What's it like working an Ortho unit?

[jbee]

I'm an RN with 1.5 years of experience who is planning to move within the next month. I have a job interview for an Ortho position next week- however, I know absolutely NOTHING about orthopedics. Can anyone tell me a bit about this population? What kinds of injuries/surgeries are common to see?

Thanks!

[Orange Tree]

Our orthos are all elderly hip fractures and knee replacements. They're considered "heavy" patients because they have difficult to control pain, "fragile" vitals and are are reliant on us for almost all of their ADLs and creature comforts. On a more positive note, most of them have good outcomes and head off to rehab when they leave us. They leave better than they came in, in other words :)

[jbee]

Thanks for the reply. "Leave better than when they come in"- that would be a good change. What's the average hospitalization period for an ortho patient?

[locolorenzo22, BSN, RN]

from time of a sx to fix a fracture about 3 days stay....for a simple rotator cuff repair, simple repair of a finger/muscle issue...overnight.

sometimes, with complications, it becomes a week. We see broken bones, knee/hip replacements, and every bone from rib fxs to shoulder tears to Incision and drainages(that's a big one lately)

[P_RN, ADN, RN]

Perfect answers y'all.

[kool-aide, RN]

Run away! As far as you can!!!!! HEAD FOR THE HILLS!!!!!!

[LouisVRN, RN]

Honestly I work ortho and post-op and love it. Yes, ortho patients are often hard, they need help to the bathroom but at the same time it is very rewarding. Most commonly the procedures we see are hip fractures (total hips) and elective hip (bipolar/hemiarthroplasties) and knee replacements, sometimes a shoulder or ankle fracture thrown in the mix and sometimes fasciotomies. Our floor also takes medical and post-op patients though so its a good mix of orthos/lap appys/pancreatitis/cellulitis. I can imagine a totally ortho floor with no aide would be very difficult physically though if you weren't well staffed or had a lot of patients. My advice on questions to ask would be primary vs team nursing, availabilty of mechanical lifts, whether it is all surgical, etc.

Average lenght of stay for non-hip/knee would be 2 days, knee 3 days, hip 4 days, pretty much get them in and out like clockwork. Major complications are post-op infections, falls, and obviously the dreaded compartment syndrome, although that's mainly with ankles. Pain management can be a big issue as well and ensuring SCIP protocols are followed.

[Flying ICU RN]

There are two types of patients that are particularly difficult to deal with, the one who can't breath, and the one in pain. Ortho is a lot of the latter.

[roser13, ASN, RN]

timmyg41991 said:

Run away! As far as you can!!! HEAD FOR THE HILLS!!

I was just getting ready to warn you that someone would be along to discourage you from ortho, then I see this quote:lol2:

I love ortho, but that's just me. They are considered "heavy" due to all the factors listed above and you need to be a physically fit person to keep up the load (in my opinion). But the patient population is so rewarding in general. For example, they often have a new lease on life when they've had a painful joint replaced.

Ortho is often combined with neuro, which may be another turn-off for some.

[ChristineN, BSN, RN]

I worked ortho for about 6 weeks at my hospital as a float nurse. I saw alot of knee and hip replacements, some ankle surgeries, and on occasion spinal fusions (although those can also be considered neuro). While I wasn't super excited to be assigned to ortho, I have to say, it wasn't bad. It can get monotonous (ie another hip, another knee), but if you like knowing what orders to expect, etc. then it might be a good place. If your hospital is a trauma center, you might see more younger pts from car accidents and sports injuries. Medically, most ortho pts are fairly stable, since they have to pass a medical, including cardiac, screening in order to qualify for "elective" surgery.

[NRSKarenRN, BSN, RN]

Moved to our Orthopaedic Nursing forum. Take a look at wonderful posts here.

[jbee]

WOW, thanks for the great answers, everyone! I've never done anything ortho-related, I've never even had a clinical on an ortho floor, so I really didn't know what ortho was all about (all I knew was what I've heard from fellow nurses: HEAVY HEAVY HEAVY).

How often does an ortho patient need to be sent to IMCU/ICU? In my current position I send approx. 2/month... would this be the same on an ortho unit? I suspect that preoperatively ortho patients tend to be healthier than the clientele I currently work with- I'm guessing that this would decrease any IMCU/ICU admissions post-op.