Orthopedic Nurse Job Description: What Do They Do?

After graduating from nursing school, nurses can choose to work in a variety of different specialties. Orthopedic nurses care for patients recovering from orthopedic injuries or surgery and can work in the operating room (OR) or in an orthopedic unit. But what is the Orthopedic Nurse job description?

Orthopedic Nurse Job Description: Orthopedic Operating Room Nurses

When patients break bones or injure ligaments, orthopedic surgery may be required to assist with healing. Orthopedic nurses care for patients undergoing orthopedic surgeries, which include total joint replacements, repairing sports injuries, and fixing fractures.

Surgical nurses work a variety of shifts throughout the day, which typically last 8-12 hours. For the duration of the shift, the nurse is assigned to an OR and cares for the patients scheduled there. The surgical nurse to patient ratio is always 1:1. 

Responsibilities Before Surgery

Prior to the patient arriving in the OR, the nurse must complete several important tasks to ensure patient safety. First, the patient is interviewed by the OR nurse to verify identity, confirm surgical consent, and witness site marking on the correct surgical site. Next, negative COVID-19 status and pregnancy tests are verified. The patient’s clothes and jewelry are removed, and a gown is put on in preparation for the OR. 

At this point, the nurse collaborates with anesthesia providers and the surgical team to ensure that it is safe for the patient to proceed with surgery. The anesthesia provider may recommend a nerve block for reduced pain during and after surgery. 

Intraoperative Implementation

In the OR, nurses plan and prepare for surgery following a surgeon’s preference card. The preference card lists surgeon-specific preferences and detailed information around the  equipment, instruments, and supplies needed for the procedure. 

OR nurses work with a scrub nurse or scrub technologist to prepare the sterile field. They work together to open all of the necessary instruments and special disposable items for the scrub to arrange on the sterile field. 

Each surgery can require different beds, positioning equipment, and implants specific to the surgical procedure. 

During the course of the surgery, the nurse will perform surgical counts with the scrub to prevent any retained foreign items from being left unintentionally inside the patient. Fire safety will be a priority for the scrub and the nurse to prevent the patient or surgical drapes from catching fire while using any of the equipment.

At the end of the procedure, the OR nurse will apply dressings to the wound and assist with safe emergence from anesthesia. The anesthesia team and the OR nurse will then transport the patient to the recovery area.

Orthopedic Nurse Job Description: Orthopedic Floor Nurses

After patients have an orthopedic surgery and are admitted to the hospital, they are typically sent to an orthopedic unit to be cared for by orthopedic floor nurses. This unit can include a combination of orthopedic patients and other postoperative or trauma patients.

Generally, these nurses work three 12-hour shifts each week either 7 a.m. to 7 p.m. or overnight from 7 p.m. to 7 a.m. The patient load for each nurse is 4:1 or 5:1, with some facilities requiring a 6:1 ratio.

Post Operative Care of the Patient

Caring for orthopedic patients requires working with physical therapy (PT) and occupational therapy (OT) to help them return to daily activities such as walking and increasing mobility. Many patients are ordered to ambulate the same day of surgery to prevent potential medical complications from laying in the bed.

It’s critical for patients to receive ordered pain medications to allow the patient to effectively participate in PT/OT, which increases the chance of a promising recovery. 

Patients with multiple serious injuries, also known as a “poly-trauma,” require increased nursing management. These patients can require antibiotics around the clock, blood products for hemodynamic stability, or management of external fixation or traction, in addition to pain management and dressing changes.

Once the patient is hospitalized, the nurse will observe the wound during dressing changes for signs of infection, wound dehiscence, or increased bleeding that would require a consult from the surgical team. The patient may have had a surgical drain placed that needs emptying and monitoring for excessive bleeding. 

Before the patient is discharged from the hospital, the nurse will provide thorough education and discharge teaching. This will include how to manage the dressings, developments that would require a consultation with the doctor’s office, follow-up appointment details, and guidance for successfully recovering at home.

In Conclusion

Orthopedic nurses have specialized knowledge to effectively care for patients recovering from orthopedic injuries and surgery. These nurses are highly trained professionals with a passion for helping orthopedic patients return to their daily routine.

About the Author

Blyss Splane BSN RN CNOR is a certified operating room nurse with years of experience scrubbing and circulating. She was an orthopedic surgical specialty coordinator for the OR at a level 1 trauma hospital. Now she travels as an OR nurse in the southeast. She is the owner of Nurse Splane Writes, creating content for healthcare websites and blogs. Blyss is an avid reader and spends her time pursuing a healthy lifestyle. She can be found at NurseSplaneWrites.com or email her at [email protected].