Orthopedic nurse assisting patient with exercise

Orthopedic nurses, sometimes called ortho nurses, earn some of the highest-paying salaries in the nursing profession. But that’s just one of the many advantages of being an orthopedic nurse. 

For example, most orthopedic patients are otherwise healthy. That means you’ll witness dramatic recoveries for your patients instead of the slow declines seen in patients within many other nursing fields.

In this article, you’ll learn how to become an orthopedic nurse, what it’s like to be an orthopedic nurse, and what you should expect to earn as an orthopedic nurse. 

By the time you finish this article, you’ll know if being an orthopedic nurse is the right specialty for you.

What is the difference between an orthopedic nurse and a registered nurse (RN)?

All certified orthopedic nurses are RNs. All RNs aren’t orthopedic nurses, though. In the sections below, we’ll discuss how an RN can progress to become an orthopedic nurses.

What qualifications does an orthopedic nurse need?

You’ll need to be an RN to be an ortho nurse. But that is only the first step. To become an orthopedic nurse certified (orthopedic nurses), you’ll need two full years of experience practicing as an RN. 

You’ll also need 1,000 hours of experience working as an RN in an orthopedic department or orthopedic practice within the past three years. orthopedic nurses you have met these requirements, you can take the orthopedic nurses exam. 

Technically, you’re an ortho nurse while gaining the experience necessary for certification. The certification process doesn’t take as much time as you may think. It’s a relatively quick process for such a high-paying position. 

The process is so short because demand is exceptionally high for ortho nurses. Moreover, with an aging population, experts expect demand to remain high over the coming decades.

The “How To Become an Orthopedic Nurse” section will discuss the steps in more detail below. In that section, we will also touch on how to advance to become an orthopedic nurse practitioner (OPN). OPNs enjoy six-figure incomes.

What work does an orthopedic nurse do day to day?

Orthopedic nurses perform a wide variety of tasks related to the musculoskeletal system — including tasks related to injuries or surgeries, such as broken bones or joint replacements. 

Orthopedic nurses also treat patients suffering from chronic musculoskeletal diseases, such as arthritis and osteoporosis. 

As an orthopedic nurse, your job includes the following:

  • Pain management

  • Educating patients about their condition

  • Assisting orthopedic surgeons before, after, and during surgery

  • Conducting physical examinations and monitoring vital signs

  • Caring for orthopedic patients

If you work primarily in a hospital or outpatient surgical facility, you may work in all phases of surgery. For pre-operative care, you’ll perform tasks such as:

  • Taking patients’ vital signs and reviewing their charts

  • Cleaning the surgical area

  • Administering fluids to the patient

If you assist during surgery, you will:

  • Prepare the equipment and supplies

  • Work with the anesthesiology team

  • Assist the surgeon

You’ll work on interesting surgical procedures such as spinal fusions, joint replacements, and rotator cuff repairs.

If you're part of the team taking care of orthopedic patients after surgery, you will probably work on the orthopedic floor. Patients usually stay for one to three days after surgery. Nurses on the ortho floor usually work three 12-hour shifts per week. 

You’ll care for four to six patients managing their pain medications and surgical drains. You will also change dressings on the wounds and assist with castings. 

Working in a hospital setting is extremely fast-moving. You can experience a slower pace in other settings. Much of what you’ll do depends on where you work. Even within the same work setting, you’ll care for a wide variety of patients.

Everyone at some point in their lives has orthopedic issues. Your patient could be a child that broke their foot sliding into second base at a little league game. Or your patient could be a major league pitcher recovering from Tommy John surgery. Next to these folks, you may have one middle-aged patient recovering from spinal fusion surgery. 

Where do orthopedic nurses work?

As an ortho nurse, you may work in any of the following environments:

  • Hospitals

  • Outpatient care facilities

  • Outpatient surgery centers

  • Doctors’ offices

  • Assisted Living Facilities

  • Nursing homes

  • Physical rehabilitation facilities

  • Health departments

Since 60% of RNs work in hospitals, that’s where you are most likely to work. However, doctors’ offices and outpatient facilities behind hospitals are the most common places for an orthopedic nurses to work. While hospitals often want ortho nurses to work 12-hour shifts, more conventional work hours are available with doctors’ offices and outpatient facilities.

What is it like to be an orthopedic nurse?

Your life as an orthopedic nurse depends on your work setting and subspecialty. For example, you may be the type that finds it incredibly rewarding to work with children who quickly recover from orthopedic surgery. If so, being a pediatric orthopedic nurse is the job for you. On the other hand, another person may enjoy working with elderly patients. If so, they’ll be happier being a geriatric orthopedic nurse. 

If you’re working in a hospital, it is very fast-paced, and you’ll barely have time to get to know your patients. But in a doctor’s office, you’ll work at a slower pace and enjoy much more time with your patients.  

How much do orthopedic nurses make?

If you search the internet for the average salaries of orthopedic nurses, you’ll notice that the amounts vary wildly. But, of course, it’s normal for wages to vary based on geographical location, work setting, and experience. 

