An overview highlights a shift in pediatric oncology nursing workflows as AI moves from passive documentation to active safety surveillance. The report focuses on immunotherapy toxicities in relapsed leukemia and solid tumors, noting that modern immune-based treatments can deteriorate patients within hours. The central operational point is timing: AI-enabled monitoring is positioned as a way to detect toxicity signals earlier, complementing clinical assessment rather than replacing it. For nursing teams, the change targets escalation triggers—when to act, who to notify, and how to prevent preventable downstream harm. This aligns with broader health-system adoption where clinical decision support is increasingly deployed at the bedside, but where governance, accuracy audits, and workflow fit remain decisive for impact.