In Shropshire, a county in the West Midlands region of England, a young girl was born who eventually became disabled at age 9, secondary to septic arthritis of the hip. Despite this unkind turn-of-fate, she enrolled in training as a nurse, and eventually opened a convalescent home for crippled children. This remarkable heroine was Agnes Hunt (1866-1948). Hunt collaborated with Robert Jones, a celebrated orthopedic surgeon; together they developed innovative treatments and care for bone and joint disorders.
Widely considered the first orthopedic nurse, Hunt was later given the title of Dame Commander of the Order of the British Empire in 1926 for her seminal contributions. Her entire nursing career was dedicated to improving the lives of crippled children and those injured by war. What began as a humble convalescent home is today the renowned Robert Jones and Agnes Hunt Orthopedic Hospital, a specialist hospital providing elective orthopedic surgery and musculoskeletal medical services. More information: http://www.rjah.nhs.uk/.
If you are a registered nurse (RN) interested in specializing, consider following Dame Hunt into a career as an orthopedic nurse. According to the National Association of Orthopedic Nurses (NAON), the role of the orthopedic nurse is “to advance musculoskeletal healthcare by promoting excellence in orthopedic research, education and nursing practice.” Musculoskeletal disease is a major health problem impacting all age groups. Per the NAON website, “Conditions such as congenital diseases of infants, trauma resulting from vehicular accidents and degenerative diseases of the aged, strike 23 million Americans.” Orthopedic nurses play a vital role in providing professional, competent care to these patients.
This nursing specialty is found across practice settings: acute care, ICUs, outpatient rehab, emergency rooms, trauma units and home care. Orthopedic patients are seen across the lifespan; and issues range from acute(fractures; joint replacements) tochronic(loss of bone density; lupus erythematosus).
Preparation of an Orthopedic Nurse
Orthopedic RNs usually need added competencies, such as traction, continuous passive motion, casting, neurovascular status monitoring and care of patients with external fixation. To stay current in this specialty, the NAON offers a peer-reviewed journal; articles from recent editions include:
- The Silent Thief: Diagnosis and Management of Osteoporosis
- Sacroiliac Joint Dysfunction: A Case Study
- Common Pediatric Elbow Fractures
- Rotator Cuff Tears: An Overview
- Better Pain Management After Total Joint Replacement Surgery
Orthopedic Nurse Certification
In nursing, certification indicates a commitment to lifelong learning and a high level of knowledge that contributes to positive patient outcomes. The eligible examinee is any U.S. licensed registered nurse who has practicing for at least 2 years, and who has a minimum of 1,000 practice hours as a RN in orthopedic practice within the past 3 years. The certification is valid for 5 years. At the end of that time period, the RN must have completed at least 100 hours of continuing education credits (at least 70 of those hours in orthopedic nursing) to re-certify. In addition, at least 1,000 hours of employment in which the RN provides patient care to orthopedic patients is necessary for recertification.
Certification is important hospitals for seeking Magnet™ designation, and a certified nurse might be more attractive to a potential employer. Content of the exam covers the following, per the Orthopedic Nurses Certification Board (http://oncb.org/):
- Degenerative disease 30%
- Orthopedic trauma 21%
- Sports injuries 15%
- Neuromuscular/pediatrics/congenital 8%
- Inflammatory disorders 8%
- Operative orthopedics 8%
- Metabolic bone disease 7%
- Orthopedic oncology 3%
While earning a BSN degree is not required to be certified as an orthopedic nurse, a bachelor’s degree improves job opportunities and options, such as being an orthopedic nurse.