Workload, Professional Quality of Life, and Barriers to Comprehensive School Nursing Practice in Oman: An Explanatory Sequential Mixed‐Methods Study

Background School nurses play a critical role in promoting student health, particularly for students with chronic conditions. Understanding their professional quality of life (ProQOL) and identifying challenges and opportunities for support are essential for improving school health services. This study assesses ProQOL level and examines whether a workload threshold, defined by the number of schools covered, influenced ProQOL outcomes. Methods An explanatory sequential mixed‐methods design was employed. Phase 1 used a cross‐sectional survey of 249 school nurses to assess ProQOL and workload indicators. Workload was operationalized as the number of schools covered (1‐2 schools vs. ≥ 3 schools). Phase 2 involved semistructured interviews with 10 school nurses to explore perceived barriers, facilitators, and professional development needs. Quantitative data were analyzed using descriptive statistics and one‐way ANOVA with post hoc tests. Qualitative data were analyzed thematically. Results Overall, ProQOL among school nurses was moderate. A critical workload threshold was identified. Significant differences were found in Compassion Satisfaction ( F (2, 246) = 4.68, p = 0.010), Burnout ( F (2, 246) = 7.14, p = 0.001), and Secondary Traumatic Stress ( F (2, 246) = 5.26, p = 0.006) across the number of schools covered. Nurses covering three or more schools reported significantly lower Compassion Satisfaction and significantly higher Burnout and Secondary Traumatic Stress compared with those covering one or two schools. Qualitative findings highlighted challenges including unclear role definition, high workload, and difficulties managing students with chronic conditions. Participants recommended strategies to enhance communication with parents and schools, emergency management, mental health support, and targeted professional development. Conclusion School nurses in Oman experience moderate ProQOL, with evidence of a workload threshold effect associated with covering three or more schools. Clear role definition, workload management, and targeted professional development are critical to supporting school nurses. Findings can inform school health policy and practice in Oman and similar contexts.