School Nurse Reflections on Visibility, Safety, and Relevance in Modern School Nurse Practice: A Qualitative Study

BackgroundSchool nurses globally face increasing professional pressures due to the growing complexity of children's and adolescents' health needs. This makes effective working within the school health team critical.AimTo explore school nurses' reflections on working within the school health team.MethodsThirty-three school nurses from four school health teams in England participated in restorative reflective supervision sessions. Observational data and field notes from four separate sessions were analyzed using qualitative content analysis.ResultsThree themes were identified: (a) collaboration and engagement with schools and multidisciplinary teams; (b) external perceptions of the school nurse role, professional identity, and boundaries; and (c) workload, emotional demands, and support needs.ConclusionSchool nurses are facing sustained pressure, with growing caseload complexity, emotional strain, and limited recognition of their role. Restorative reflective sessions can act as a protective factor against burnout by giving school nurses the opportunity to share experiences, process emotional strain, and sustain their capacity for compassionate care. The findings underscore the need for systemic investment in school nursing, through clearer role definition, professional visibility, emotional support, and opportunities for career development.