Availability, perceived need and satisfaction for school nurses in Spain: a cross-sectional study involving the school community

Background: School nursing in Spain faces crucial challenges that require immediate attention. This is the first national study developed by the School Nursing Observatory Research Group of the General Council of Nursing (GCN) in Spain on the school nurse (SN) professional profile and their availability at schools. The objective is to understand the social-labor situation, as well as the availability, perceived need, and satisfaction of the school community with the SN, as well as the factors related to these variables. Methods: Cross-sectional study using three ad hoc designed and validated questionnaires through a digital platform. Participants included 376 SNs, 1193 teachers and school principals, and 582 mothers, fathers, and representatives of parents’ associations (PAs). Descriptive and bivariate statistical analyses were conducted using SPSS v.28. Results: Most SNs work in a single school in exclusive, mainly employed by the education department or privately funded special education schools, in urban areas and schools with a high number of students. Both school staff and PAs perceive a high need of and satisfaction with SNs. According to school staff, SNs are more in private and subsidized schools and, according to PAs, in schools where a child has a disease. In schools where there are children with certain diseases, according to PAs, a greater need for a SN was perceived. And the schools staff also found SNs especially necessary in schools located in disadvantage areas. Conclusions: Despite the high level of satisfaction with the role of the school nurse, structural deficiencies remain in its implementation and territorial distribution within the Spanish educational system. These limitations hinder compliance with international quality standards, such as the nurse-to-student ratios recommended by the WHO and other European countries. It is essential to increase the allocation of school nursing professionals, particularly those working on an exclusive, full-time basis, with priority given to rural settings, publicly funded schools, and socioeconomically disadvantaged areas. Strengthening this resource would help reduce health inequities among children and adolescents, address the needs identified by the educational community, and contribute to the achievement of the Sustainable Development Goals (SDGs), particularly those related to health, equity, and quality education.