Oruche started her acting career in the US after an education in the Actors Studio in Los Angeles. She is best known for her role as Liberty Baker in Footballers' Wives, for which she won a Screen Nations award. She has appeared in American and British television shows including The Bill, Nip/Tuck, Charmed, Buffy the Vampire Slayer, Diagnosis Murder, NYPD Blue and The Unit. Her film credits include The Forsaken (2001) and Happy Ever Afters (2009).

Oruche ran the 2007 and 2006 London Marathons, raising £35,000 for the Anthony Nolan Trust.

In Dublin, Oruche presented a show three days a week on Ireland AM for TV3 and in London as a continued regular panellist on the morning discussion programme The Wright Stuff she was "Babe in the Booth" for the week starting 29 April 2008, when she was 36 weeks pregnant.

On 29 March 2010, it was revealed she had been cast to play the mother of a new family in teen soap Hollyoaks.

A published Writer, Oruche had a weekly column in the Liverpool Echo. Her autobiography Liberating Character was published in April 2012.

Her one-woman Identity Crisis, based on her own life story, received its debut at the Edinburgh Festival Fringe in 2016, subsequently playing in 2017 at the International Slavery Museum in Liverpool, before its first London run at the Kennington Ovalhouse.