Meet an Orthopedic Nurse Practitioner
Most people experience some type of orthopedic injury in their lifetime. Work-related accidents, sports injuries, slip and fall accidents, or car accidents can all result in orthopedic injury. Did you know that there are more than 3.5 million orthopedic sports injuries in children and teens alone each year? And that's just one segment of the population that orthopedic nurse practitioners work with each day.
According to the American Academy of Orthopaedic Surgeons:
- The average age of an orthopedic surgeon in the U.S. is 56.5 years, roughly 10 years from retirement.
- The workforce is 90% male.
- The practice has been consistently growing since 2006.
- Only 12% are in solo private practice.
This means that as practices are growing and surgeons are aging, there is an expanding and unique role for orthopedic nurse practitioners to fill. On this page, we share the experience of one orthopedic nurse practitioner before delving into how to become an orthopedic NP, what they do, and how much they make.
Q&A With Orthopedic Nurse Practitioner
Nancy Brook, FNP
Nancy Brook is a certified nurse practitioner with more than 20 years of experience working with patients and families in various clinical areas. She is a graduate of Vanderbilt University School of Nursing and the University of San Francisco where she received masters' degrees in both nursing and counseling psychology. She is certified as a family nurse practitioner and is an adjunct faculty member at several colleges of nursing. Brook has been an advanced practice provider and career mentor at Stanford Orthopedic Surgery since 2005, and she currently supports the orthopedic oncology team.
Why did you choose a career in nursing?
I grew up in a family of physicians and was always interested in health and wellness. I knew I wanted a career where I could help others and impact their lives in a meaningful way. When I became sick and was treated by a nurse practitioner, I knew I had found a career that would suit me well.
What led you to pursue orthopedic nursing, specifically?
I had the opportunity to do some part-time work for a local sports medicine group and really fell in love with the specialty. I enjoyed working with high school and college athletes and learning more about the rehabilitation process.
I also enjoyed gaining more understanding of the procedures and was fascinated by the surgical aspect. I got to see how the expertise of our surgeon could impact the lifestyle of our patients, young or old.
I believe it is life-changing work, often with healthy patients. I also spent several years working with an orthopedic oncologist, caring for patients with musculoskeletal tumors and participating in their complex care.
How has your dual degree in counseling psychology interacted with your role as a nurse?
So much of our work is meeting the patients where they are emotionally, helping them to feel seen and heard, and helping to decrease their anxiety. Having the dual skill set has been a real bonus for me, and I believe this has allowed me to provide more holistic care.
As a career mentor, what is the main advice you offer to your mentees?
First, I listen. Regardless of the field of nursing, there are inherent stresses that come with taking care of patients with illness or injury. I encourage them to communicate well with their teams, express their needs, and to continue learning.
Nursing is a career where ongoing learning is critical; things change quickly. I also support them in their own self-care. It is important for all healthcare workers. Finally, I support them advancing in their careers and/or education if that is a goal or desire.
What are some of the biggest challenges of your work as an orthopedic nurse?
All surgical specialties mean that sometimes your days don't go as expected, so there is a lot of multitasking and maintaining flexibility at all times, [such as] collaborating with many other providers and managing time well to make sure that everyone is taken care of efficiently.
And the greatest rewards?
The relationships we have with our patients. We may have a patient whom we meet in a wheelchair, who is really limited in their mobility, and when they walk into our clinic unassisted, that is really the best feeling in the world — to know that I was a small part of their healing journey.
What advice would you give to those considering a career as an orthopedic nurse?
Talk to other nurses in the field. Shadow an orthopedic or sports medicine nurse, nurse practitioner, or physician assistant. Ask questions and don't be afraid to make the change.
What Does an Orthopedic NP Do?
Orthopedic nurse practitioners' patient populations have many musculoskeletal challenges, including:
- Orthopedic injuries
- Arthritic conditions
- Joint dislocations
They must be knowledgeable about ordering the correct imaging study and adept at reading them. Orthopedic NPs place splints and casts, prescribe medication, perform joint injections, and monitor patients after surgery and through rehabilitation.
