# Development of the Pediatric Nursing Specialty in Spain: A Critical Analysis of Its History, Current Situation, and Regional Disparities: A Narrative Review

## TL;DR

Pediatric nursing in Spain has developed unevenly across regions, leading to disparities in training and employment that affect care quality.

## Contribution

This paper provides a critical analysis of the historical and current state of pediatric nursing specialization in Spain, highlighting regional disparities and proposing solutions.

## Key findings

- From 2010 to 2024, 2312 pediatric nursing intern places were offered, but their distribution was unequal across regions.
- Only five regions have a specific employment exchange for pediatric nursing, while others like Catalonia and the Basque Country have not implemented the specialty.
- Reconversions of vacancies and lack of national recognition contribute to disparities in pediatric nursing employment.

## Abstract

Background: The development of the pediatric nursing specialty in Spain is uneven, with marked differences between Autonomous Communities in training and employment. This study analyzes its evolution, current situation, and existing disparities. Material and Methods: A narrative documentary review was carried out including quantitative and qualitative data obtained from academic databases, legislative sources, and professional associations. Results: In 1964, 2554 nurses obtained the title of specialist in pediatrics and childcare, validated in 2005 as pediatric nursing. From 2010 to 2024, 2312 places for pediatric nursing interns were offered, with an unequal distribution between communities. By the exceptional route, in 2015, 9875 nurses obtained the specialty, adding up to an estimated total of 13,978 specialists. The first public employment offer was announced in 2019 in Galicia, followed by Castilla y León, Madrid, and Murcia in 2023. A total of 245 vacancies were advertised, with reconversions of vacancies in some regions. Communities such as Galicia, Madrid, and Murcia have created the category, while others, such as Catalonia and the Basque Country, have not implemented it. Finally, only five regions have a specific employment exchange that is currently operating. Conclusions: Specialization in pediatric nursing presents inequalities in training and employment that influence the quality of care. To improve this situation, it is necessary to increase training places, create specific employment exchanges, and unify the recognition of the specialty at the national level to ensure equitable and quality specialized pediatric care throughout the country.