NurseSchedRL: Attention-Guided Reinforcement Learning for Nurse-Patient Assignment

Abstract

Healthcare systems face increasing pressure to allocate limited nursing resources efficiently while accounting for skill heterogeneity, patient acuity, staff fatigue, and continuity of care. Traditional optimization and heuristic scheduling methods struggle to capture these dynamic, multi-constraint environments. I propose NurseSchedRL, a reinforcement learning framework for nurse-patient assignment that integrates structured state encoding, constrained action masking, and attention-based representations of skills, fatigue, and geographical context. NurseSchedRL uses Proximal Policy Optimization (PPO) with feasibility masks to ensure assignments respect real-world constraints, while dynamically adapting to patient arrivals and varying nurse availability. In simulation with realistic nurse and patient data, NurseSchedRL achieves improved scheduling efficiency, better alignment of skills to patient needs, and reduced fatigue compared to baseline heuristic and unconstrained RL approaches. These results highlight the potential of reinforcement learning for decision support in complex, high-stakes healthcare workforce management.