PURPOSE This study explores school nurses' emergency care experiences and their needs for systemic institutional support. METHODS Data were collected in 2016 from the interviews with five focus groups comprising thirty school nurses. Qualitative content analysis was then performed using the collected data. RESULTS The study found that school nurses were vulnerable to over-reaction in uncertain situations as the school's sole health service provider. The study's findings are divided into ten categories. 1) Major obstacles to overcome as the sole health service provider, 2) Assessing an uncertain situation and making appropriate decisions, 3) Providing limited first aid while maintaining control over the situation, 4) Referring or transferring a student to a hospital that creates tensions and raises cost, 5) Becoming an advocate for information disclosure and treatment, 6) Ensuring follow-up actions and proper transfer of responsibility, 7) Making preparations for future emergency, 8) Responding to conflicts arising from over-reaction as a safeguard and professional expertise, 9) Need for the development of standardized manual for school emergency care, 10) Need for practical case-based training. CONCLUSION The findings of this study should contribute to the development of the programs aimed at improving school emergency care and the professional competence of school nurse.
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