How to Become an Orthopedic Nurse—A Great Career, Make No Bones About It

When you become an orthopedic nurse (more formally known as an orthopaedic nurse), harrumph!), you’ll be one of the lucky registered nurses who routinely get to see their patients make progress. That’s because your responsibilities will involve caring for patients as they recover, partially or fully, from injuries and musculoskeletal conditions, or after surgeries. Many, if not most, of your patients will go on to live fully mobile, pain-free lives. If you’re partial to satisfying outcomes, that’s something to consider as you choose a nursing specialization.

There are plenty of other reasons to become an orthopedic nurse; we’ll discuss those below. In this article about how to become an orthopedic nurse, we’ll answer the following questions:

• What does an orthopedic nurse do?
• Where do orthopedic nurses work?
• What skills are needed to be successful as an orthopedic nurse?
• What kind of training does an orthopedic nurse need?
• Do you need a master’s degree to work in orthopedic nursing?
• Are there certifications for orthopedic nurses?
• What are the prospects for a career as an orthopedic nurse?

What does an orthopedic nurse do?

Orthopedic nurses specialize in providing expert care to patients with musculoskeletal issues, an umbrella term used to describe a wide variety of conditions affecting the:

• Bones
• Joints
• Tendons
• Ligaments
• Muscles
• Nerves

When you become an orthopedic nurse, you’ll do things like:

• Examine patients
• Take patient histories
• Take X-rays
• Monitor patients’ neurovascular status
• Assist with continuous passive motion therapy
• Set fractures
• Cast
• Administer medication
• Change bandages
• Treat wounds
• Educate patients
• Prep patients for orthopedic surgery
• Assist orthopedic surgeons during procedures
• Provide post-operative care after procedures like joint replacements

Where do orthopedic nurses work?

Orthopedic nurses work alongside doctors, physical therapists, and orthopedic surgeons in all kinds of clinical and medical settings, including:

• Emergency rooms
• Surgical units
• Trauma units
• Orthopedic units
• Pediatric units
• Oncology units (many cancers impact the musculoskeletal system)
• Sports medicine practices
• Outpatient surgical practices
• Rehabilitation facilities
• Nursing homes
• Long-term care facilities
• Home health care agencies

What skills are needed to be successful as an orthopedic nurse?

Like all RNs, orthopedic nurses need to have:

• A great memory
• Plenty of empathy and compassion
• Deft fingers
• A good bedside manner
• Strong communication skills

Orthopedic nurses have to be strong and fit because working with patients with muscle and skeletal issues can involve lots of lifting and positioning. They also need to be okay with the “ickier” parts of nursing. Even though the majority of your patients will probably be recovering from things like broken bones and trauma, you may have to perform tasks like placing chest tubes and NG tubes or dealing with ostomies and infections.

You’ll also need to be comfortable with the fact that you’ll probably never have a slow day in orthopedic nursing. People get into car accidents every day, and broken hips happen. When you aren’t dealing directly with an injury, you’ll be working closely with people. As Estrella “Star” Montes, RN, ONC, put it in an interview with Working Nurse Magazine, orthopedic nursing is “now more patient- and family-centered than ever. We involve the whole family through education and pre-op classes. We educate them about surgical expectations, labs, the pre-op workup, and what they can expect from their hospital stay and their recovery at home. We let patients know that once the surgery is done, we’re going to have them up and out of bed, generally on the same day. We keep them very busy while they’re in the hospital.”

What kind of training does an orthopedic nurse need?

Surprisingly, there is no single educational path leading to orthopedic nursing. You have choices. The first step is training to become a registered nurse, and there are currently various ways to do that. You can:

• Earn an associate’s degree from a two-year RN program that confers an Associate Degree in Nursing (ADN)
• Earn a bachelor’s degree in nursing from a four-year nursing program that confers a Bachelor of Science in Nursing (BSN)
• Earn a diploma from a nursing school at a hospital that has a two-year diploma program (e.g., Graham Hospital School of Nursing, Signature Healthcare Brockton Hospital School of Nursing)

Your best bet is to go all in on the BSN degree or, if you already have your ADN, to look into RN-to-BSN programs or even RN-to-MSN programs. That’s because there’s a big push in the nursing world to make the BSN the entry-level degree for nursing, so it may not be long before you’ll need a bachelor’s degree to work. Even if the bachelor’s isn’t ultimately required, more and more of the nurses you’ll compete with for jobs will have a BSN or MSN, so the competition is going to get stiffer going forward. There’s no question that having a long and lucrative nursing career will eventually mean having at least a bachelor’s degree.

