Welcome back to the Great Work podcast. Today on Great Work, Keir T. sits down with Shane Brown, CEO of Nurse.io, a healthcare staffing marketplace that's rewriting the rules on how nurses and facilities connect. Shane comes from a background in medical technology, giving him a unique perspective as a staffing executive. They discuss why traditional staffing models are breaking down, how Nurse.io is using AI to onboard nurses in under 24 hours and why same day pay can be life-changing for caregivers. Shane also shares ⁓ his journey from med tech to staffing, his take on the supply versus demand debate, and what great work really means when lives are on the line. Okay, let's get into it.

Kirti Shenoy (01:10)
Hi and welcome to episode two of the Great Work Podcast. Today I'm joined by Shane Brown, the CEO of Nurse.io. Shane, thanks for coming on the podcast.

Shane Brown (01:20)
Hey, I'm glad to be here. Thank you.

Kirti Shenoy (01:22)
Awesome, well Sheen, ⁓ obviously I know a lot about Nurse I.O. but maybe you could start off by just giving us a pitch of Nurse I.O. like what do you guys do for those that are unfamiliar with the model?

Shane Brown (01:34)
Yeah, we've designed a really interesting marketplace that connects healthcare facilities that need short-term help, primarily on the nursing side of their staffing, through any different data sources. There's over 500,000 additional nurses are needed within our country today. And we just like to connect the healthcare facilities that are trying to provide really good care with clinicians that don't want to be working full-time anymore or just want a little bit more freedom

and empowerment within their schedule and we just help connect the two.

Kirti Shenoy (02:08)
Absolutely. Nurse staffing has been huge, especially since the pandemic. Nurse staffing, think, really just ended up surfacing and people saw the impact of deploying these nurses across the United States in really hard to reach areas. So really love all that you guys are doing. And, you know, what particularly within nurse IO would you say is the niche that you're going after? Because obviously nurse staffing, would say, is one of the pillars of the Holy Trinity. You know, professional services, light industrials and nurse staffing. would say nurse staffing is one

of those big overarching industries in staffing. So what particularly are you guys tackling at Nurse.io? In that niche?

Shane Brown (02:45)
Yeah, we are consumed right now. We're about to launch into the hospital market and the ambulatory surgery center market. But up until this point, we've been really focused on

detox and behavioral health and assisted living and ⁓ nursing homes and rehabilitation centers, primarily for RNs and CNAs, nursing assistants. ⁓ But it's kind of broadly the PRN category. It kind of just means temporary per diem staffing. ⁓ That being said, our algorithm and our abilities, we can help to staff a lot of different roles within health care. And that's just really the start of what

we're consumed with today.

Kirti Shenoy (03:29)
That's awesome. And you know, she and I have so many questions that I want to dive into on nurse IO. But before we do that, I want to talk about you. you you didn't really come from a staffing background, but really started working at really large major med tech companies like Abbott and GT Medical. What made you kind of make the switch into staffing?

Shane Brown (03:51)
Yeah, I've been in ⁓ the medical device world in healthcare for almost 30 years. And I remember a conversation with my father when I was kind of midway through college. And he said, hey, I think you'd enjoy being on the commercial side of a business because you build trust well and you communicate well and all these things and you're competitive, but make sure it's an industry that's growing and that is meaningful to you.

And so at that time, ⁓ I really put all my chips on the table for healthcare sales jobs. And I started out as a surgical rep standing next to a surgeon with a patient on the table. And that's always been a really fulfilling thing for me. You know, it's knowing that even though I may be on a late flight or in a conference room or with a board of directors or, you know, looking at a spreadsheet, somebody within the team that I'm part of

is helping a clinician take really good care of a patient. And so it's always been in the midst of a heart valve or an ablation catheter for a heart arrhythmia or a PICC line or GT was radiation from the inside out for patients with brain tumors. All of those things meant a lot to me. And when I was thinking about this opportunity at Nurse I.O.,

It's the same exact sentiment. It just is eliminating the widget in between. I'm still consumed by and fulfilled by helping to line up the right clinician to take care of the right patient. Your family member, my family member, somebody else's neighbor, somebody else's colleague.

