NPs in Ortho or Sports Med?

danceluver · Mar 17, 2017

Following....

OrthoFNP · Mar 27, 2017

I am an FNP working in Orthopedics. I have been an FNP in Ortho for 6 months now. Prior to NP school I was an RN on a joint replacement floor. We took care of mostly hip, knee and shoulder replacement post operative patients. Once I graduated I got a job at the Sports Medicine clinic where the joint replacement surgeons work. In addition to these guys there are sports medicine surgeons and foot and ankle as well as spine and hand surgeonns. Between the 17, yes 17 partners, they care for every body part! Needless to say I had and still have A LOT to learn. It's not impossible, but in NP school we learn how to care for common orthopedic injuries one may encounter in family practice. I mistakenly thought it was going to take some time to learn, but not a lot of time. Boy was I wrong! There's a completely different language in ortho. There are more things that can be wrong with one body part than I ever imagined. Just make sure you take advantage while in the ED to look at X-rays and collaborate the images with the radiology report and read some of the physicians notes for some good practice. Oh, and really pay attention to and review your A&P! Ortho is a specialty where knowing the actual names of the parts of the long bones WILL come in handy. Also, pay attention to muscles, tendons and ligaments, where they are and how they allow that body part to move. So, YES it's A LOT, but if you love it as I do, you won't let that discourage you. Just understand you will feel lost for a while in ortho even after you are practicing. Make sure you are hired by a very supportive practice. I've been pretty fortunate because my biggest resource is my boyfriend. He's an orthopedic surgeon. Good LUCK!!!

Perez79 · Mar 28, 2017

Awesome!! Thank you so much for the detailed and thoughtful response OrthoFNP. I'll be sure to take that advice to heart.

Cheers!

akulahawkRN, ADN, RN, EMT-P · Mar 28, 2017

Disclaimer: I'm not an APN of any sort...

Now that being said, I do have a Bachelors in Sports Medicine. I was going to be an Athletic Trainer. The education required to become an ATC is basically a LOT of A&P, biomechanics/kinesiology, exercise physiology, therapeutic modalities (theory and application), physical assessment (particularly that of the extremities), management of athletic injury/rehab, and between 800 and 1500 hours of internship covering non-contact, contact, and collision sports. The ATC works very closely with either a Sports Med physician or an Orthopedic Surgeon. Chances are quite good that I can "speak" Orthopedic Surgeon...

An FNP or PA is going to have a bit of a learning curve at first. You have to become very familiar with bones (particularly long bones), ligaments of the same, muscle origin, insertion, and action for prime movers and stabilizer muscle groups, and their innervation as well. In addition you'll have to learn the stress tests needed to determine what's damaged, and here's the hard part - developing a feel for degree of injury. Imaging is nice and wonderful, but as you get good, the imaging you'll do is more to confirm a diagnosis rather than give you data to make the diagnosis. The Orthopedic Surgeons have one big advantage that most everyone else won't: they can look directly at the injured structures during surgery and can compare what they see to what they felt on exam.

It's going to take a while to really learn well. Sports Med is very much a specialty, and fortunately the NP and PA has a good foundation for shortening the amount of time to become decently functional in this field as a clinician but don't expect it to be easy. The more solid you are with A&P and biomechanics/kinesiology, the easier time you'll have of learning the rest.

Oh, the education I got made Paramedic School incredibly easy and Nursing School didactics reasonably easy. I didn't have to study much for either, it felt like it was all review for me. Learning to think like a nurse was the really hard part.

danceluver · Mar 29, 2017

Anyone familiar with the UNC fellowship in Orthopedics?

Perez79 · Mar 29, 2017

Wait?!

There's a UNC Fellowship in Ortho for FNPs??? Please tell me more!! :)

penniv · Apr 2, 2017

I have been an Adult Nurse Practitioner with a specialty in ortho for 6 years. My RN background was 100% ortho as well. I have my own clinic time and have been a surgical first assist in 100's of surgeries. I absolutely love ortho!

Now, with that being said, ortho is hard work. You will need to have an immediate and vast knowledge of the musculoskeletal system. Depending on your specific role, you may have a surgical requirement where you will need to get certified as a RNFA (RN First Assist) in order to bill the insurance companies. I have reduced 100's of fractures, injected thousands of joints and tendon sheaths/origins. I write Rx meds as needed and refer patients to therapy. I also interpret my own x-rays and order advanced imaging as needed. It is a great field to work in. Good luck!!

chiromed0 · Apr 6, 2017

Well, I'm in pain management now but I got hired on at a hospital first as an ortho NP. I turned down the job for this one but only because of the commute. My background as a chiropractor helped land that position but I would be practicing as an NP not DC. I mention this because having a background in Ortho (as an RN or other) validates your experience with orthopedic patients as an NP with hiring managers. So as an RN go work in ortho or joint replacement. I did and it helped but I already had 10 years as a chiro. You can get the Ortho NP certification but that doesn't matter much to the docs, experience does. I don't know of anything "sports medicine" related as an NP that would matter to an Ortho doc/practice b/c that's just a sub-specialty--you'll make your bread and butter with the same ortho injuries sports related or not.