There is a health profession that goes far beyond the application of protocols or the healing of patients. It represents constant care, active listening or comfort. They know our fears and understand our silences. And they don’t ask what you have, but how you are. They are nurses, historically excluded professionals from strategic forums and decision structures, but essential in attendance, research, management, teaching or promotion and prevention. There is no doubt that contribute to sustaining the health system with vocation, knowledge and delivery that transcends labor; However, they currently do so in a structural deficit framework, precariousness, lack of emotional recognition and overload, without visions to improve. Many work with temporary contracts, impossible ratios and conditions that push them, more and more, to migrate or abandon the profession.
At present, according to the Document of the General Nursing Council (CGE) entitled «Radiography of the Nurse profession. Human Resources Report 2023 », to reach European ratios (Media de Eurostat, OECD and WHO) It would be necessary to increase the number of professionals in 122,993 nurses. This would mean 40% more than we have at this time. That is, while in Europe there are 8.8 nurses per 1,000 inhabitants, our state barely reaches 6.3. “In our country there are 345,000 nurses, but only more than 306,000 appear as non -retired, so those are likely to serve the population,” they explain from the CGE. And they add: “Countries like Norway, Austria or Iceland triple the number of nurses we have in Spain.” In addition, there is one worrying disparity between the different autonomous communities and provinceswhich causes inequalities in the health system.
The report warns that, to the current rhythm, it would take between 22 and 30 years to reach the necessary level of professionals to guarantee care with full guarantees. It is a structural lack that especially impacts areas such as primary care and home care, where the templates are especially limited.
To this panorama is added another disturbing factor: The aging of the profession. According to OECD data, 18.6% of Spanish nurses are over 55 years old and it is expected that more than 64,000 will retire in the next decade. In Andalusia alone, for example, it is estimated that more than 10,000 nurses will withdraw from professional practice in the next ten years. A recent study by the Ministry of Health ratifies the forecast. In this case, it indicates that in the next 10 years they will end their working life 49,791 nurses, 16.9% of the total active professionals.
This retirement wave implies considerable loss of experienced personnelwhich puts in check the sustainability of the health system if the training and hiring of new professionals is urgently increased. These retirement are joined by the teaching and researcher personnel. According to the data, 42% of the teaching and researcher staff of the nursing faculties are over 50 years old.
According to the CGE, reverse this situation requires “investing in nurses, in training, in creating new places in universities, in retaining talent so that it does not go out of our borders, in recovering those who have left out… among other issues. They are solutions that are not in the short term, but you have to start planning them.
Labor precariousness
Actually, nursing is considered to be full employment. According to SEPE data, the state employment service, in 2023 there were 3,349 unemployment nurses, which represents an unemployment rate of 1.09%. Despite this and the high level of responsibility they assume, Many nurses continue to chain contracts of days or even hours, without the possibility of stability or professional development. To this is added that employment is seasonal, unemployment figures are especially reduced in the summer months and in some winter peaks, increasing precariousness.
This temporality is especially pressing among young nurses, who after years of training face chronic instability. In addition, working conditions hinder conciliation, promote chronic stress and directly affect the physical and mental health of professionals. According to a macro -concentration of the Ministry of Health in collaboration with the CGE, 95% of nurses believe that their workload is excessive. 60% have considered abandoning the profession and 23% have needed a work decline for psychological reasons.
For some nurses, the solution goes to work to another country. Only in 2024, more than 1,100 nurses requested the necessary documentation to exercise outside our borders. The main destinations: Norway (336), United States (226), United Kingdom (92), Ireland (60), Netherlands (43), Australia (41), France (40), Switzerland (39), Canada (22), Belgium (13), Saudi Arabia (11) and Portugal (11). Norway, for example, is the main destination right now of Spanish nurses, who can see how their salary is multiplied by four.
«Spanish nurses are highly requested in the most developed countries in the world. But we invest in training highly qualified professionals who end up going to other countries in search of better conditions, so that all the investment in training that has been carried out is lost, ”lament the CGE spokesmen.
Nurse prescription: an incomplete advance
The reform of the Law of the Medication approved by the Government in April 2025 was an important milestone: the prescriptive capacity of nurses in equality with doctors, dentists and podiatrists is legally recognized. However, its real application is still pending. Royal Decree 954/2015, which regulates this capacity, has barely generated ten guides in a decade, leaving many professionals without legal support in daily practices such as the administration of certain drugs. The CGE demands that this reform be completed with the update of the guides and the regulatory development that guarantees legal certainty and care efficiency.
Other pending accounts: specialties and professional group
Spain has seven specialties in nursing, but only one – the midwife – is fully implanted in all autonomous communities. The rest have an unequal application, lack of labor recognition and absence of specific calls in many regions. Thus, nurses who have completed two additional training ends up working as generalists, without recognizing their qualification, and patients lose access to more specific and updated care.
Another of the great challenges is the institutional recognition of nursing within the health system. Today, nurses are still classified in Group A2 of the statutory personnel, despite having a university training of degree and, in many cases, with masters or doctorates. The CGE has claimed its inclusion in a unified A1 group, and even in an A1+ group for those with training Postgraduate. This classification affects not only the salary, but also the possibility of promotion, access to management and representation positions in strategic spaces.
Another pending account has to do with its presence in the spaces where health policies are designed. Only three regional health counselors are nurses. In Congress there are three representatives and in the Senate, only one. From the CGE and the National Association of Nursing Directors (ANDE) a commitment determined by nurse leadership, both in hospital management and political levels, is claimed.
Another of the most urgent deficiencies is that of nurses in the educational environment. In Spain there is a school nurse For every 6,368 studentsa figure that prevents effective strategies for prevention, education for health and care for children with chronic diseases or special needs. In the same way, primary care continues to be the great forgotten of the system. The expense for this care level barely reaches 14% of the health budget (when WHO recommends 25%), and nursing templates are far from what is necessary to serve an increasingly aging population with quality and with greater chronicity.
In research, the panorama is no more hopeful. Nurses who want to devote themselves to research meet multiple barriers: Lack of financing, scarce recognition, absence of protected time and a poorly defined research career. Many of them are in the position of having to sacrifice personal or even work time to advance their scientific projects. And this, taking into account that their contributions are key to improving the care and efficiency of the system.