If you don't have the right clinician, whether that's a nurse or an RT or a CNA or a home health worker, if you don't have those people lined up, somebody's not getting the care that they can. And maybe they have a little bit less hope. Maybe they're not going to recover as fast. But ultimately, our health care system and every health care system that's quality around the world is really contingent on the right ratio of caregivers to each individual patient to make sure that they get what they need.

Kirti Shenoy (05:58)
I really like that Shane and I think that's a really unique perspective you bring. I've met many staffing leaders over the years but I don't think I've met very many that come from sort of the med tech space but I really love that you brought it home with the overall mission being that end, ⁓ the end person at the end of the day that's receiving care and how can we make care more accessible and better for everyone across America. Yeah and kind of.

Going back on the nurse IO side, so nurse IO, you guys really built this company as an on-demand marketplace for healthcare staffing. So what do you think is broken about the traditional staffing model? Because I think nurse IO is doing something really cool, but what do you think is broken and kind of sets you apart from the traditional sort of nurse staffing companies on the market?

Shane Brown (06:46)
Well, on the nursing side...

People don't necessarily want to be working at one hospital or one nursing home for 40 or 50 hours a week for 30 years. People ⁓ enjoy having flexibility now and the quote unquote gig economy that really has gained steam in the last 10, 15 years took off, as you know, during COVID and everybody was in need of more nurses, more staff, more home delivery services for Uber Eats.

or Grubhub or all of these things. So I think generationally, people want more control and empowerment to work where and when they want to and not necessarily putting in, depending on their tenure ladder, putting in, hey, I really want Christmas Eve off or I want July 4th off, but I'm third or fourth person in the pecking order. And so I'm not gonna be able to get that time off this year. People really wanna have control over that or people are taking

care of an older family member or they want to be more present at home and help out with coaching a soccer team or helping out in a classroom or in a place like Phoenix it's really hot in the summer. Some people just want to get out of town for a couple of months in the summer even if that means working extra in the fall and the winter and so like what we're doing is ⁓

Shane Brown (08:12)
It's unique in the way that the features that we bring to people and the talent that we deploy, but it's not unique that people want more freedom and platforms like Nurse.io help to empower people to have more freedom. And then on the facility side of things, there's some structural barriers for nurses right now. know, five to 10 % of nurses have retired in the last five years.

There's not enough nursing programs that are putting new nurses, qualified nurses out and into facilities across the country. There's, you know, things that are unfortunately growing like substance abuse and ⁓ emotional counseling that's needed and psychological hurdles that people are wrestling with. So there's all these demographics at work and there's just not enough people. And so during the COVID, the pandemic surges with everything.

hospitals and facilities did what they had to do to bring in staff. And there was heavy federal stimulus money to do that. ⁓ But in reality, if you picture a hospital setting for one, the labor spend in a hospital is between 40 and 60 % of their overall budget. And when you bring in a locum or you bring in a longer term traveler on a contract,

Kirti Shenoy (09:28)
Wow.

Shane Brown (09:34)
That's not only really expensive and 40 % of hospitals are not making any money today. Even non-for-profits are not covering their costs. But also you can think of the morale in an emergency room or an ICU when you and I are doing the same exact job, but you are under a travel contract and you're making 50 % more than I am, even though I know everything I need to know within that hospital unit. not only is the spend really difficult for most healthcare facilities,

accommodate, but also it's pretty bad for morale too and surveys and polls and everything else affirm that. And so what we're trying to do is connect those people, those clinicians that want more freedom with those facilities that are trying to manage their costs, especially with you know a last-minute call-out somebody got sick, how do we gonna staff accordingly and we just connect the two in a very easy and straightforward way.

Kirti Shenoy (10:31)
I really like that perspective Shannon, kind of bringing it back to the worker flexibility. I totally relate to this. I used to have an old roommate who actually worked as a travel nurse and she had a really, really amazing life in her twenties. You know, traveled across multiple cities, would take...

shifts for three months, four months, and then have a whole month off to sort of vacation and travel somewhere else that she felt inspired to go to and then kept doing that. And that was a great way for her to sort of get that flexibility that she wouldn't have gotten with a traditional hospital to your point, but also have the ability to make money, travel, learn what types of hospitals worked best for her, but also enjoy her life in her 20s while she wanted to travel and explore. So I really liked that and totally relate

that and yeah kind of moving kind of moving back to the app-based staffing market you know you shared a little bit more about nurse IOs niche in particular compared to traditional staffing companies but you know we've seen in the market that there's a ton of companies now that are

towards building more app-based, shift-based staffing companies. So what do you think in particular is truly transformative about the sort of mobile forward, app-based technologies that companies like Nurse.io are really investing in?

