Aim: The aim of this systematic literature review, a meta-synthesis, was to understand and make visible the prevailing discourse of the school nurse within current nursing research published between 1999 and 2009. Background: The school nurse's position in school health care is currently unclear and the school health care does not seem to live up to society's expectations of it. There is also a lack of collective strategies to achieve the objectives of school health services. Methods: The search for published studies was conducted in the databases Cinahl and Medline and by manual additions. Data set (24 included studies), were analyzed qualitatively (Discourse analysis) by careful reading, interpretation for deeper analysis and a synthesis.Findings: Three discursive concepts were formulated that together formed the discourse of the school nurse: (i) the discourse of caring, (ii) the professional discourse, and (iii) the institutional discourse. Conclusion:The discourse expresses ideas about the school nurse as in possession of skills and abilities that are not fully expressed. This indicates a dilemma between ambition and actual conditions. An implication for school health services is to clarify the school nurses tasks to facilitate the prioritization of time instead of vague terms of responsibility.