Can you tell me more about Ortho/Neuro Nursing?

Idontknowbetter · Feb 14, 2010

ortho = knee replacements, hip replacements, fractures, etc. taking care of a 75 year old patient with a broken hip can be frustrating and extremely hard on your back. be careful. they literally are just weight... can't move.

neuro = usually see spinal cord surgeries. i'm not sure what type of surgeries they are called though. have to be careful with them too!

ortho floors have a lot of pain, as you can imagine, from all the fractures. Nurses on this floor will be giving a lot of IV pain medicine (i'm told ortho floors give the most pain medicine in all of the hospital). ortho patients will be working with physical therapy, and you'll have to premedicate them with pain medicine. it's a lot of hussling around.

i'm not sure if it's considered a specialty floor. it's usually med-surg that takes these patients, so you get a lot of other patients too (pneumonia, anemia, abdominal pain, uncontrolled diabetes, end of life DNR patients, you name it).

PostOpPrincess, BSN, RN · Feb 14, 2010

Ortho neuro is a specialty; but is is still medical-surgical. A great learning experience, but very strenuous physically. Good med-surg background can be obtained here.

locolorenzo22, BSN, RN · Feb 14, 2010

true...I work O/N...but we also take detoxes, craniotomies, etc. I enjoy it, but it can be a pain to really convince people they HAVE to move post surgery. You get used to it after a while.

alliecat11011 · Feb 14, 2010

JoPACURN said:
Ortho neuro is a specialty; but is is still medical-surgical. A great learning experience, but very strenuous physically. Good med-surg background can be obtained here.

Agreed! Definitely is hard on your back, but you do get some great experience. I think it tends to be busier than other floors, as well because a lot of the patients need more assistance getting into/out of bed, etc. I work on an Ortho/Neuro unit and we tend to get stroke patients as well-I'm not sure if this is the norm though.

nicole109 · Feb 14, 2010

I worked on a Neuro floor, we had an ICU and IMC and a floor---we got Neurosurgery and Neuro, so lots of stroke patients, some dementia/alzheimers, parkinsons, neuroencephalitis, MS, craniotomy, spine surgeries of all kinds, basically anything that dealt with the brain or spine we got it. We were considered a specialty floor, and because we had 2 services (both neuro and neurosurg), we kept pretty busy--when we weren't busy though, we would get overflow from medicine service, so the floor is considered a med-surg area. And you will get exposure to a variety of different things.

RNperdiem, RN · Feb 14, 2010

I used to work ortho as a nursing assistant.

This was a long time ago, but there were a lot of hip replacements, knee replacements and various back surgeries, if you work at a trauma center, add trauma patients too.

An ability to work well with nursing assistants is essential because you will depend on them a lot since few orthopedic patients can move independently. When the 0600 Lasix dose given to your elderly patient with a hip replacement kicks in during report, a good CNA will get moving.

Straydandelion · Feb 15, 2010

I think it depends where you work. If there are a lot of ortho docs, you will have an entire floor that is ortho-neuro...neuro being mainly laminectomies or simple procedures, others going to step-down if the facillity has that. Ortho seems to be mainly hips and traction where I worked. Your best bet is to visit the floor you are considering and see what type of patients they have.

melsman1904 · Feb 15, 2010

The ortho floor I work on sees mostly hip/knee replacements with a good bit of fx pts (femur/tib/fib) and medical overflow (N/V, AMS, COPD Exac.).

SnowStar4 · Feb 15, 2010

The thing to remember on an ortho flow is that patients can be very time consuming. On our floor, they can't get up alone until they are practically out the door for safety reasons. They have walkers, CPMs, SCDs or foot pumps, IVs, braces to put on/take off....it can be a tedious task for some surgeries! That means someone is there to help them in and out of bed every single time they have to go, which is quite often for some people. A good unit will take into account how time consuming these patients are and not give you too many. Sure the PCTs/students (and PT when they are around) do most of the ambulation but if they are tied up for 20 minutes moving one patient, expect to lend a hand.

And like many people said....expect lots of pain meds!

We have knee/hip replacements, lots of osteotomies, foot surgeries, fracture repair, manipulations, shoulders, back/neck, and random other procedures.

Nurse · Mar 31, 2023

An ortho nurse primarily cares for patients who have had a knee or hip replacement or have a fracture of some sort. On the neuro side of this nursing, it can be anything related to the spinal cord or brain. You may care for a lot of patients with laminectomies or those who have suffered a stroke or TIA.

For ortho patients, it can be a lot of pain management with either IV or oral medications. These patients will require a significant amount of help with mobility and you will need to consistently encourage them to be up and moving and regain their strength and range of motion. You will probably also work closely with PT for these patients. Timing of pain medication prior to PT is extremely important for these patients so that they can participate in their therapy to the highest degree.

For neuro (spine) patients, there may be very strict guidelines on mobility that must be followed. These individuals can also experience a significant amount of pain and therefore, pain management will be a large part of your nursing care.

Both can require a lot of lifting on the part of the nurse, and so it is extremely important to educate yourself on proper lifting techniques and good body mechanics.

Ortho/neuro tends to be next to linked with med/surg units however, it may be dependent on the facility. Being considered a specialty may also be dependent on the facility. Larger facilities may have a specific unit for these patients and then it may be considered a specialty nursing unit. There are additional certifications for both ortho and neuro nurses that you can obtain after having practiced in these areas for a while that will show to your employer or potential employers that you are well versed in these areas of nursing.

mmc51264, BSN, MSN, RN · Apr 1, 2023

Our service line is ortho/spine/neuro. We are a specialty. My unit is ortho/trauma and we also see a lot of ortho oncology. One unit does intermediate neuro and ortho spine and then we have the neuro ICU and neuro step down.

Yes I give a lot of pain medication. Good body mechanics and proper lift use keep my back safe.

I have been an ortho nurse for 10 years, am ortho certified and love it!! Most of our pts are not "sick" just broken LOL. Neuro, to me, is a little scarier.