Shane Brown (11:50)
Yeah, it's several things. You we take a lot of pride in the fact that we were the first company to offer transparent pricing. And so some companies will say, hey, if you want a nurse to show up tomorrow at noon.

dedicate $100 to us, we'll charge you for $100. And then the company, the app will negotiate with the nurse. Okay, you get $30, but we get $70 or something like that. It's not transparent. We don't ever want to be in the way of a facility putting a compensation out on the marketplace. We don't want to compete with that. We have pre-negotiated flat rates in most of our facilities. And and market pricing, that's all AI driven.

Shane Brown (12:33)
So I can tell you if you're a nursing director at a hospital you can press the market pricing button within the app and you can see exactly the going rate for nurses within your zip code doing a very similar job that way you pay them what they what they deserve to be paid. We have a pre-negotiated rate on the side of that for each shift that's picked up. We were the first ones to offer that. We were the first ones to offer this market pricing that's That's AI driven that I discussed. We can onboard a nurse within 24 hours, which is all AI driven. Sometimes that can take a traditional staffing company over a month to verify documents, to decipher handwritten records for COVID vaccines or TB. We can do that really quickly. And we were also the first ones in the marketplace that were paying on the same day. Now, if you picture yourself, which most CNAs are ⁓ women.

Shane Brown (13:28)
And most of those women are single moms. And so not only is the rate very important of saying, hey, I'm going to make $20 an hour or $50 an hour if I take that shift.

But also if you know you're getting paid within two hours after you finish that shift, that helps your cash flow within your household. Hey, I can go grocery shopping tomorrow. I can make sure that my kids have what they need for school starting in two weeks. You don't have to wait a week or two or a month to get paid like other marketplaces and gig economy platforms do. We're paying on the same day. overall, and also two-way rating system. Like the facility can rate the clinician,

But the clinician can also rate the facility. And so if somebody's on the nurse side is on their phone the whole time and they're not willing to be a team player and they seem disinterested and they're literally just there to pick up a paycheck, that's going to come through on the rating system. And also on the nurse's perspective.

If nobody's welcoming to them when they show up for their shift, they have no idea how to enter into the EMR, the records that need to happen. They don't know where to park. There's no good food options nearby. All of those will come up as well of, hey, people were rude to me. I don't want to work there anymore next time they post a shift. So all of these things, and I'm only giving a small subset of what we think are true advantages, but I think the sentiment hopefully comes through.

Kirti Shenoy (14:53)
Wow.

Shane Brown (14:59)
that we want to be empowering and help clinicians have freedom. And we want to make sure the facilities get fantastic people to work shifts. And we don't need our name sprung all over the place. We don't need anything fancy. We just want to help people connect and provide great care.

Kirti Shenoy (15:17)
I really like that point, Shane. I think there's so many win-wins that you just mentioned in that answer. First off, market pricing, that's super unique. I actually haven't, talk to hundreds and thousands of staffing companies each year, and I haven't really heard a lot of people do the market pricing. And that's just in and of itself a huge win because the facility wants to place the roles. And if the pricing has changed in a localized market, they should know that. And they should be able to act really quickly without a lot of bureaucracy to just enable the platform to connect

More workers to that facility. So I love that and on the worker side It's also win-win because the worker gets fairly compensated even on a micro level Whether those rates are changing on a quarterly basis or an annual basis or even on a week to week basis They're getting fairly compensated for what's market standard So I really really love that market pricing point and another thing that really resonated me with me is same-day pay and

You know, as well as I know, it's really hard to kind of get same day pay across to the worker. There's so much that goes into that from making sure you have the correct onboarding information on file, making sure that the time is pre-approved, making sure that you have those agreements with your clients that, like, if we validated that the workers have actually done their work, we're going to send out the payments. We're not going to do this song and dance for two weeks for you to approve a time card before we can pay out a particular worker. And then, you know, lastly, it's just the technology that's really involved to actually

push payments out for same day pay for the worker and making that sort of financial investment as well. So same day pay is totally an operation. I know because I help so many companies set that up every year, how much goes into that, but it's a huge perk for the workers, especially in the scenario that you mentioned where, you know, lot of these ⁓ RNs are really single moms. They need their funds as soon as they do the work. ⁓ And that's awesome that you guys provide that perk for them. And kind of, you know, we love Nurse I.O. We want to see you.

