The average school nurse has to look after more than 2,500 schoolchildren, the equivalent of seven schools. A quarter looked after more than 10 schools, with one nurse responsible for 26.
Nearly three-quarters of school nurses now spend a significant amount of time dealing with child protection issues, compared with around a half questioned for the last report in 2005.
The RCN believes that government targets to increase the number of school nurses are unlikely to be met by the deadline next year.
Janet Davies, the RCN's executive director of nursing and service delivery, said: ‘The fact that there is a shortage of nurses to meet the rising demand is simply unacceptable. Overburdened school nurses are looking after too many pupils and it is children who are being disadvantaged.
‘The prime minister reaffirmed his commitment to provide a school nurse for each secondary school and cluster of primary schools when he spoke to the nurses at the RCN Congress in May. Delivering this pledge would mean making as much progress in the next year as we have seen in the last four.'
The total sample of school nurses was 1,601, with valid responses received from 1,145.