Orthopedic Nursing

Orthopedic nursing is a specialty that focuses on musculoskeletal diseases and disorders.  These orthopedic issues include conditions like arthritis, bone fractures, broken bones, joint replacements, genetic malformations, arthritis, and osteoporosis. Orthopedic nurses are familiar with traction, casting, mobility devices, and pain management.  When musculoskeletal conditions require surgery, orthopedic nurses assist physicians with preparation for the procedure and assists patients with their postoperative recovery.  Some orthopedic nurses may even work in the operating room. 

Orthopedic nurses work in hospital units, offices, and outpatient care clinics. They work with a wide age range of patients and care for both men and women.  Accordingly, they must be familiar with a large variety of orthopedic conditions, medications, and operations.  Orthopedic nurses work a variety of shifts dependent on their employment facility. Office and outpatient nurses usually work during the day, but orthopedic nurses on hospital inpatient units have the ability to work day, evening, or night shift. Orthopedic nurses assist and educate those with orthopedic conditions and complications.  They provide support to the office, outpatient, and inpatient procedures. Orthopedic nurses provide an imperative role to patients during a time where they advocacy, encouragement, and education.

An orthopedic nurse is an expert in orthopedic conditions and caring for patients experiencing these conditions. Orthopedic nurse works closely with the patient, their family, and the orthopedic team to ensure clear client education, a smooth recovery, and minimal complications. The orthopedic nurse performs musculoskeletal health exams, assists with casting and traction, and administers pain medication.  An orthopedic nurse spends time encouraging patients to increase their mobility, educates about how to protect their joint and bone health, and implements strategies to minimize their pain and complications.

As an orthopedic nurse, you must be empathetic when working with patients dealing with chronic pain and mobility concerns.  An orthopedic nurse has impeccable communication skills to ensure the healthcare provider is aware of patient needs and facilitate the appropriate follow-up.  Some orthopedic nurses take care of postoperative orthopedic patients, which opens a whole new world of nursing skills!

Education is the most important aspect of being an orthopedic nurse to promote patient health, prevent disease, encourage patient understanding of troubling symptoms, and promote compliance with ongoing treatments.  An orthopedic nurse is an excellent educator that gives patients extensive, comprehensive information.  They also educate patients and family members who have questions and concerns about medications, pain management, and discharge service coordination.  Orthopedic nurses are well versed in educating patients on the risks and complications of orthopedic treatment and surgery. Orthopedic nursing is a worthwhile, significant, and stimulating career.

Education Requirements

In order to become an orthopedic nurse, you must obtain a nursing degree from an accredited nursing program.  Most inpatient orthopedic nurses are Registered Nurses, but you can work as an orthopedic nurse as a Licensed Practical Nurse or Licensed Vocational Nurse (LPN/LVN) by attending an accredited school program.  LPNs go to school for one to two years to become a nurse.  A Registered Nurse can attend an Associate Degree program (two years) or pursues a Bachelor of Science in Nursing (four years).  After receiving your nursing degree, you will sit for the NCLEX-PN or NCLEX-RN exam to become licensed as a nurse.  Finally, you will apply to the Board of Nursing in your state to become an RN, LPN or LVN.  Orthopedic nurses will train with specific training regarding orthopedic conditions from their employer.

Certification

The elite orthopedic nurses display their extensive knowledge and experience in the orthopedic field by choosing to pursue certification in their specialty. Orthopedic nurses must have appropriate experience before they can sit for the Orthopedic Nurse Certification(ONC) Examination, which is offered through the Orthopedic Nurse Certification Board. By completing your ONC, you can be confident in your level of orthopedic competence and expertise. 

You do not need to have a BSN to take the ONC examination.

To take the ONC exam, you must have:

  • Completion of an accredit nursing education program,
  • A current and unrestricted RN license,
  • Two years experience as a Registered Nurse,
  • A minimum of 1000 clinical practice hours as an RN in orthopedic nursing practice in the last three years. These hours can be in administration, adult care, clinic, critical care, education, emergency room, home health care, long-term care, medical-surgical nursing, oncology, operating room, community nursing, and pediatrics.

The exam is 150 questions and you must answer 97 questions correctly to receive your certification.  These questions are taken from all areas of orthopedic nursing, including degenerative disorders, orthopedic trauma, sports injuries, metabolic bone disorders inflammatory disorders, pediatric conditions, musculoskeletal tumors, and neuromuscular disorders.  Typically, orthopedic nurse certification is valid for four years.

Job Description & Duties

The basic duties of an orthopedic nurse are described below. The description of job duties depends on your facility, your patient population, and where you live.

  • Monitor client vital signs.  Report any abnormal vital signs to the healthcare provider and proceed with any orders, protocols, or PRN medications accordingly.
  • Provide nursing skills, such as:
    • Provide head to toe assessments of patients and provide relevant data to your supervising health care provider
    • Collect urine samples, tissue samples, and blood work.
    • Prepare blood, urine, tissue, and other client samples to send for laboratory analysis.
    • Provide dressing changes and assess client and wound for signs and symptoms of infection.
    • Create and enact client care plans, addressing emotional considerations and pain management.
    • Insert IVs and administer pain medications by the appropriate route.
    • Reposition patients safely according to their mobility and surgical restrictions.
  • Interpret diagnostic studies, such as imaging and laboratory studies.
  • Understand medication dosage, complications, contraindications, and interactions.
  • Perform extensive patient and family education regarding a variety of joint, muscle, bone, and tissue disorders.
  • Work as a team with the physician, medical assistants, family members and patient to prepare an orthopedic patient for lifestyle changes.
  • Educate regarding suitable medications and therapy services.

Job Outlook and Salary

The average salary for an Orthopedic Registered Nurse is $69,000* annually.  Salaries for orthopedic nurses vary related to the type of nursing licensure you obtain (LPN, ADN or BSN), your job description, your length of nursing experience, and your geographical location.  As predicted by the US Bureau of Labor Statistics, the career outlook for Registered Nurses is an increase of 19% in the coming 10 years.  Orthopedic nursing services are growing as the population grows older and requires additional orthopedic surgery and care for issues like hip replacements and arthritis that plague the elderly population.


* Applicable for 2018

References and Further Reading

National Association of  Orthopedic Nurses
http://www.orthonurse.org

Orthopaedic Nurses Certification Board
https://www.oncb.org