One bootstrapped biz is solving the nursing crisis
Here's a lie that won't die: bootstrapping means staying small and you can't build anything meaningful without investors.
NurseHub, an online community to help nursing students pass their nursing exams, is a perfect example of why that's wrong.
For Alex Hollis, the founder of NurseHub, this isn't just test prep. NurseHub exists "to end America's nursing shortage, one future nurse at a time."
And they're making real progress on that mission. Today, NurseHub has helped over 50,000 students pass their nursing exams and they're on track to make over $4 million in annual revenue this year.
In this deep dive, I'll go over how Alex got into this space without being a nurse, why he chose to build "slowly and sustainably" (even while racking up $40,000 in credit card debt), and one of the more interesting community growth strategies I've seen.
Let's dive in.
The Story of NurseHub
Teach for America Experience
Alex started his career as a high school physics teacher in the Mississippi Delta through Teach for America. Moving from Boston to rural Mississippi was a culture shock, but what really hit him was seeing the educational gap firsthand.
"I think I kind of had this epiphany of how privileged I was, because when I was coming up for taking the SAT I knew well in advance what the SAT was," Alex told me. "My parents were very fortunate, you know, paid for prep for me, and expensive tutoring and all these things. So I could increase my scores on this exam and ended up getting into the school I wanted to get into. And these students did not have that opportunity."
The difference was stark. Back in Boston, ACT prep was just part of the process. In Mississippi? It barely existed. Since standardized test scores can make or break college admissions, Alex decided to do something about it.
He started running his own ACT prep sessions during homeroom and after school. The results were impressive. "They ended up really improving their scores pretty dramatically," Alex said. "That made me really excited because it opened up a lot more doors for these students that they otherwise likely would not have had."
This experience stuck with Alex. He saw how test prep could be "such a make or break time point for students and their futures," especially for students who couldn't afford expensive tutoring.
I will quit my job to join you
After his two-year commitment with Teach for America, Alex headed back home to Boston where he landed at Wayfair. This was perfect timing. Wayfair was in the middle of consolidating all their micro-brands under one umbrella, so Alex got to see how a major e-commerce company scales.
But Alex had bigger ambitions. He'd heard about a venture capitalist who was an alumnus from his school, Loyola College. Alex decided to reach out directly.
"I cold emailed him and I was like, I think you're really interesting. Your background is really interesting. I would love to get into entrepreneurship," Alex told me. "I'm an Eagle Scout. I was student body president of my college, trying to impress him. And I will quit my job and come work for you if you'll have me."
The VC's response? "Sure."
Alex joined him and got a crash course in entrepreneurship. "That's where I learned more about entrepreneurship and it was like just the greatest gift he could have ever given, was his time and mentorship," Alex said. "That's where I learned a lot about how to start a business and scale a business."
But even while learning the ropes of business, Alex couldn't stop thinking about his former students in Mississippi. Many of them had wanted to become nurses, but they kept hitting the same wall: entrance exams.
The start of NurseHub
As Alex dug deeper into the challenges his former students faced, he realized the problem went beyond just entrance exams.
"These students were smart, they were capable, they were compassionate. They would've made great nurses, but they really, really struggled with their entrance exams," Alex told me. "And then those that did make it struggled with that critical first semester of nursing school where I've come to find now, about 50% of all dropouts happen in that first semester."
Alex started researching the nursing space and realized there was a bigger opportunity here. Unlike the ACT, which is a one-time test, nursing education never really stops. "There's an opportunity to be with these students throughout their entire career," Alex said. "Because you're always learning as a nurse. You can never stop learning as a nurse, you have to continue your education. There's opportunities for advanced credentialing."
As Alex researched further, he discovered just how dire America's nursing shortage had become. "We're actually short about a million nurses right now, which is incredible," Alex told me. "And we know what kind of impact that has on mortality rates. A floor that is understaffed, the mortality rate of patients goes up about 6%."
So Alex started working nights and weekends from his couch, building what would become NurseHub. He racked up about $40,000 in credit card debt in the process, but eventually the business started making enough money for him to cover his bills and quit his full-time job.
