The purpose of this article is to share the findings of implementing a standardized, blended approach to school nurse orientation. This includes using classroom training, mentor/supervisory support, and skills labs to assure specific competencies that are needed for new nurses to successfully transition into this independent setting. This includes a description of the specialized skills and knowledge that are needed to successfully transition into this nursing specialty. School nurses are caring for more complex students. For example, students who were once homebound requiring tube feedings, ventilator, and tracheostomy care are now attending schools. They are responsible for triaging students with diverse needs which requires critical thinking skills. They case manage students with chronic diseases including: diabetes, asthma, life threatening food allergies and seizures. Lastly, school nurses manage students with risky behaviors related to drug usage, bullying and unprotected sex resulting in pregnancy.