About
Clinician first.Everything elsefollows from that.

I'm Nicholas Thrash, an acute care nurse practitioner in Houston. I've spent more than a decade in intensive care, looking after some of the sickest patients in the hospital, and that perspective shapes everything else I do.
I started in 2014 as a nurse in the trauma ICU at a Level I trauma center, working as a staff and charge nurse, and from 2015 on the rapid response team. Those six years taught me how quickly patients deteriorate, and how much depends on the systems and people around them.
In 2020 I moved into practice as a nurse practitioner at Methodist Hospital in San Antonio, covering the burn, cardiovascular, COVID ECMO, medical, neuro and surgical ICUs, and later worked in the cardiovascular ICU at Methodist Hospital in Houston. Today I'm in the Heart Failure ICU at Memorial Hermann, caring for patients with advanced heart failure and heart and lung transplants, many of them supported by durable or temporary LVADs and VA or VV ECMO.
Day to day, that means working alongside cardiovascular surgery, transplant, pulmonary critical care, nephrology and cardiology. It means placing central, arterial and dialysis lines under ultrasound, and managing ventilators, hemodynamics and mechanical circulatory support. It also means teaching: I lecture for colleagues and nursing staff, and I've presented at our monthly morbidity and mortality conferences.
I started Thrash Solutions to put that experience to work beyond the bedside. That means education that makes complex critical care clearer, and advisory work for the companies, investors and teams building the devices, software and services clinicians will rely on next.
01 — Path
Experience
- 2026 — Present
Founder
Thrash Solutions, LLC
Clinical education, advisory boards, expert calls and consulting.
- 2021 — Present
Acute Care Nurse Practitioner
Memorial Hermann · Heart Failure ICU, Houston
Advanced heart failure, heart and lung transplant, durable and temporary LVAD, VA and VV ECMO.
- 2022 — 2023
Acute Care Nurse Practitioner
Methodist Hospital · Cardiovascular ICU, Houston
Pre- and post-operative cardiovascular surgery patients, ECMO cannulation and ICU overflow.
- 2020 — 2021
Acute Care Nurse Practitioner
Methodist Hospital · Critical Care Medicine, San Antonio
Burn, cardiovascular, COVID ECMO, medical, neuro and surgical ICUs, plus adult rapid response.
- 2014 — 2020
Staff & Charge Nurse, Trauma ICU
Level I trauma center
Trauma intensive care from 2014, and the rapid response team from 2015 to 2020.
- 2019
MSN, Adult-Gerontology Acute Care NP
Texas Tech University Health Sciences Center
Master of Science in Nursing.
- 2014
BSN
Texas Tech University Health Sciences Center
Bachelor of Science in Nursing.
02 — At the bedside
Clinical expertise
- Mechanical circulatory support
- Durable and temporary LVAD, RVAD, IABP, VA and VV ECMO
- Procedures
- Central venous (IJ, subclavian, femoral), arterial, dialysis and PA catheters; intubation; chest tubes; thoracentesis; paracentesis; lumbar puncture; femoral ECMO access
- Critical care management
- Mechanical ventilation, hemodynamic monitoring, CRRT, external ventricular drains, point-of-care ultrasound, rapid response
- Clinical systems
- Epic, Cerner and Meditech
03 — Background
Credentials & focus
Certifications & licenses
- ACNPC-AG — Adult-Gerontology Acute Care NP
- CCRN — Critical Care Registered Nurse
- APRN & RN — Texas
- ACLS, BLS & Fundamentals of Critical Care Support
Memberships
- American Association of Critical-Care Nurses
- American Association of Nurse Practitioners
- Sigma Theta Tau International Honor Society
Focus areas
- Critical care
- Trauma critical care
- Advanced heart failure
- Mechanical circulatory support
- ECMO
- Heart & lung transplant
- Point-of-care ultrasound
- Clinical education
- Health technology