Shane Brown (17:24)
It could be demoralizing if all of a sudden you work a shift, you know you're going to get paid, and then you have to go to a payday loan place and they're taking 12 or 15 or 17 percent of what you have earned. And that's not even taxes or anything else. That's literally right off the top. So we want to help people to get paid what they've earned and then to be able to take care of their families.

Kirti Shenoy (17:34)
Yep.

I couldn't agree more. So now, you know, my next question is really, we love nurseIO and you guys are working on an amazing niche and we want to see you sort of in more states. you know, right now, Nurse IEO, I believe you guys are operating in around seven states. So how do you think about expansion and expanding beyond the initial geographies that you're currently in?

Shane Brown (18:11)
Yeah, most of our business is in Arizona, a little bit in Texas, a little bit in Louisiana. So even a subset of those seven states that we're ready to go with. And what we've done is we wanted to make sure we had product market fit. a lot of people, strategic and marketing people talk about product market fit. We know for a fact across a lot of different ⁓ facility modalities from

a mom and pop nursing home to a detox center, to a rehab hospital, to an assisted living center, et cetera, et cetera. We know that we can staff well with people that genuinely care and facilities are recognizing that in us. So we've recognized those patterns and what we've done is we have a whole chart that we put together and our launch plan in several different states. We've identified 10 more markets that have the demographics that we need, right?

a lot of a need in facilities for short-term nursing care. Also that nurses are there and a lot of nurses are on our app, even in states we haven't gone into yet, because they know how easy it is to onboard their credentials. They've heard from friends in other states that we're a good company to work with. And so we combine there's a need in the facilities, there's nurses that are already on our platform, and the regulatory environment is amenable for us to jump into.

Shane Brown (19:37)
Some states make it really, really hard to launch anything staffing wise into that state. That doesn't mean we will never be there. That just means it's not our next 10 markets to go. But we think we're very well positioned to in the next, literally in the next few weeks to jump in to several more key markets across the country that nurses are already there on the nurse IO app and the facilities just need to be educated that we're there and we're here to help.

Kirti Shenoy (20:05)
Awesome. And you know, lastly, kind of wanted to ask you a little bit about Nurse IOs AI powered platform. I know AI is all the hype across all staffing companies. Everyone wants to do AI. So what are you guys particularly investing in, in the AI landscape and what are you seeing good results with around your AI investments?

Shane Brown (20:29)
Yeah, it's kind of ⁓ a legacy from being a bootstrap company. We've been frugal from the start, meaning we've never taken a dollar from outside investors. We've never taken a dollar from outside lenders. And so we've always tried to figure out a way to do things.

in a very high quality way and creative way and innovative way, but also in a great value way, meaning we were very early into using AI both on the development of our features and our app and our soon to be launching software. But also that same AI ability taught us that we could bring a lot more features to the marketplace. Like some of the ones I've mentioned today that people can't do really well. So.

Kirti Shenoy (21:09)
Mm-hmm.

Shane Brown (21:14)
Every company now in healthcare IT or staffing, everybody's mentioning AI. AI is our native language. It is how we develop all of our software, our app, our feature sets for facilities. It's all on AI. And so that makes us very, very responsive and quick to the marketplace. If you and I have a conversation on a Monday afternoon, within an hour, I could have a totally different feature to you if it made sense.

Kirti Shenoy (21:34)
Yep.

Shane Brown (21:42)
You know, if you say, instead of, you know, the market pricing feature that we talked about, could I look at other states that, you know, for nursing homes, so kind of our peer group across the country, what does that look like? And we can, you know, change that within our app or within our easy button within minutes where...

Teams are still with the big companies. Sure, they can say that they use AI, but they still have huge development teams. They have huge sales teams. They have huge marketing teams. We don't need any of that right now because we know that our history has been frugal and we want to make sure that the money that we are spending now is all to continue to make a great product that helps people connect.

