Background: School nurses have a unique opportunity to promote health when they meet school children during the Health Dialogue. The Health Dialogue concept is used by all the school nurses in a county in Mid Sweden.

Aim: To describe school nurses' experiences of the Health Dialogue concept.

Methods: A qualitative descriptive study with latent content analysis of interviews performed during February–April 2012, where 16 school nurses participated.

Findings: The school nurses experienced the Health Dialogue concept as a useful tool to work with school children's health in a relationship-based, child focused, structured, and systematic way, which was reflected in one overarching theme: 'To be in a relationship-based, health-promoting practice.' However, school nurses also experienced loneliness and frustration from the many difficult situations with school children, and they indicated needs for further collaboration.

Conclusions: The Health Dialogue concept is child-focused, systematic and structured, but it requires further development and continuing work on statistical feedback. School nurses indicated a need for collaboration with teachers, parents, and other health professionals, as well as professional-reflective supervision.