Jump to content

Orthopedic Nursing

Updated | Published

Specializes in Nephrology, Cardiology, ER, ICU. Has 27 years experience.

How can I become an Orthopedic Nurse?

Orthopedic Nursing encompasses the care of those with injuries or diseases of the musculoskeletal system. Patients from all stages of life can require orthopedic care. From the infant who has a congenital issue, to the teen injured in a motor vehicle accident, to the elder who has elected to have a joint replacement, these patients require many different levels of care.

Orthopedic Nursing

Orthopedic Nursing is rooted in Victorian England. As a 9-year-old child, the specialty's matriarch, Dame Agnes Hunt, was crippled from septic arthritis of the hip (osteomyelitis). She overcame obstacles to become a Nurse and devoted her entire nursing career to improving the lives of crippled children.

Work Environment

  • Hospital acute units
  • Hospital surgery units
  • Outpatient surgical centers
  • Oncology units (in -/out-patient bone cancer treatment)
  • Orthopedic private practices
  • Trauma units
  • Rehabilitation hospitals
  • Easter Seals organization (congenital defects, pediatric trauma)
  • Early intervention clinics
  • Long-term acute care rehab hospitals
  • Home care

Duties and Responsibilities

  • Caring for patients who have orthopedic injuries or who are having or have had orthopedic surgery
    • surgical assistant
    • set broken bones
    • apply casts and/or splints
  • In-patient rounds and documentation
  • Patient/family education
  • Coordinate plan of care
  • Pain management
  • Interaction with orthopedic healthcare colleagues
    • physicians and surgeons
    • case managers
    • physical therapists
    • social workers
  • Pre -/Intra -/post-operative care
    • preparing for an orthopedic surgical procedure
    • patient recovery from orthopedic surgery
  • Counsel patients contemplating joint replacement
  • Facilitate acute care for critically ill patients with multi-organ trauma and/or multiple fractures/trauma
  • Assist with rehab
    • bedside care
    • coordinate care of physical and occupational therapists as well as ancillary personnel
  • Home care
    • assess the environment
    • provide advice for safe transferring, bathing, cooking, overall living

Professional Orthopedic Nursing Organization

The National Association of Orthopaedic Nursing (NAON) is a nonprofit, volunteer-run organization. They sponsor conferences and define standards of practice and research guidelines for Nurses. It is an accredited provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation (ANCC - COA).


  • Graduate from an accredited school of nursing that offers a Registered Nurse (RN) or Licensed Practical/Vocational Nurse (LPN/LVN) program
    • LPN/LVN:  Certificate, Diploma, or Degree
    • RN: Associate Degree in Nursing (ADN), Diploma in Nursing,  Bachelor of Science in Nursing (BSN) - Advanced Practice Nurses (NP, CNS, etc.) have at least an MSN or higher degree
  • Successfully pass the NCLEX-RN or NCLEX-PN examination
  • Current, unencumbered RN or LPN/LVN license in the U.S. state of practice


The Orthopaedic Nurses Certification Board (ONCB) offers the ONC® certification, the ONP-C® certification, and the ONC-A™ Advanced Certification (by portfolio) examinations.

ONC® Exam Eligibility (not all-inclusive)

  • Candidates for the ONC examination are not required to have a BSN
  • 2 years of full-time experience practicing as an RN
  • Minimum of 1,000 hours work experience as an RN in orthopedic nursing practice within the past three years
  • Current, unencumbered RN license in the U.S. or its possessions, OR hold a current, full and unrestricted license to practice as a first-level, general nurse in the country in which the candidate’s general nursing education was completed, and have educational equivalency established by outlined agencies (see site)

ONP-C® Exam Eligibility (not all-inclusive)

  • 3 years of full-time RN or APRN experience
  • Master of Science in Nursing (MSN), or higher, from an accredited APRN nursing program as a Nurse Practitioner (NP) - NOTE: Candidates must have earned graduate degrees in the U.S.
  • Minimum 2,000 hours of APRN experience within the past 3 years and presently be functioning as an NP who cares for patients with musculoskeletal conditions
  • Current, unencumbered license as an RN in the U.S. or its possessions OR hold a current, full and unrestricted license to practice as a first-level, general nurse in the country in which the candidate’s general nursing education was completed, and meet the eligibility criteria for licensure as an RN in the U.S. in accordance with requirements of outlined agencies (see site)

ONC-A™ (by portfolio) Eligibility (not all-inclusive)

  • 3 years (full-time) RN experience
  • Master of Science in Nursing (MSN), or higher, OR related discipline with direct involvement in musculoskeletal health (not available to Nurse Practitioners)
  • Candidates whose graduate degrees were earned abroad are not eligible to apply for this certification
  • Minimum 2500 hours work experience in musculoskeletal health since completing the graduate degree OR within the last 3 years if degree completion was more than 3 years ago
  • Current, unencumbered RN license in the U.S. or its possessions

Salary (2020)

According to ZipRecruiter, the average annual salary for an Orthopedic RN in the U.S. is $96,259 a year with annual salaries as high as $144,000. The majority of Orthopedic RN salaries currently range between $69,500 to $120,500 across the U.S.

According to salary.com, the average Orthopedic NP salary in the U.S. is $113,300 with the range falling between $105,800 and $120,500.

Job Outlook

Orthopedic nurses can fulfill many nursing roles in many varied environments. As healthcare continues to evolve, it will be very important for the Orthopedic Nurse to take advantage of continuing education (CE/CEU) opportunities as well as experience in a variety of orthopedic specialties.

Choosing a Specialty but not sure which one is best for you?
Download Nursing Specialties Guide!

14-yr RN experience, ER, ICU, pre-hospital RN, 12+ years experience Nephrology APRN.

165 Articles   21,045 Posts

Share this post

Link to post
Share on other sites

2 Comment(s)


Specializes in SCRN. Has 7 years experience.

I can put ortho nursing on my resume due to mandatory floating there from my beloved cardiac/neuro unit. I am forced to work ortho, and do not like it.

Oh ,and there was no cross training provided, we are just to figure it out.

mmc51264, ADN, BSN, MSN, RN

Specializes in orthopedic; Informatics, diabetes. Has 9 years experience.

I LOVE ortho! been an ortho RN for 9 years. Our "sister" units are neuro/ortho spine and we aren't cross trained to spine as much as I would like. The trend now is total joints are same day or OPS. We don't very many on the floor as much (partly because of Covid). 

Some say it's harder, but with the right orientation and good body mechanics, it is easier than Gen Med. I think  🙂