Research has shown that there exists an increase in the amount and complexities of students with health care needs and the need for school nurses to safely and effectively support these students. Notably, research also revealed that the majority of nurses who enter this specialty practice lack the comprehensive knowledge base and are underprepared to practice in educational environments. The purpose of the qualitative, action research study was to provide school nurses an opportunity to reflect on and voice their novice school nursing experiences in order to examine the contents that should be included in new school nurse orientation programs. The researcher used a qualitative, action research design to develop the methodology for this study. The research questions that guided this study were: 1. What do practicing school nurses report regarding orientation programs for novice school nurses? 2. What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in the key principles (Maughan, Bobo, Butler & Schantz, 2016) of school nursing practice? 2.1 What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in the standards of practice? 2.2 What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in care coordination practices? 2.3 What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in quality improvement practices? 2.4 What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in leadership practices? 2.5 What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in community/public health practices? Select parts of the NASN Framework (Maughan et al., 2016), and Benner’s (1984) definition of novice nurses, together, formed the conceptual framework that examined school nurses’ reflection regarding the content that should be included in new school nurses’ orientation programs. A purposeful sampling (Maxwell, 2012) was used to recruit practicing school nurses from across a Northeastern state in rural, urban and suburban school district settings. Efforts to include school nurses from all regions resulted in 27 participants. Participants engaged in semi-structured interviews and shared about the experiences they had as novice school nurses. A two-step process was used to analyze the data: first, open coding was performed to identify underlying themes and, second, a crosswalk of the resulting matrices against the already defined components in the NASN Framework (Maughan et al., 2016). The researcher found that institutional culture and organizational sensemaking were central to the perceptions and experiences described by participants during their transition to school nursing practice. Findings of the study culminated in four major themes that were identified as critical to school nursing practice and that must be included in orientation programs for novice school nurses: 1) mentoring and supervising; 2) communicating; 3) developing specialized skills; and 4) identifying resources.