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Kaiser Permanente nurses who answer advice and triage calls say their duty of care for patients is being increasingly threatened by workplace surveillance.

Seven current and former nurses told The Markup that those who spend more than 15 minutes on a call with a patient routinely face criticism from Kaiser management or get called into performance evaluation meetings. Call time, they said, factors into monthly performance scores they receive.

In addition to tracking call length, they said Kaiser uses software that tries to predict on a daily basis whether they’re being unproductive or failing to answer calls quickly. Artificial intelligence systems have also been used to rate their empathy and tone of voice.

Their comments come as the California Nurses Association begins negotiating a new contract with Kaiser this month with AI a likely issue. Kaiser nurses went on strike against AI for one day in March and picketed against AI last fall. The CNA is bargaining for 25,000 nurses, including 1,000 in call centers.