School nursing was introduced a century ago as part of a range of public health measures. However, the roles and responsibilities of school nurses varied considerably throughout the Western World. This paper explores these responsibilities during the early part of the twentieth century, with a particular emphasis on role of school nursing in Queensland, Australia. While school nurses were initially employed to support the medical officers within the school setting, the school health system evolved to be essentially a nursing service. However, it was not a well resourced service. This meant there were unrealistic expectations placed on school nurses. Furthermore, because of the nature of the work undertaken by school nurses there were potential conflicts that needed to be negotiated on a daily basis between the nurse and the schools, parents, doctors and government departments.