i have been loving my job, but recently caught wind of the "bosses" wanting to pull me out of the hospital for lack of reimbursement (as compared to the clinic), and quite frankly... i don't want to be pulled out of the hospital. that is why i am an acnp. not an fnp. or an anp. i was talking with the cardio director of the hospital (for whom i work fairly closely) and she proposed i talk with the ceo about a position for me permanently in the hospital. well, that'd be great and all... but i don't wanna tick of the cardiologists i am working with now because it is a small town. i would like to keep an amicable relationship with them. so, my thought is what about a chest pain obs unit... like a "rule out" place. i would be the primary overseer of the unit, managing labs, monitoring for changes, discharging, supervising stresses, etc. with the collaboration of one of the cardiologists. i know these units are out there... and i'm not talking about a regular imc unit... i mean a smaller unit solely for chest pain pts. sometimes these are based out of the er (which is where my background is)... and the hospital i am spending a lot of time in has talked about setting one up in the past. i suppose an alternative would be that i went around to all the chest pain patients scattered everywhere and do the same thing.
1. what determines the success of these units?
2. how could i propose this idea where it would benefit the cardiologists that i work with, so they wouldn't think i was betraying them by going to the hospital... and how could i propose it so the hospital would pay me sufficiently and make the most of my time?
and off the wall: how can you improve "productivity" if the reimbursement is so poor in the hospital setting?