How do school nurses spend their time? A quantitative time study within Norwegian school health services

School nurses perform a unique role by providing health care to all children and adolescents. In Norway, their activities are regulated by the National Professional Guidelines for Health Promotion and Prevention Work in Health Centers, School Health Services and Youth Health Clinics. However, a large part of their workday involves independently planning and prioritizing activities. Understanding how they allocate this time is limited. Filling this knowledge gap is important, both for central authorities in their planning and staffing of the service, and for the continuous development of school health services. This study aims to describe how school nurses spend their time within the Norwegian school health services.

Over a period of 10 days, 104 school nurses documented all activities spent in school health services for a cross-sectional time study. An activity list was developed that encompassed 25 activities, 10 of which were directly devoted to interactions with children, adolescents, and/or their guardians. Time was measured at 10-minute intervals and analysed via descriptive statistics.

Administrative work constituted the largest proportion of the registered time (22.1%), followed by individual consultations (15.9%) and meetings (10.9%). Minimal time was allocated to group activities for pupils and guardians, comprising 2.8%. The time dedicated to direct interaction with children, adolescents, and/or guardians accounted for 36% of the time, whereas the remaining 64% was spent on activities not involving direct interaction.

This study provides insights into how school nurses spend their time within Norwegian school health services and indicates a large variation in the time spent on different tasks. Future research should investigate the reasons behind these variations and analyze the content and interventions used in various activities. Although the study is conducted in a Norwegian context, the methods for describing time usage are applicable to other health sectors and countries.