{ "source": "Cooked Index — occupational AI risk register", "page": "https://cookedindex.com/jobs/orderlies/", "methodology": "https://cookedindex.com/methodology", "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.", "scored_at": "2026-08-11", "model": "claude-opus-5", "occupation": { "title": "Orderlies", "soc_code": "31-1132", "category": "Healthcare Support", "us_employment": 52440, "median_annual_wage": 38290 }, "verdict": "EXPOSED", "risk_resistance": 56, "contested": false, "near_boundary": false, "dimensions": { "task_resistance": 15, "embodiment": 19, "liability_shield": 3, "trust_premium": 11, "judgment_accountability": 8 }, "reasoning": { "task_resistance": "A two-person lateral transfer of a 300-pound sedated patient off a gurney, a manual reposition to prevent pressure ulcers, and a terminal clean of an isolation room are physical acts no software performs, which is why this sits at 15 rather than 18 — the AGV linen cart, the automated transport-ticket queue, and the bed-status board have already taken the fetching-and-dispatching slice of the shift.", "embodiment": "The work happens in occupied patient rooms, ORs, morgues and elevators, with wet floors, C. diff precautions, combative or confused patients, and lifting loads that put orderlies among the highest musculoskeletal-injury rates in any US industry; 19 rather than 20 only because some of the shift is pushing carts down predictable corridors.", "liability_shield": "No state licence gates this job — most hospitals require a high school diploma, CPR, and in-house lift and bloodborne-pathogen training, and when a patient is dropped during a transfer the claim runs against the hospital and the supervising RN who ordered the move, so the 3 reflects only that a documented competency checklist exists at all.", "trust_premium": "Being the person who moves a frightened patient to imaging or handles a body for the family means patients and nurses ask for the orderly they know, and charge nurses protect the ones who can turn a room fast — but you are assigned by the dispatch queue, not chosen, and float across units, which caps this at 11 instead of the mid-teens.", "judgment_accountability": "Lift protocols, isolation precautions and transport orders are written down and you follow them; the 8 is for the calls that are genuinely yours — refusing an unsafe solo transfer, spotting that a patient has gone gray or unresponsive mid-transport and stopping to call it in, deciding a confused patient shouldn't be left on a gurney unattended." }, "rationale": "Orderlies transfer patients between beds, gurneys and wheelchairs, reposition immobile bodies, transport specimens and equipment, and clean rooms — none of which language models touch and none of which today's robots do safely around frail humans. The exposure is not AI replacing the work but software squeezing it: automated dispatch and transport-request systems, tracking of bed turnover, and AGV carts for supplies and linens erode the non-patient portion of the shift and let hospitals staff thinner. There is no license or personal liability shield here, and the discretion is real but narrow — recognizing that a patient looks wrong and escalating.", "outlook": "Demand grows with the aging population and the work stays hands-on, but pay stays low and hospitals will use dispatch software and transport robots to cover more patients per orderly — the path up is certification into CNA or a surgical/sterile-processing tech role.", "what_would_raise_it": { "levers": [ { "dimension": "task_resistance", "change": "State safe-patient-handling laws (already in ~11 states: WA, NY, CA AB 1136, NJ, MN) being extended to require a dedicated two-person lift/mobility team for any transfer of a patient above a weight or dependency threshold — this converts transfers from 'whoever is free' into a staffed function that dispatch software cannot thin out, and shifts the remaining shift toward the mobility/handling tier rather than errand-running", "plausibility": "plausible", "would_add": 2 }, { "dimension": "task_resistance", "change": "Task-mix shift as AGVs and tube systems absorb specimen and linen runs: what remains is hands-on repositioning, early-mobility ambulation protocols, and fall-risk observation. Recognizable marker would be hospitals formally reassigning orderlies to mobility-technician or 1:1 observation duty rather than cutting headcount", "plausibility": "already happening", "would_add": 2 }, { "dimension": "judgment_accountability", "change": "Joint Commission or CMS Conditions of Participation naming the transporting or repositioning staff member as an accountable reporter in fall, pressure-injury (HAPI), and deterioration escalation pathways — e.g. a documented handoff signature required before a patient leaves a unit for imaging, and inclusion of transport staff in rapid-response activation criteria", "plausibility": "plausible", "would_add": 3 }, { "dimension": "judgment_accountability", "change": "Hospital pressure-injury and fall metrics are CMS penalty-linked; if repositioning-turn documentation becomes an auditable, individually-attributed entry in the EHR (as some systems already do with turn-timer sensors), the role owns a consequential, named call", "plausibility": "already happening", "would_add": 2 }, { "dimension": "liability_shield", "change": "State-level extension of nurse-aide certification (42 CFR 483.152-style training and registry, currently mandated in long-term care) to acute-care transport and handling staff, with registry-recorded abuse/neglect findings attaching to the individual. This creates a credential and personal record, not personal malpractice liability", "plausibility": "plausible", "would_add": 3 }, { "dimension": "trust_premium", "change": "Private-duty and concierge patient-sitter/companion market where families pay directly for a named human to stay with a frail or dementia patient during hospitalization — already a paid service in some markets and explicitly not substitutable by monitoring cameras", "plausibility": "already happening", "would_add": 2 } ], "ceiling_note": "Liability shield has a hard low ceiling: no US jurisdiction licenses orderlies as independent practitioners and none is proposing to, so signature authority and personal malpractice exposure are not realistic routes. Embodiment is already near maximum and cannot rise. The dominant threat here is headcount thinning through staffing software, which staffing-ratio and lift-team mandates address directly while credentialing does not." }, "adjudication": null, "employment_history": { "points": [ { "y": 2019, "emp": 46990, "wage": 28980 }, { "y": 2020, "emp": 43570, "wage": 30030 }, { "y": 2021, "emp": 45160, "wage": 29990 }, { "y": 2022, "emp": 44790, "wage": 34520 }, { "y": 2023, "emp": 48710, "wage": 36830 }, { "y": 2024, "emp": 53020, "wage": 37700 }, { "y": 2025, "emp": 52440, "wage": 38290 } ], "from": 2019, "to": 2025, "change_pct": 11.6, "comparable_from": 2019, "spans_soc_revision": false }, "pivots": [ { "slug": "childcare-workers", "title": "Childcare Workers", "verdict": "SAFE", "risk_resistance": 71, "median_wage": 34980, "overlap": 56, "skills_to_close": [ "Monitoring", "Instructing", "Learning Strategies", "Persuasion" ] } ], "license": "https://cookedindex.com/terms" }