You’ll find highly-ranked Bachelor of Science in Nursing programs at schools like:

• Duke University (which has the only orthopedic nurse practitioner program in the world)
• Johns Hopkins University
• New York University
• University of Pennsylvania

For most nursing jobs, an undergraduate degree from your nearby state university should be more than sufficient. It will also be a lot less expensive than a degree from one of the top schools. Look into local options before deciding on a program.

No matter what kind of nursing degree program you choose or what school you attend, you’ll take classes like:

• Anatomy and physiology
• Psychology
• Microbiology
• Statistics
• Nursing assessment
• Nutrition
• Pharmacology
• Nursing theory
• Nursing research

You’ll also complete clinical rotations during your nursing school years. These rotations take place in different working environments. It’s common for nursing students to complete rotations in maternity, psych, the ER, and surgery. Most of the time, aspiring RNs don’t get to choose where they attend clinical rotations because nursing programs have existing arrangements with facilities that accept students. It’s up to you to look for BSN programs that include an orthopedic rotation.

Graduating from nursing school doesn’t mean you’re a nurse. You still have to take and pass the National Council Licensure Examination (NCLEX-RN) exam and apply for an RN license from your state board of nursing. Only then will you be an RN, legally sanctioned to care for patients. You may, however, not be able to find a job working with orthopedic patients right away. As is the case in many nursing specialties, gaining a foothold in orthopedics may require racking up a few years of work experience in family practice or in the ER.

While you look for work in orthopedic nursing, look for specialized continuing education courses in topics like osteoporosis care, osteoarthritis care, hand trauma, crush injuries, sports injuries, and hip and knee conditions. The more you know about musculoskeletal conditions, the more likely it is that you will be able to find work in this specialty.

Do you need a master’s degree to work in orthopedic nursing?

Only if you want to become an orthopedic nurse practitioner, though having a Master of Science in Nursing (MSN) may make it easier to land the best jobs in orthopedic nursing. Orthopedic nurse practitioners (NPs or ONPs), can do quite a few things that RNs working in orthopedics can’t, like:

• Prescribe medication
• Order diagnostic tests
• Analyze X-rays and other diagnostic scans
• Develop patient care plans

Because they can do more, they also get paid more. The average orthopedic nurse practitioner salary is about $100,000 while an orthopedic nurse may only make around $63,000.

Are there certifications for orthopedic nurses?

Yes, and you should plan to pursue them as soon as you’re eligible to do so. The orthopedic nurse certification available to RNs is the Orthopaedic Nurses Certification Board’s Orthopaedic Nurse Certified (ONC) credential. You’ll be able to take the certification examination once you have at least two years of experience as an RN and at least 1,000 hours of experience working in orthopedics.

Nurse practitioners and clinical nurse specialists (another type of advanced practice registered nurse) can earn the Orthopaedic Nurse Practitioner Certified (ONP-C) credential.

What are the prospects for a career as an orthopedic nurse?

In a word, good. Depending on where you work, how many years you’ve been working, and what kinds of certifications you have, orthopedic nursing can be one of the best-paying nursing specialties. While the US Bureau of Labor Statistics doesn’t track job growth for orthopedic nursing or other specialties, its most recent reports do suggest that jobs across nursing are increasing faster than average for all industries. Chances are good you’ll always find work in orthopedic nursing in particular because the US population is aging (one in five Americans will be over 65 by 2040) and orthopedic care is an important part of the growing field of geriatric medicine.

Is this the right career for me?

That depends on your interests and your reasons for wanting to become a nurse. If you’re fascinated by the musculoskeletal system (and musculoskeletal problems) and/or you’re looking to get into one of the higher-paying nursing specialties, you should definitely dig more deeply into this specialty.

Those aren’t the only reasons you might want to explore a career in orthopedics, however. One thing that attracts some nurses to this specialty is that it’s relatively straightforward and often easy to help patients get back to 100 percent—or as close to it as possible. You’ll deal with the occasional medical mystery, but as nurse Geri L. Tierney put it in a 2004 issue of Orthopaedic Nursing, “Our orthopaedic patients are often not so “sick” as much as just “broken”, but they need special care to make sure they are cared for while the broken parts heal and get back to optimum function.” If that sounds rewarding, you’ll probably love working in this area of nursing.

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