These tasks may require collaboration with orthopedic surgeons, physical therapists, occupational therapists, physiatrists, nutritionists, and orthopedic nurses. Orthopedic NPs work closely with patients who may have experienced a life-changing injury or with patients dealing with a lifelong chronic illness.
"So much of our work is meeting the patients where they are emotionally, helping them to feel seen and heard, and helping to decrease their anxiety." - Nancy Brook, Orthopedic NP
These healthcare professionals must offer patients a compassionate, empathetic ear while providing care and comfort. Having bedside nursing experience in orthopedics is a plus and can help smooth the transition into the orthopedic NP role.
These are the key skills and responsibilities an orthopedic nurse practitioner can benefit from.
- Surgical experience
- Examination, diagnosis, treatment, and rehabilitation
- Continuing education for nurses
- Assessment and intervention in urgent situations
- Wound care
- Pain management
- Outpatient care
- Independent work and working collaboratively with physicians
- Support to patients and families
- Cultural competence in nursing
How to Become an Orthopedic Nurse Practitioner
Orthopedic NPs start their career as registered nurses (RNs). After completing a nursing program from an accredited school, nursing candidates must pass the National Council Licensure Examination. All states use this test to get an RN license.
While most orthopedic NP candidates start with a bachelor of science in nursing (BSN) degree, there are bridge programs for nurses with an associate degree in nursing (ADN) to move directly to a master of science in nursing (MSN). These are called RN-to-MSN programs.
Nurses with a BSN may also choose to move directly to a doctor of nursing practice (DNP) degree. A DNP is a terminal degree in nursing. While a DNP is not mandatory to practice as an orthopedic NP, it may be advantageous if you want to teach in a nursing program.
On average, it takes four years to complete a BSN program when the nursing candidate attends full time. Some nurses may choose to complete an ADN program in 2-3 years and then finish their BSN while working.
After completing an MSN or a DNP program in adult, geriatric, or pediatric care, a nurse practitioner must be recognized and licensed in the state to practice. This means they are certified as a family nurse practitioner, adult-gerontology nurse practitioner, or pediatric nurse practitioner.
To become certified by the Orthopaedic Nurses Certification Board, a nurse must have the following:
Three years or more experience as an RN or advanced practice nurse
Current, full, and unencumbered RN license
Master's degree or higher with preparation to practice as an NP
Minimum of 2,000 hours working as an advanced practice nurse in the past three years
Role treating patients with musculoskeletal conditions
Completed an orthopedic fellowship or a residency program
How Much Do Orthopedic Nurse Practitioners Make?
The average annual salary for an orthopedic nurse practitioner is $100,040, according to Payscale in April 2022. This is only the base salary and doesn't include bonuses and benefits.
Depending on where you work and what they offer, your benefits package may include:
- Annual bonus
- Health insurance
- Disability insurance
- Paid time off
- Tuition reimbursement
- Life insurance
- Malpractice insurance
- Licensure reimbursement
- Signing bonus
- Professional organization membership
As you'll note, your benefits package should be considered with your salary since it can include a significant portion of the money. It is also important to include these benefits when negotiating with your future employer as a nurse.
Orthopedic nurse practitioners can work nearly anywhere that patients are treated for injuries. This may include:
- Emergency rooms
- Orthopedic departments
- Orthopedic physicians' offices
- Specialty outpatient clinics
- Urgent care facilities
After several years of experience, an orthopedic NP may find work with a medical device company, insurance company, and the federal government. Nurses interested in rehabilitation may work with a doctor in physical medicine and rehabilitation or may work in an oncology department with patients with bone or muscle cancer.
According to the American Academy of Orthopaedic Surgeons, there was a greater density of orthopedic surgeons in Wyoming and Montana from 2008 to 2016 than in any other state. During the same period, Alabama had the lowest density, followed by Mississippi.
Several factors help determine an orthopedic NP salary. These include:
- Geographical location
- Nurse practitioner experience
- Educational qualifications and certifications
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