In the changing contemporary society, certain demands for health care system become evident. In recent years, declining health indicators of Lithuanian schoolchildren prompt to analyze the situation of schoolchildren's health care: whether health care at schools is sufficient and effective and how school nurses deal with schoolchildren's health problems on a daily basis. OBJECTIVE. To analyze how school nursing specialists work at school and what problems they encounter while providing health care to schoolchildren. MATERIAL AND METHODS. A total of 202 school nurses from five main Lithuanian cities participated in the survey in 2005. More than three-fourths (77.7%) of the respondents had been working at school for more than 10 years. For the survey, an original closed questionnaire, consisting of 28 questions, was used. RESULTS. The survey showed that most of school nurses were approached by schoolchildren with the following health problems: visual impairment, anomalous posture, and scoliosis. More than three-fourths (75.5%) of the school nurses noted that schoolchildren's health was getting worse over the last five years. School nurses usually provide care to 11-30 schoolchildren per day. Most of their time is spent on schoolchildren's health check-ups, health education, and documentation. The school nurses noted that the efficiency of health care system at school was reduced by a number of problems, including poor working conditions, the lack of medical equipment, inadequate computer systems. Therefore, the cooperation among nurses, school administration, and parents must be substantially improved. CONCLUSIONS. The competence of school nurses should be maintained through an educational approach by developing their qualification, as well as through a social approach by improving their cooperation with school community and parents.