5 Steps to Becoming an Orthopedic Nurse Practitioner

Becoming a nurse practitioner requires dedication to schooling and gaining relevant on-the-job experience. Orthopedic nurse practitioners, like orthopedic doctors and surgeons, focus on diseases and injuries that impact the musculoskeletal system. They can treat patients with chronic health conditions like arthritis or those with broken or fractured bones. Helping patients regain mobility after injuries or illnesses is another important aspect of the job.

This article will cover the following topics:

• What is an orthopedic nurse practitioner?
• What are the day-to-day responsibilities of an orthopedic NP?
• What are orthopedic NP education and certification requirements?
• What is the orthopedic NP salary and job outlook?

What is an orthopedic nurse practitioner?

The musculoskeletal system can experience genetic abnormalities and deformities, be struck by disease, or sustain traumatic injuries. Orthopedic NPs are Advanced Practice Registered Nurses (APRNs) who receive specialized training in musculoskeletal diseases and injuries. There are more than 325,000 licensed NPs in the U.S., with a small percentage of those focused on orthopedics.

Orthopedic nurse practitioners were introduced to the U.S. healthcare system in 1863 in New York City, where the first orthopedic institution opened to treat patients with diseases like polio and tuberculosis. Orthopedic NPs are found in every type of clinical setting. From emergency rooms in hospitals to working alongside physical therapists in rehabilitation clinics, their expertise is valued.

Within orthopedic nursing are additional specializations some NPs may pursue. They include:

• Foot and ankle surgery
• Joint reconstruction
• Musculoskeletal birth defects
• Neuromuscular disorders
• Spine surgery
• Sports medicine

What are the day-to-day responsibilities of an orthopedic nurse practitioner?

Where an orthopedic NP works determines their day-to-day tasks. Some employers may require additional responsibilities outside the normal routine for orthopedic NPs. Here are some of the more common job responsibilities:

• Assisting orthopedic surgeons during surgical procedures and providing after-care for patients
• Creating pain management routines for patients
• Conducting routine health assessments and physical exams
• Educating patients and their families about orthopedic conditions and treatment options
• Monitoring prescription medications for allergic or other adverse reactions
• Reviewing an orthopedic diagnosis and medical history with patients

Orthopedic nurse practitioners work in a variety of healthcare settings. Doctors’ offices, emergency rooms, nursing homes, and outpatient care clinics are among some options. Orthopedic NPs who work in emergency rooms or other trauma care settings can expect a faster-paced environment than those who work in a rehabilitation or other outpatient care facility.

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What are orthopedic nurse practitioner education and certification requirements?

In order to become an orthopedic NP, a commitment to extensive education and training is a must. The minimum degree an orthopedic NP must possess is a Master of Science in Nursing (MSN). There are several other steps involved with becoming a licensed orthopedic NP.

Step #1: Earn a Bachelor of Science in Nursing (BSN) Degree

Nurses without any prior experience or nursing education can expect to spend three to four years completing a BSN program. If a nurse already possesses an Associate Degree in Nursing (ADN), enrolling in an RN-to-BSN program is the quickest way to earn a BSN. This program can complete one in 18 to 20 months. There are similar accelerated nursing programs available for Licensed Vocational Nurses and Licensed Practical Nurses.

Step #2: Pass the NCLEX-RN Exam

Some nurses already hold RN licensure before they decide to advance their career by becoming an orthopedic NP. If they already hold an RN license, this step can be skipped. All other candidates must pass the NCLEX-RN exam.

Step #3: Earn a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP)

Eligibility for Orthopedic Nursing Certification from the Orthopaedic Nurses Certification Board requires an MSN, which takes between 18 and 24 months to earn from an accredited program. MSNs help you earn higher salaries and better opportunities for advancement in the nursing profession. There are RN-MSN programs available, as well as RN-DNP. Orthopedic NP candidates who pursue a Doctor of Nursing Practice (DNP) often choose to work in academic or research settings.

Step #4: Gain Relevant Experience

After earning an MSN or DNP, an orthopedic NP candidate must work a minimum of 2,000 hours of relevant experience as an APRN. Most nurses spend two to three years working in a setting where they can access this level of on-the-job learning.

Step #5: Get ONP Certification

The final step is to gain ONP certification. The ONP-C certification exam provided by the Orthopaedic Nurses Certification Board. The exam is competency-based and provides the certification board with an accurate assessment of a candidate’s knowledge and skills. Orthopedic NP candidates can expect 135 scored questions and 15 unscored questions on the exam.

Specific knowledge of conditions and tasks evaluated on the exam include:

CONDITION/TASK	TOTAL NUMBER OF QUESTIONS
Degenerative Disorders	53
Orthopedic Trauma	24
Sports Injuries	19
Inflammatory Disorders	11
Metabolic Bone Disorders	11
Congenital/Pediatric	8
Musculoskeletal Tumors	4
Neuromuscular	5
Clinician/Practitioner	85-95
Educator	13-23
Manager	3-9
Consultant	11-19
Researcher	3-9

What is the orthopedic NP salary and job outlook?

Orthopedic NPs are among some of the highest-paid nurses in the healthcare industry. The annual median salary for an orthopedic NP is $115,000, according to Salary.com. Some of the top earners in this nursing field make upwards of $128,946 a year. All specializations of Nurse Practitioners remain in high demand. Data from the U.S. Bureau of Labor Statistics indicates NPs will experience a 45% increase in job growth between now and 2029.