How to Become an Orthopedic Nurse

Nurse Types / Orthopedic Nurse

Becoming an orthopedic nurse is the perfect career for someone interested in musculoskeletal issues like arthritis, fractures, and joint and bone diseases. Orthopedics is the branch of medicine focused on the entire musculoskeletal system, which includes bones, ligaments, muscles, soft tissues, and tendons.

Occasional pain in the joints and muscles is normal. Lower back pain is the most reported musculoskeletal condition among adults. Arthritis is the second most common orthopedic complaint. Orthopedic nurses are part of the solution.

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In this article, we will cover:

• What is an orthopedic nurse?
• What does an orthopedic nurse do?
• Where do orthopedic nurses work?
• What are specific types of orthopedic nurses?
• How do you become an orthopedic nurse in 3 steps?
• What are additional requirements for orthopedic nurses?
• What are the salary and career outlooks for orthopedic nurses?
• FAQs

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What is a orthopedic nurse?

An orthopedic nurse is a registered nurse (RN) trained to assist patients with musculoskeletal issues. You’ll care for patients with broken or fractured bones, joint replacements, and osteoporosis.

Americans fracture bones at a rate of  2.4 per 100 people every year. That’s a lot of broken bones! More men break bones than women, but you can choose to work with one age group or with patients across the age spectrum.

Qualities of a successful orthopedic nurse

You’ll need certain qualities to be successful as an orthopedic nurse. One of the most important is to be empathetic. Patients with bone breaks or fractures can be in excruciating pain. Part of your job is to soothe them before, during, and after treatment.

Other skills include:

• Excellent collaboration
• Keen observation
• Strong communication

What does an orthopedic nurse do?

Orthopedic nurses work directly with patients to help resolve complaints about musculoskeletal pain. A large part of their job duties centers on pain management. They assess new patients and assess their symptoms, then report back to the healthcare team to devise an appropriate treatment strategy. 

They also follow up with established patients and can cast broken bones and dress wounds.

Other common duties include:

• Assisting orthopedic doctors in administering care for musculoskeletal issues
• Educating patients on the best way to recuperate from orthopedic surgery or injuries
• Establishing a pain management schedule and assisting with administering pain medications for patients prescribed this protocol
• Helping patients improve mobility and strength following orthopedic surgery
• Monitoring patient vitals during surgeries and other treatments
• Treating injuries, casting breaks and fractures, and dressing wounds

A day in the life of an orthopedic nurse

Orthopedic nurses can work in many settings such as:

• Clinics
• Hospitals
• Private practices 
• Assisted living centers
• Home health agencies
• Outpatient rehabilitation centers

Work can be fast-paced, so you’ll need to be flexible. One minute, you might be handling a fracture. The next, you could be assisting with orthopedic surgery.

Common conditions treated by orthopedic nurses

Broken and fractured bones are one of the most common conditions orthopedic nurses treat. Other musculoskeletal diseases and injuries you might handle as part of your nursing duties can include osteoarthritis and other ligament and joint damage.

Where do orthopedic nurses work?

Where you work as an orthopedic nurse depends on your specific interests and goals for your nursing career. You have choices, including:

• Hospital orthopedic units. Patients who have undergone orthopedic surgery need time to heal before going home. It’s your job to provide bedside care and work with the physical therapy team to get your patients healthy enough for discharge.
• Orthopedic outpatient clinics. You’ll treat a variety of patients in this setting, including those who are recovering from a recent injury or orthopedic surgery. You’ll need to educate your patients on the best way to recover and prevent future injuries.
•  Orthopedic surgery centers. Nurses are needed at orthopedic surgery centers to assist with the surgeries, as well as patient recovery. In this role, you can work in preoperative, perioperative, or postoperative surgery care.
• Orthopedic physician private practices. Orthopedic private practices need nurses to help with assessing patients. In this setting, you may see patients more than once, so you can build long-term relationships and help them improve their quality of life.

What are specific types of orthopedic nurses?

As an orthopedic nurse, you have options for specialties just like orthopedic doctors and surgeons. If you choose to specialize in a specific orthopedic discipline, you may need to complete advanced training or focus on continuing education courses that emphasis your specialty.

Some of your options include:

• General orthopedics nurses treat a variety of musculoskeletal system conditions and diseases. It’s a good choice if you like variety.
• Orthopedic oncology nurses care for patients with tumors affecting the musculoskeletal system. You can help with post-surgery bedside care and recovery or assist surgeons in the operating room.
• Pediatric orthopedic nurses specifically deal with children with bone conditions or injuries. Because children’s musculoskeletal systems are still developing, you may need extra training for this role.

