Background: Electronic health records (EHRs) were introduced to improve documentation, communication, and patient safety. However, unintended consequences have emerged, particularly for nurses who rely on these systems in daily practice. This systematic review aimed to explore nurses’ experiences with the unintended consequences of EHR use in acute care settings. Methods: A comprehensive search of PubMed and CINAHL databases was conducted for studies published between 2009 and 2024, supplemented by manual reference screening. Studies focusing on registered nurses and unintended consequences of EHR use were included. Following PRISMA guidelines, 101 articles were identified, 29 underwent full-text screening, and 7 met the eligibility criteria. Data on study design, setting, aims, and reported consequences were extracted and synthesized narratively. Results: Seven studies were included, predominantly qualitative in design, with one mixed-methods study. Across settings in the United States, Sweden, and Iran, nurses reported multiple unintended consequences. These included workflow disruptions, increased documentation burden, usability challenges, redundant or duplicate data entry, communication barriers, and insufficient training during implementation. Such issues were found to contribute to cognitive overload, inefficiencies, and potential risks to patient safety. Conclusion: While EHRs offer potential benefits for nursing documentation and care coordination, this review demonstrates that their implementation often generates significant unintended consequences. Addressing these challenges requires aligning EHR design with clinical workflows, providing adequate training, and ensuring nurses’ involvement in system development. Greater awareness and proactive planning may help minimize negative effects and optimize the role of EHRs in supporting high-quality, safe patient care.