved far beyond delivery of care. Today, nurses are refining workflows in electronic systems, coordinating remote care, interpreting data in real time, and contributing to the design of new tools. These are not supporting activities. They determine whether technology improves care or creates an additional burden.
As artificial intelligence and digital platforms scale, decisions about what to implement and how to use them cannot rest solely with vendors, policymakers, or hospital management. Without strong nursing input, systems will continue to miss clinical reality, leading to low adoption and wasted investment. This is also why the European Specialist Nurses Organization (ESNO) published in January 2026 a position paper titled “Digital Nursing, Anchoring Digital Health Innovation in Clinical Reality and Professional Value.”
Nurses need to step into roles that influence decisions upstream. This includes procurement, governance, and policy discussions where digital strategies are defined. If nurses are not present in these spaces, others will shape the systems on their behalf. Digital health succeeds when those who deliver care every day take responsibility for how that technology is built, introduced, and used. Doctors have long shaped this process, but now nurses must step in to give digital transformation the right direction.
