School Nurse Well-Being as a Workplace-Embedded Outcome: A Collective Qualitative Case Study.

Abstract

Work-related stress has been examined in traditional healthcare settings, yet the well-being of school nurses remains underexplored. This collective qualitative case study examined workplace factors and school nurses' psychological well-being. Data collection was guided by the Neuman Systems Model using sociodemographic questionnaires, semi-structured interviews, and journaling to explore intra-, inter-, and extra-personal workplace factors. This manuscript reports findings from questionnaire, interview, and journal data. Results showed that well-being was achieved through organizational and relational conditions rather than individual coping alone. Team membership, professional recognition, role clarity, and schedule flexibility promoted psychological security through inclusion in decision-making, respect for clinical expertise, and clear reporting structures. Exclusion, role ambiguity, and limited authority undermined well-being. Relationships with students provided meaning that sustained school nurses' commitment to the profession despite rising medical acuity and workload. These findings highlight the need for structural workplace interventions to support school nurse well-being and ensure safe student care.