Regulating at the AI frontier: The collision of policy, regulation, and nursing practice

Abstract

Artificial intelligence (AI) is rapidly transforming clinical decision-making and healthcare delivery, yet state-level legislation addressing AI integration in patient care often lacks alignment with nursing-specific regulatory frameworks. This policy analysis examines enacted and proposed AI-related legislation across the United States, with specific attention on implications for nursing practice, licensure, and professional accountability. Using a structured review and thematic categorization of state legislation, eight major policy domains were identified, such as “AI in Clinical Decision-Making,” “Nursing Scope-of-Practice or Autonomy Protections,” and “AI Governance via Task Forces or Commissions.” While development of state-level AI policy is gaining momentum, few legislative efforts explicitly define nursing roles, responsibilities, or protections within AI-integrated environments. Furthermore, the majority of proposals addressing nursing autonomy are pending rather than enacted. These findings highlight a growing regulatory gap that may expose nurses to increased liability, ambiguous role expectations, and reduced clinical authority in AI-augmented care settings. Key AI policy and regulatory priorities for the nursing profession focus on competencies in nursing education, updated licensure frameworks, and structured approaches for boards of nursing to assess disciplinary concerns arising from AI use. Foundational insights for nursing organizations seeking to proactively engage with AI policy development and ensure safe, ethical nursing practice in the digital era are provided.