Nurses picketed outside Kaiser Permanente San Rafael Medical Center on Tuesday, Sept. 1, over staffing levels and the use of artificial intelligence in patient care.

The two-hour demonstration at 99 Montecillo Road, held from 7:30 to 9:30 a.m., was part of informational pickets at 22 Kaiser facilities across California organized by the California Nurses Association/National Nurses United (CNA/NNU). The union and Kaiser are negotiating a new contract after the previous deal expired Monday, Aug. 31.

More than 25,000 Kaiser nurses in California are represented by CNA/NNU, the Press Democrat reported. The union is seeking commitments on safe staffing and protections against what it calls untested uses of AI technology in patient care.

The informational picket was not a strike. The union said it was intended to draw public attention to nurses' concerns at the start of bargaining.

"New technology must be tested, regulated, and include us in the conversation about its implementation," Deb Capistrano, a registered nurse in the Telemetry Department at Kaiser San Francisco Medical Center, said in a CNA/NNU press release ahead of the pickets. "Anything less threatens our practice as nurses and our patients' health."

The union wants Kaiser to invest in nursing staff and give nurses a role in decisions about how new technology is tested and deployed. Union leaders said the two sides had not yet discussed wages as of Tuesday, KQED reported. Talks were expected to resume Wednesday, Sept. 2.

Kaiser spokesperson Elissa Harrington said in a statement that the health system's technology supports nurses and does not interfere with their clinical judgment or replace them in patient care. Kaiser said it meets and often exceeds California's state-mandated nurse-to-patient ratios and adjusts staffing shift by shift based on patient needs.

Kaiser also reported that 95% of CNA-represented nurses in Northern California stay with the health system year to year, according to the Almanac.

The San Rafael picket was one of four North Bay locations. Nurses also demonstrated in Vacaville, Vallejo and Santa Rosa on Tuesday. Bargaining between CNA/NNU and Kaiser began about a month before the Sept. 1 pickets, according to the SF Examiner.