Beyond the Binary

Abstract

This dissertation analyzes where and how the algorithmization of nursing care is transforming nursing professionalism. This topic is highly relevant, given the rapid rise of algorithmic technologies (AI) in the field of nursing. These advancements have sparked discussions about how AI might or should impact nursing care, as well as the role and status of nursing professionals. Yet, what exactly ‘the rise of AI’ entails — and where and how ‘AI’ is transforming nursing professionalism in practice — has remained under analyzed. This research examines the rise of AI in nursing care as a dynamic and multi-sited process of algorithmization, encompassing the imagination, production, and delivery of AI-related nursing care. Employing a multi-sited digital technography, this study analyzes multiple empirical cases of algorithmization in nursing care, shedding light upon how policymakers, technology developers, and nurses enact algorithms in practices of imagining, developing and delivering nursing care. The study shows that algorithmization affects nursing professionalism subtly, yet profoundly. It influences not only nurses’ tasks and responsibilities but also their professional identities. Furthermore, the study shows that processes of algorithmization are seductive but delusive for nurses. These processes are surrounded by promises of professionalization, but existing power hierarchies are left intact. In addition, the research highlights the often shrouded, yet essential roles that nurses play in algorithmization processes. Nurses are key stakeholders in the development and implementation of AI technologies, but they frequently remain unaware of their crucial contributions. All in all, this dissertation argues that algorithmization is not a simplistic story of ‘technological disruption’ in nursing care. Rather, it is a continuous, multi-sited process involving numerous actors and practices, including nurses themselves. Although they are often unaware, nurses form an essential link in the algorithmic transformation of their own professional domain.

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