The business model of NurseHub
Since nursing education is ongoing, Alex knew a one-time course payment wouldn't make sense. Instead, he built NurseHub as a subscription-based online education community.
Students can pay monthly or quarterly for around $30 per month to access practice tests, video lessons, and community support. But here's what really builds trust: NurseHub offers a guarantee that's pretty bold for the education space.
As Alex put it, "If you complete our course material and don't pass, we'll refund you for up to 3 full months and cover your exam retake. That's how confident we are in your success."
It's a smart way to remove risk for students who are already stressed about these high-stakes exams. And it works. Today, NurseHub has helped over 50,000 students pass their nursing exams and is on track to hit over $4 million in annual revenue this year.
The growth has been steady too. Alex told me it took about three years to go from zero to $250k in annual revenue. From there, they've grown between 30 and 50% year over year.
Why Alex bootstrapped NurseHub
Most founders bootstrap because they can't raise money or want to own everything. Alex's reason was different.
"I wanted to build it slowly and sustainably," Alex told me.
Wait, slowly? The same guy who racked up $40,000 in credit card debt wanted to build slowly?
Alex's reasoning made sense once he explained it. He was still learning and didn't want the pressure of investor money while figuring things out. "I realized, I think that I was learning really early on, and I knew that I didn't know enough that if someone were to give me millions of dollars, which I don't think anyone would've anyway, even if I had asked, I didn't know if I would know how to spend it and not waste it."
But there were other reasons too. Alex wanted to run NurseHub according to his values, not investor expectations. They donate 5% of their profits to charitable organizations and offer incredible benefits to their 18 full-time employees. As Alex put it, "I knew that these were the different things that I wanted to have my company embody. And I was most confident that I could do that myself, and I didn't want to get pushed too far into looking at short term profit gains."
Alex also didn't want the pressure of owing money to people he knew. As Alex put it, "You don't wanna be like, Hey, so, uh, Alex, what's going on with that hundred thousand dollars I gave you? You'd be like, well, um, you know, I sunk it into Facebook ads and it didn't work out."
Growth Strategies of NurseHub
Word of Mouth and Referrals
When Alex surveys new NurseHub users about how they found the platform, the top answer is word of mouth from other students. The second most common answer? Recommendations from teachers and deans at nursing schools.
"That's awesome because not only is it free, but it's also telling it's great feedback that our product works and that it's a high quality product because it's getting these recommendations organically for word of mouth," Alex told me.
This creates a powerful flywheel. When NurseHub delivers on their promise of helping students pass their exams (they have a 98% pass rate), it becomes natural for those students to recommend it when others ask for study resources. Teachers and deans also recommend NurseHub because it supplements their work and helps their students succeed.
It's a win-win-win situation. If a student passes their exam, the student wins, the college wins, and NurseHub wins. Everyone's incentives are aligned.
Facebook Groups
Alex's first real traction came from Facebook groups, but not in the way you might expect. Instead of spamming existing nursing groups, Alex created his own.
"We started Facebook groups around folks who are studying for the exams that we prepare for, as well as like cohorts who are going into their first semester of nursing school where they could lean on each other and support each other," Alex said.
These groups focused on the problems students were facing rather than promoting NurseHub directly. It was a smart way to meet students where they were already going for help and build community around their needs.
The strategy worked. Alex mentioned their biggest group has around 35,000 people in it, which is substantial for such a targeted audience.
TikTok Live
While Facebook groups got NurseHub started, TikTok has become their biggest social media growth driver. But it's not just about posting videos. Alex and his team go live nine times a week on TikTok.
"Going live on TikTok has been not just a great marketing tool for us, but it's also been a way for our instructors to really like reconnect with students and interact in real time," Alex said.
During these live sessions, instructors teach on specific topics like "TEAS 7 Anatomy" while students ask questions in the chat. Even better, students who have already passed their exams often come back to the live streams to share their success in the comments.
"My favorite part of this job is when we're on TikTok lives and we have an instructor teaching our students, and we have folks who come back into the chat and say, Hey, I just wanna let you know that I passed," Alex told me.
It's live feedback that shows the community working in real time.