JMIR Publications

ABSTRACT

Artificial intelligence (AI) is increasingly embedded in nursing practice through decision support, risk prediction, documentation assistance, triage, patient education, staffing, and workflow management. Existing nursing AI literature has made important contributions by defining AI literacy, identifying ethical and safety concerns, and positioning nurse leaders as essential actors in technology governance. However, less attention has been paid to how AI-mediated care reshapes patient recognition, clinical meaning-making, moral presence, communication, documentation, and professional accountability. This Viewpoint argues that the next frontier of nursing digital competence is not simply AI literacy, but humanistic meaning-making and behavioral governance. We propose MESH as a provisional conceptual framework for AI-mediated nursing care, consisting of Meaning-making, Ethical presence, System and relational workflow governance, and Human-in-the-relationship. We also introduce the MESH-Action Cycle—Recognize, Interpret, Communicate, Govern, and Evaluate—as a practice-facing approach for nurse leaders to examine and govern the behavioral and relational consequences of AI implementation. This article reframes nurses not as passive end users of AI systems, but as interpreters, moral agents, workflow stewards, and guardians of the caring relationship. When AI helps the system see the patient, nursing must ensure that the patient still feels seen.