Ortho - a stepping stone?

Specialties Orthopaedic

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Let me pre-face this that I am asking this from a genuine place - I am not looking to putdown ortho nurses in any way because in fact I hope to be one! However, I guess the message I have gotten thru school and from professors and such is that Med Surg nursing is a "stepping stone" a "great place to start" and "a place to hone your skills"....thus, the under-lying message is that Med-Surg, and especially ortho since it is often dealing with post-surgical bone stuff, is for "beginners" or, worse, for nurses who weren't quite "good enough" to handle ICU, NICU, or ED.

AGAIN - this is the message I have gotten from others, and it is NOT what I am trying to say is my POV. I guess I am looking for reassurance against this wave of opinion though. Yes, I know I shouldn't care, but it has bothered me - more than I care to admit.

I guess if I keep hearing "it's a good place to start", it's almost as if they're saying, "you won't want to stay once you've got your skills and experience"...like it's not good enough, or something.

AC

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The"wave of opinion" is wrong. Or you are misinterpreting what they are saying.

A med/surg or ortho unit nurse who can handle the same 4-6-8 patients during an eight hour shift. Then come back 16 hours later to the same patients, is doing something most ER or ICU nurses could not do. To say nothing of a nursing home nurse who may have four times that many patients.

A good Ortho nurse who knows to keep on top of the pain. Knows how to position the extremity. Knows how to educate the patient and their family on how to manage at home. That is as much a specialty as any ICU or ER nurse.

IF your professors are ONLY implying that med/surg is a good place to start as a new grad, even be a stepping stone, IF your dream is to work ICU, ER, or any other specialty unit in a hospital, that may be accurate. Many specialty units prefer nurses who have some med/surg nursing. But your interpretation that it means med/surg or ortho is less than other units is wrong, wrong, wrong.

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1 hour ago, brownbook said:

The"wave of opinion" is wrong. Or you are misinterpreting what they are saying.

A med/surg or ortho unit nurse who can handle the same 4-6-8 patients during an eight hour shift. Then come back 16 hours later to the same patients, is doing something most ER or ICU nurses could not do. To say nothing of a nursing home nurse who may have four times that many patients.

A good Ortho nurse who knows to keep on top of the pain. Knows how to position the extremity. Knows how to educate the patient and their family on how to manage at home. That is as much a specialty as any ICU or ER nurse.

IF your professors are ONLY implying that med/surg is a good place to start as a new grad, even be a stepping stone, IF your dream is to work ICU, ER, or any other specialty unit in a hospital, that may be accurate. Many specialty units prefer nurses who have some med/surg nursing. But your interpretation that it means med/surg or ortho is less than other units is wrong, wrong, wrong.

Thank you! I needed to hear that! Yes, I agree, it could be my own interpretation which is why I was looking for input from others to redress the balance, so to speak.

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My first hospital position was at an LTACH (long term acute care) hospital... where i gained invaluable experience! took the experience i learned there to another hospital as an Ortho nurse..... and let me tell you, from my experience, ortho is not easy at all!!! dealing with post op patients, broken bones, back surgeries, and patient/family teaching really taught me a lot. I left there and went to case management nursing........due to family reasons, i needed the hours and weekends off... but now that my life is back to where is once was 2 years ago, i am returning back to Ortho nursing in the next 2 weeks! and i cant wait!!

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Specializes in orthopedic/trauma, Informatics, diabetes.

As an ortho certified nurse, I am going to try not to take offense.

Orthopedics is a LOT more than "bone stuff".

We have Stepdown, pts on telemetry, pain management using many multimodal interventions (ketamine gtt, lidocaine gtt) We also get many older pts with multiple comorbidities.

I work in a large teaching hospital that is a Level 1 trauma center. They do hand transplants. Orthopedic oncology, surgeons that people come from all over the US to get their procedures done. We have to be on our game.

We have to guide new residents. I have a MSN in Informatics and have decided to stay at the bedside. I love orthopedics. We have a lot of nurses that don't like it because it is too hard. Not just physically, but because of all the conditions we see.

Please don't write us off.

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Thank you to all who have replied! I'm feeling reassured that this is a great place to work!

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Let me say I’ve worked in many specialties. I was a medic for 7 years before RN. I started as an RN in an ER, then to MICU and SICU, then Med/Surg tele, then to Oral and Maxillofacial Surgery, OR-Assist, now I’m an Ortho Clinic. Thru all of it I would have to say I learned all of my fundamental Nursing skills, time management, and prioritizing in Med/Surg, among many other things. You build confidence and good work ethic. It it probly the most Labor intensive with the highest ratio. In every specialty I’ve been in- I relied on those skills and used them daily. Everyone knows and learns their specialty but the groundwork and basics of nursing are the framework for you future as a RN. Never think you are less than any other RN- we are all in this for the same purpose- to care for our patients. Learn from the experienced, ask questions, inquire with others, observe the “good ones” and ask for input from the mentors who love to teach. Ignore the ones who think they’re “all that” or “better” somehow bc they work in a more or less critical setting- Usually those people would never make it in Med/Surg and they’d why they can’t stand to float there. Trust me, it’s not a waste of time and you will see that down the road. They are correct it is the absolute BEST place to start for all you basic nursing skills which are the building blocks and foundation to everything else you will learn in your career. My advice is to take constructive criticism positively, don’t ever pretend you ever know it all, there is always something else to know or learn, use the advance practice RNs to learn more, but never let another nurse ever make you feel that your any less than them! I ran into that in my first year in Med/Surg and by the end of that year the same “know it all” RN was learning things from me. Good luck in your career.