But these factors don’t explain the extreme variances for orthopedic nurses. Part of the problem is defining what an orthopedic nurse is. Are you talking about an RN with orthopedic skills but not certified? Are you talking about an orthopedic nurse or an ONP? 

How much an orthopedic nurse makes is further compounded by the extreme versatility of the position. Unlike other specialties, orthopedic nurses work with various settings, patient types, and specialties. 

For example, an orthopedic oncology nurse only works with cancer patients, but an orthopedic nurse works with patients from every age group, whether or not they’re otherwise healthy. 

The best place to determine what an ortho nurse makes is the Bureau of Labor Statistics (BLS) data for RNs. The BLS provides the following median pay rates for RNs:

  • $85,970 for RNs working for the government

  • $78,070 for RNs working in hospitals

  • $76,700 for RNs working in outpatient facilities

  • $72,420 for RNs working in residential care facilities such as nursing homes

  • $61,780 for RNs working in educational services

For RNs certified as orthopedic nurses, you can expect the pay to be higher. You could also expect higher pay if you earned a bachelor’s degree instead of an associate's degree. But if you want to make big money, being an orthopedic nurse practitioner (ONP) may be your best bet. Their median salary is $119,600, with the top 10% making over $130,000. Being an orthopedic nurse is a great way to gain the experience necessary to qualify as an ONP.

Advantages and disadvantages of a career as an orthopedic nurse

Just as with any other job, there are advantages and disadvantages to being an ortho nurse. Unlike many other jobs, as an orthopedic nurse, you have much more flexibility to avoid the disadvantages.  

Advantages of choosing a career as an orthopedic nurse

The demand for orthopedic nurses has never been higher with an aging population. Because of high demand, many employers are offering signing bonuses for orthopedic nurses. 

The high demand and array of subspecialties mean you’re more likely to find a job that fits what you want than other nursing specialties. 

Disadvantages of choosing a career as an orthopedic nurse

Of course, there are some disadvantages. For example, with assisted living facilities, sometimes elderly patients become confused by your treatment instructions. 

With surgeries, in rare circumstances, patients unexpectedly die. Unfortunately, this happens even though death is relatively rare for orthopedic surgery patients.

How to become an orthopedic nurse

To qualify for a job as an orthopedic nurse, you’ll usually need to be at least an RN. You can get a job as an orthopedic nurse without certification, but it’s more complicated. To be an orthopedic nurse, you must be an RN. 

To become an RN, you’ll need either an associate’s degree or a bachelor’s degree in nursing. If you’re a full-time student, you can complete some associate degree programs in as little as 18 months. But some jobs require that you have a bachelor’s degree.

After you finish school, you must pass the National Council Licensure Exam for Registered Nurses (NCLEX-RN). Orthopedic nurses you’ve passed the exam, you’re officially an RN. Now, you can move toward your orthopedic nurse certification.

The orthopedic nurse certification requires you to pass the orthopedic nurse exam and work at least 1,000 hours in an orthopedics department within the last three years. You’ll also need two years of experience as an RN. 

If you want to move to the highest level of orthopedic nursing, your next step is to gain your orthopedic nurse practitioner certification. 

You’ll need a master’s degree (or equivalent program) in nursing to qualify to become an orthopedic nurse practitioner (OPN). This degree will take 18-24 months to complete. 

Then, you need three full years of experience as an RN or advanced practice RN (APRN) and 2,000 hours of advanced practiced experience within the past three years. 

On top of this, you need to work as a nurse practitioner (NP) who cares for orthopedic patients when taking the exam. After passing the ONP-C exam, you’re certified as an orthopedic nurse practitioner (ONP-C).

This may sound like a long time, but there are ways to shorten it. For example, your 1,000 hours of experience necessary for the orthopedic nurse's exam can go toward the 2,000 hours of experience required for ONP exam eligibility. 

There are options for the master’s program requirement, such as associate’s degree to nurse practitioner programs, that reduce your time in school. 

Frequently asked questions about orthopedic nurses

How long does it take to become an orthopedic nurse?

If you’re an RN working primarily in an orthopedic setting, you’re already an orthopedic nurse. The time-consuming part of the process is meeting the educational requirements. 

After that, instead of paying to work hard, which is the case with education, you’re being paid to work hard. So, while earning money, you’re gaining the experience necessary to qualify for the orthopedic nurse exam. 

You can complete an associate’s degree within 18 months. Then, when you pass the NCLEX-RN, you can start accumulating the required two years of experience, including 1,000 hours in an orthopedics setting that will make you eligible to become an orthopedic nurse. 

That means the shortest time route to become an orthopedic nurse is 42 months. That’s less time than it takes to gain a bachelor’s degree in nursing.

Doctors must complete their bachelor’s degree plus four years of medical school. After this grueling eight years, doctors spend another three to seven years in a medical residency program making $50,000 to $70,000 per year. 

As an orthopedic nurse, you can make that much within four years. You’ll make six figures within seven years if you take an accelerated route to become an ONP-C. 

That’s not bad. While physicians who started their education at the same time as you are still in medical school, you will already reach a salary of $70,000 to $120,000 per year. 

As you can see, the time necessary to become an orthopedic nurse is time well spent.

Read more: How long does it take to become a nurse?