Kirti Shenoy (22:26)
Yep, and I really like that point around, you know, the genesis of the company really started as a bootstrap company. So, you know, when you're a bootstrap company, you need to figure out how to automate everything because you're certainly not going to use outside capital to hire hundreds of workers to do day to day operations. So I really love that that's always been in the bloodline of nurse IO. think a lot of other staffing companies that maybe started off, you know, in a more traditional way with a lot of human capital are now trying to figure out how do they undo those systems, both people systems and technology.

systems to now start investing in AI and reap the rewards of it. And I certainly think that the companies that are investing in AI and automation are going to win in the market because in staffing it's just such a margin game that you have to optimize everything to a T so that you can offer the best value to your workers and also to ⁓ the clients on the demand side that you're working with.

So yeah, I think this concludes the main section of today's podcast. I have four questions for you in sort of our rapid fire session that we like to do, Shane. So maybe just answer the next couple of questions as quickly as you can. But for the first question, what's something that you believed about health care or staffing that you no longer think is true?

Shane Brown (23:19)
No doubt. No doubt.

Yeah, I was kind of on the mindset and I'm a little bit generationally that ⁓ nurses just show up and they do their shift and they go home. In reality, your average nurse, they care deeply about what they're doing. They're passionate about what they're doing. And so the burnout rates are very high. studies show that when you do integrate, you know, part-time staff and per diem staff and float pool staff,

Kirti Shenoy (24:01)
Hmm.

Shane Brown (24:10)
It really helps the morale and the energy overall of a unit because people do get burnt out and people do need some time to regenerate. And it's not just during COVID, it's any time where you're doing something where you're caring for people all day, every day, it takes a toll. And again, that's a nice benefit that companies like Nurse.io jump into is that we're helping people to stay fresh. We're helping them just duck away for maternity leave. We're helping them take care of a sick child. And that's all because

We care and we're willing to jump in with people at where they are.

Kirti Shenoy (24:45)
Yep. ⁓ Next question is, what do you think staffing companies and marketplaces should really figure out first, the supply side or the demand side?

Shane Brown (24:55)
think the supply side, I really do. mean, if you want a warm body to show up for a shift, a lot of people can do that, right? You post an ad and you send them where they're supposed to end up, but truly a quality person that has the right credentials, the licenses are up to speed, they've been interviewed, they are rated by facilities over a certain amount of time.

Nothing can guarantee that every person going out on one of these shifts is perfect. But what we do is try to minimize any sort of risk and know that we are sending a great person with the right credentials and the right licenses to take care of your neighbor and my parents and our children.

Kirti Shenoy (25:37)
Nice. And as someone who came from the med tech space, what is your favorite med tech innovation from the past five or 10 years?

Shane Brown (25:47)
Yeah, I've been fortunate enough to be part of amazing teams that are wrestling with, you know, heart valves and, and, ⁓ digital at home sleep apnea tests that people can do from their, their beds without going into a sleep lab. But I think the chapter that I worked in before nurse IO was an internal radiation source for patients suffering from brain tumors. I think that was a brilliant solution invented by Dr. Dave Brockman and it's helping thousands of patients across the country.

So instead of external beam radiation that's coming through healthy brain to get to a brain tumor, this technology is put in at the time of surgery. And so the radiation can start acting right there and then to zap any legacy cancer cells. And it's helping people day to day. And it's a population of patients that don't have much hope. And GT is giving people hope.

Kirti Shenoy (26:41)
So awesome. And lastly, Shane, you know, we call our podcast Great Work. What does great work really mean to you?

Shane Brown (26:49)
Great work means a lot of people that aren't trying to take credit for anything as individuals, but they know the importance of the project or the product or the service that they're working on can genuinely make a difference to other people. That to me is great work. Nobody's raising their hand and saying, hey, you I created that last Saturday and everybody needs to get out of my way and I need all the credit. It is what can we help solve in healthcare today?

and all of us with our own skill sets and collaboration and communication and focus, working together to make sure that that solution is not only innovative, but also affordable and ready to help people do what they do best.

Kirti Shenoy (27:31)
Super awesome. Well, Shane, thank you so much for the time today. I certainly learned so much about Nurse I.O. and how you view the future of healthcare staffing. So excited to see you guys continue to scale and thanks for coming on.

Shane Brown (27:46)
Sounds good. Nice to see you. Take care.

Kirti Shenoy (27:50)
Awesome.

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