Many students require prescription and nonprescription medication to be administered during the school day for chronic and acute illnesses. School office staff members are typically delegated this task, yet these individuals are unlicensed assistive personnel without medical training. Five school nurses developed and participated in a medication audit providing a glimpse into the administration and management of medications in school health offices. The audit included 154 medications. Results of the audit showed a wide range of errors and discrepancies, including problems with transcription, physician orders or lack thereof, timing, documentation, and storage. Audit results highlight the importance of training in medication administration and management at schools. It also directs attention to view training not as a once-a-year event, but as a process. A process is needed to ensure and sustain the safe and accurate administration of medication. Towards this end, school nurses need to periodically evaluate school office staff, audit school medication records and documents, and conduct refresher classes throughout the school year. (Contains 2 tables and 1 figure.)