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Summarizes the difficulties facing today’s adolescents and data on the prevalence of risk‐taking behaviour which threatens their health. Describes how the school nurse is in a unique position to influence the health of school age children, and is often perceived by them as a caring, listening person whom they can trust. Suggests that school health services are in a rut, straddling the boundary between health and education services and failing to fit neatly into the primary health care team. Outlines how this is having a weakening effect, as providers and purchasers are unwilling to support a service which appears expensive and of questionable value. Deplores the lack of documented evidence on the effectiveness of school health services. Applauds authorities which have replaced routine medical examinations with more appropriate services. Urges the school health service to design services which recognize adolescents as a group with specific health needs. Makes a list of recommendations for achieving this aim.

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