What it’s Really Like on an Ortho Unit

by | Mar 9, 2021 | Ortho Nursing | 0 comments

Ortho nurses are registered nurses (RNs) who work with patients suffering from a variety of musculoskeletal issues (joint/knee problems, bone issues, arthritis, osteoporosis, etc.). The job environment will have you working closely with orthopedic doctors and surgeons in a hospital. Occasionally, you may be working at rehab centers and outpatient clinics. Patients in an ortho unit are generally healthy, minus their musculoskeletal injury, say, for example, hip fracture patients. In that way, care is fairly straightforward. Today, we will be going over the day-to-day of an RN working in an ortho unit.

What it's Really Like on an Ortho Unit

High Throughput

An ortho unit can get busy, with people coming in and out on a daily basis. If you think about it, and ortho unit has to coordinate across multiple places for different levels of care: rehab centers, outpatient clinics, back home, and PACU’s (post-anesthesia care units). PACU’s are where orthopedic patients first enter for recovery after their operation. You may find the pacing very fast and it feels like a revolving door of patients, physical therapists, doctors, and surgeons. Your job is to be the mediator and facilitator for your patients between stages of care. 

Detailed Care

Working in an ortho unit requires keeping track and following your doctor’s or surgeon’s steps of post-op care. This step involves managing devices and drains in a specific way according to care instructions. We also don’t want to sugar coat it, but this step may also be the least pleasant part of the job. You will likely see a lot of wounds in the ortho unit too.

Again, as the mediator in all this, your job is to follow these recovery steps to the best of your ability. You are also looking for signs and anticipating any issues that might arise as your patients recover. In this part of care, you are also in charge of teaching and helping patients understand how to make use of aftercare devices and how to best position themselves during their care. This may be difficult for some new RNs to get used to coupled with the high throughput of patients, physical therapists, doctors, and surgeons.

Aftercare: Pain Management & Therapy Aftercare

We included these both in the same vein because they both fall under the umbrella of aftercare. As part of working in an ortho unit, your job is keeping track and managing a patient’s care from start to finish.

Giving pain medication and antibiotics is going to be a very common occurrence. You’re going to be tracking how often your patient is taking their medication, their dosage, and how it’s affecting them. You may have to adjust medication accordingly. 

Concurrent with that may be coordinating with a physical therapist. The roles work together to help patients achieve their recovery goals, manage pain, their physical therapy schedule, how it’s affecting them, and getting them the equipment they need. Not as important, but also likely is you are going to be communicating with a patient’s family or kin on what you do and how they can best care for their loved one after being discharged. You are teaching them how to help them move around after, how soon, and setting up expectations on how to best help their loved one during recovery.

As an RN working in an ortho unit, you are going to be facing a lot of patients in pain. And while all nurses have to get acclimated to helping others deal with their pain, your role in the ortho unit requires a very delicate balance of communication and judicious decision-making to best ensure a patient’s long-term health.

Ortho Unit Conclusion

We’ve included the Orthopedic Nurse Crash Course for those of you interested in learning more. It goes over what requirements are needed to work in the ortho unit, like your orthopedic nurse certification, schooling, etc. 

The ortho unit is kind of like a dance with multiple people. The more you work with the same doctors, the more you learn their preferences for care and how they like to operate devices and drains. The reward for working in an ortho unit is being able to build a high level of trust with your surgeons and doctors. It can be very satisfying to be called on by your doctor or surgeon specifically to provide quality care for patients with tricky or difficult care plans. Another reward of this job is seeing your impact as a nurse directly on your patient’s quality of life. All the fruits of your labor coordinating their recovery really show over time.

Ortho STRONG: Crash Course For New Ortho Nurses

If you want to learn more about this job so you are more convincing in the interview, check out this ultimate resource for new ortho nurses.

Ortho STRONG is written by a phenomenal nurse practitioner who works with some of the best ortho surgeons in the country. She put everything that she learned into this course. It is highly valuable.

Ready to Master Ortho Nursng?


Ortho STRONG from FreshRN® is your one-stop ultimate resource and online course, crafted specifically for brand new Ortho nurses. If you want to get ahead of the game so instead of merely surviving orientation, you’re thriving all the way through from day one to day done - this is the course for you.

Start Lesson #1 Now

More Resources for Othro Units

Picture of Kati Kleber, founder of FRESHRN

Hi, I’m Kati.

Kati Kleber, MSN RN is a nurse educator, author, national speaker, host of the FreshRN® Podcast, and owner of FreshRN® – an online platform created to educate, encourage, and motivate newly licensed nurses in innovative ways.

Connect with her on YouTube, Pinterest, TikTok, Instagram, and Facebook, and sign-up for her free email newsletter for new nurses.


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