1. Welcome Back
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15,000 nurses braved six weeks of freezing weather - and won contractual limits on AI. If frontline labor is negotiating your tech stack before you are, that’s not a labor story. That’s a business story. → Share this on X
2. The Weekly Run Down
What’s happening? After nearly six weeks on strike, New York City nurses headed back to work. The final 4,200 nurses at NewYork-Presbyterian reached an agreement on Saturday, ending the city’s largest and longest-running strike. The agreements include 12% pay raises over three years, staffing increases, no cuts to health benefits, workplace violence protections and for the first time: AI safeguards written into the contract - that’s the headline beneath the headline.
Why this matters:
Staffing = safety. The strike wasn’t just about pay. Nurses argued chronic understaffing was putting patients at risk. Several research studies support that higher nurse staffing is tied to better outcomes.
The shortage isn’t local. Even if NYC improves ratios, the U.S. still faces a projected need for 275,000+ additional nurses by 2030 as the population ages and retirements accelerate.
AI is now a labor issue. Mount Sinai agreed to notify the union before implementing AI tools that affect nursing practice. Montefiore clarified that nurses can override AI-driven patient care decisions using clinical judgment. Technology is no longer just an IT decision, it’s a workforce governance issue.
What this means for founders and operators: AI tools that reduce documentation burden, improve handoffs, or support discharge planning could meaningfully reduce burnout. But implementation without transparency or governance will create backlash. The winners won’t “replace nurses”; they'll partner with them to create new models of care. From risk-based staffing models to accelerated training programs to workflow automation that lets nurses practice at the top of license - the future of nursing capacity will be built collaboratively, not imposed. If the strikes have shown us anything, it’s that these nurses possess grit and resilience, traits of the best healthcare founders.
Sources: News 19, Science Direct, Concordia University, Gothamist
3. Healthcare Leader Spotlight
Sarah Pesce, COO of precision medicine platform Radence and a trained Adult Nurse Practitioner, brings deep operational and clinical expertise to consumer health. Her background spans senior leadership at Mount Sinai Health System, including serving as COO of Lab100 and Senior Director of Business Development and Clinical Operations for its Executive Health Program, as well as COO of Thorne Lab, where she led the buildout of a 360° clinical platform for individualized health. This week, we sat down with her to talk about where consumer health is headed.
Sarah Pesce, COO Radence - An RA Capital Venture Company
So, we asked Sarah some questions we wanted to share with you:
What trends in consumer health are the most exciting to you?
Wearables and at-home diagnostics, from WHOOPs and Oura Rings to microbiome tests and blood-based biomarkers, are pushing consumer health beyond fitness tracking and into early risk detection across the “big four”: cardiovascular, cancer, neurocognitive, and metabolic disease. These tools are only getting easier to self-administer at home, creating an explosion of personal health data. The next frontier isn’t just collecting biomarkers: it’s translating disparate data into a cohesive, personalized report card with recommendations tailored to your unique biology.
What problems would you encourage young founders to focus on solving today?
Build a true health “report card” system: We generate endless data, but we haven’t found a way to contextualize it to meaningfully change behavior. Founders should focus on translating clinical and biometric data into clear, motivating scorecards that actually move the needle.
Reimagine adolescent care as its own specialty: Pediatric care drops off after early childhood, yet ages 9–18 face unique challenges from mental health, social media, vaccines to identity formation. There’s whitespace for a distinct adolescent-focused care model rather than lumping teens in with toddlers or adults.
Precision practicing: We talk about precision medicine, but we don’t talk enough about precision practicing. Beyond new drugs and diagnostics, we need more tailored delivery models: advanced primary care, better segmentation by life stage, and specialties designed around how care is actually practiced, not just how it’s studied.
4. In Case You Missed It…
Millions of US Medicare Advantage enrollees were forced to switch plans, study finds (Reuters)
Kintsugi, mental health AI start-up focused on biomarkers recently shut down operations after raising $30M, here’s what its CEO has to say (Forbes)
Hims & Hers announced that it will acquire Australian digital health start-up Eucalyptus in $1.15B deal, broadening its global presence (MedCity)
Optum unveils Value Connect, an AI-powered tool to address key barriers in value-based care from data fragmentation to administrative burden (Fierce Healthcare)
5. If anything, leave with this:
Our Key Takeaway:
There's a structural tension in healthcare. Hospitals are operating on razor-thin margins and nurses are operating at a cognitive overload. Simply hiring more nurses is a band-aid fix. The root issue isn't supply, it's how nursing is designed and deployed.
6. Shout-Out to Our Sponsor
Shift Notes is co-produced with Inflect Capital, an early-stage healthcare fund investing from pre-seed through Series A. Inflect is backed by Vituity, a national provider network of 8,000+ clinicians serving 14 million patients annually across 30 states. If you are building a category defining healthcare solution, we’d love to hear from you: [email protected]
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— The ShiftOS Team
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