Orthopedic nursing

[NurseOz]

Hello,

I am about the start a new job in an orthopedic ward. I worked in another orthopedic ward last year for 8 months, but since then have worked in a urology/colorectal ward. I am worried that I will have forgotten some of the key things to do with ortho. In particular, I am worried that I will have forgotten some of the important manual handling and positioning specifications with patients following hip replacement, shoulder surger, and spinal surgery. Can anyone tell me what are the most important things I should remember as an ortho nurse, particularly with the issues mentioned above? I would really appreciate it.

Thanks,

Jane

[Riseupandnurse]

For total hips and hemiarthroplasties, don't have patients lay very long on the operative side. For traditional hip replacements, don't cross the legs or adduct. For the newer anterior approach though, don't abduct (confusing!) For ORIFs, it doesn't matter. Shoulder surgery, they will be in immobilizers and just don't supinate the hand, as it turns the humeral head completely around. Spinal surgery, logroll only. Often the spinal surgery patients should not get up without a brace and don't let them sit very long as it's hard on the spine; walking is easier on the spine than prolonged sitting.

[twistedpupchaser]

Where do I start? Ortho is complicated in a simple way. I can't help with the shoulder surgery stuff because we don't have the capacity. Still being new I can ask the seniors on staff and most are pretty good about explaining the details which I may have forgotten.

During our handover we are usually told what care is required, if it isn't, one thing I find helps is to look at the surgical notes as early as possible and find out what the surgeon wants, usually there will be orders for the type and weight of traction, devices such as CPM or Charnley (sp?) pillows, gallows slings or immobilisers, elevation on pillows or Thomas Splint, our surgeons are also specific to what angle our Pt's can sit to and what activity they can undertake, (soob, sosob).

Very quickly it should all come back and you will know what is right and what doesn't "seem" right

[NurseOz]

Thank you both very much for those very helpful pieces of advice. I really appreciate it! Hope I can pay it forward.