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On 7/31/2019 at 7:27 PM, tjgriz said:

Let me say I’ve worked in many specialties. I was a medic for 7 years before RN. I started as an RN in an ER, then to MICU and SICU, then Med/Surg tele, then to Oral and Maxillofacial Surgery, OR-Assist, now I’m an Ortho Clinic. Thru all of it I would have to say I learned all of my fundamental Nursing skills, time management, and prioritizing in Med/Surg, among many other things. You build confidence and good work ethic. It it probly the most Labor intensive with the highest ratio. In every specialty I’ve been in- I relied on those skills and used them daily. Everyone knows and learns their specialty but the groundwork and basics of nursing are the framework for you future as a RN. Never think you are less than any other RN- we are all in this for the same purpose- to care for our patients. Learn from the experienced, ask questions, inquire with others, observe the “good ones” and ask for input from the mentors who love to teach. Ignore the ones who think they’re “all that” or “better” somehow bc they work in a more or less critical setting- Usually those people would never make it in Med/Surg and they’d why they can’t stand to float there. Trust me, it’s not a waste of time and you will see that down the road. They are correct it is the absolute BEST place to start for all you basic nursing skills which are the building blocks and foundation to everything else you will learn in your career. My advice is to take constructive criticism positively, don’t ever pretend you ever know it all, there is always something else to know or learn, use the advance practice RNs to learn more, but never let another nurse ever make you feel that your any less than them! I ran into that in my first year in Med/Surg and by the end of that year the same “know it all” RN was learning things from me. Good luck in your career.

WELL SAID! I was always told to "Master the Basics" in anything I did because the basics is what ever other level is built from.

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Specializes in Ortho.

You have been grossly misinformed. I did Ortho nursing for 5 years and I took care of patients with a wide variety of medical issues. Yes, they were primarily there for an Ortho-related diagnosis (i.e. knee replacement), but this didn't mean I could ignore their extensive cardiac history, for example. I had to draw on my knowledge and treatment of a wide range of diseases while also keeping the patients on telemetry monitors. I had to deal with trachs, feeding tubes, developmental delays, unruly teenagers, fistulas, and telemetry. I also had to go to ICU units and help the nurses set up Buck's traction or handle wound vac machines for them. Most of all, I had to admit numerous ER patients so I had that experience as well. The point of my rambling is that Ortho nurses have to deal with many high-stress situations while juggling up to 8 patients. Have you ever had to admit 3 patients and discharge 3 patients in 1hr before? I have and so have my former coworkers. It was a very common occurrence.

Ortho is an extremely fast-paced unit since you usually don't have patients that will stick around for weeks like you would in an ICU. There are constant admissions and discharges. To claim that an Ortho nurse or med-surg nurse wasn't good enough to work in ICU is absurd. It is merely another specialty and is no better or worse than working in ICU. There are plenty of ICU nurses who cannot handle Ortho and vice versa. Whether you can handle a particular specialty depends a lot on your personality, skill set, experience and comfort level.

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Specializes in orthopedic/trauma, Informatics, diabetes.
Quote

Have you ever had to admit 3 patients and discharge 3 patients in 1hr before? I have and so have my former coworkers. It was a very common occurrence.

LOL I laugh at this. I work the floor and as charge nurse. The other day we had 11 d/c before 1300. Yesterday we had 9 d/c and 16 post-ops. We have veteran float nurses that cannot keep up with us ortho nurses!!! ?

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Thank you all for your replies! ?

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Could not be more backward misinformation given out by instructors and others. It is actually the opposite, as most nurses can't handle the multi tasking complexities, autonomy and rigors of bedside nursing. It is a bold faced lie. Orthopedics is a highly difficult fast paced specialty that I see many RNs passing through that crumble and can't keep up and are not safe. They then probably bad mouth Ortho to make themselves feel better. The worst instructors and managers that I have encountered are those that have only worked in ERs or ICUs as they are lacking the specific skill set it takes to be a bedside nurse. It is very much so a lifetime specialty that is not taught as such and it is insulting and detrimental for it to be so misconstrued.  Why are there the most severe shortages at the bedside and nurses leaving in droves? It is not because it is just a stepping stone, but because they are not truthful enough to admit they don't or can't work that hard, give me a break. 

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