Closely related fields

One of the closely-related fields you may enjoy is EMT/paramedic. Some broken and fractured bones happen in scenarios that require an ambulance to transport the patient to a hospital or trauma center for treatment.

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How do you become an orthopedic nurse?

Becoming an orthopedic nurse can be rewarding. You must commit to the required level of education and experience to earn your nursing credentials and be attractive to healthcare employers.

If you’re already a nurse and want to change your nursing specialty, you can take continuing education courses and seek relevant experience. For those just starting out, you must follow these three steps to become an orthopedic nurse.

Step 1: Become a Registered Nurse

Nursing candidates who wish to pursue a career in orthopedic nursing must become licensed registered nurses (RNs) first. Earning an Associate Degree in Nursing (ADN) is one way to do it.  The other option is to continue with nursing school to earn a Bachelor of Science in Nursing (BSN) degree.

Earn a Bachelor of Science in Nursing

Some nurses prefer to complete their ADNs and earn their RN licensure, then work in their field to gain experience. While they work, they continue with their education toward earning a bachelor’s degree.

You can use the RN-to-BSN accelerated program to help move things along more quickly. RN-to-BSN accelerated programs are shorter than standard BSNs because they allow RNs to build on their ADN education and nursing experience.

Pass the NCLEX exam

Sitting for the NCLEX-RN exam is the only way to become a licensed RN. Nursing students can apply to take the NCLEX-RN exam when they are six weeks out from graduation.

The exam includes between 75 and 265 questions with a five-hour time limit for completion that includes scheduled breaks. NCLEX-RN questions include the following topics:

• Health promotion and maintenance
• Physiological integrity
• Psychosocial integrity
• Safe and effective care environment

Nurses who do not pass the NCLEX-RN the first time must wait 45 days to repeat the process. Students who fail the exam receive an NCLEX Candidate Performance Report that provides an overview of how they did on the test. It can be used as a study guide to help prepare for the retake exam.

Step 2: Accumulate experience

After you become a licensed RN, you’ll want to seek out relevant work experience in your nursing field. You could look for roles where orthopedic patients sometimes seek treatment, including:

• Emergency rooms
• Home health agencies
• Outpatient care facilities
• Physical therapy
• Trauma care centers

Helpful skills and experience

A large part of your job as an orthopedic nurse involves pain management. Patients recovering from orthopedic surgeries or in rehabilitation for orthopedic injuries can experience significant pain.

If you want to be effective at your job, you must know how to administer and monitor pain medications, plus assess appropriate pain medications. You’ll also be expected to educate patients on pain control and the risk of becoming dependent on pain medications.

Changing specialty to an orthopedic nurse

Changing your nursing specialty to orthopedics isn’t difficult if you already have your RN licensure. Nurses most suited to this changeover include those with some trauma care experience.

For instance, if you work as an ER nurse and want to make the switch, you can take nursing CEUs that focus on orthopedic care to prepare.

Step 2: Obtain certifications

Orthopedic nurses must obtain specific credentials to work in their field. The Orthopaedic Nurses Certification Board issues the ONC® exam.  Eligibility requirements include:

• Completing 1,000 hours as a working orthopedic RN
• Possession of an unencumbered RN license
• Working as a licensed RN for at least two years

Test-takers can expect to complete 150 questions of which 135 are scored. The remaining 15 questions are pilot items and do not count against the final score. Nurses must correctly answer 97 questions to pass the exam. Credentialed orthopedic nurses must demonstrate continuing competence to renew their certification.

What are additional requirements for orthopedic nurses?

Orthopedic nurses must maintain their certifications once they have them. Taking free nursing CEUs is one way to stay current in your field. Most certifying bodies require a retest periodically to keep your credentials.

What are the salary and career outlooks for nurse managers?

Orthopedic nurses make an average annual salary of $96,259. Some states offer better wages than others. The top five states for the highest salaries for this nursing specialty include:

• Washington – $107,160
• Maryland – $105,798
• Nebraska – $103,590
• Virginia – $102,231
• New York – $102,111

The job outlook for orthopedic RNs and all RNs is rosy for the foreseeable future. The U.S. Bureau of Labor Statistics projects 6% between 2021 and 2031. You can explore your nursing career opportunities to find the best fit.

Job satisfaction

Working as an orthopedic nurse can be a fulfilling nursing career. If you have questions about this nursing specialty, you can chat with other nursing professionals to get their pulse on this option.

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Next steps

Orthopedic nurses have options for career advancement. One of the most obvious transitions is to continue your education and become an orthopedic nurse practitioner. In some states, orthopedic NPs operate independently.

They can:

• Assist in orthopedic surgeries
• Evaluate patients in a clinic or hospital setting
• Order imaging, procedures, and treatments for orthopedic conditions and injuries

FAQs