Background and Purpose: School nurses have the critical task of overseeing the health and wellness of school-aged students. Utah is 1 of 17 states which allow parents to exempt their children from vaccines. The most common parental reason for exempting children from vaccines is personal choice. With the number of students without vaccinations on the rise, school nurses are tasked with responsibilities related to the spread of vaccine-preventable diseases. However, few studies have explored the role of school nurses in managing a disease outbreak. Therefore, the purpose of this study was to 1) explore the responsibilities of Utah school nurses during a disease outbreak; 2) review disease outbreak training for Utah school nurses; 3) identify groups with which the Utah school nurse would collaborate during a disease outbreak; and 4) identify Utah school nurse concerns while attempting to manage a disease outbreak. Methods: A qualitative descriptive design was used with a semi-structured interview guide for focus groups (3 focus groups, 24 total participants) of Utah school nurses. Qualitative analysis of content and themes was utilized. Results: School nurses' responses revealed their collaborative role and cited strong teamwork with the local health department; lack of standardized disease outbreak training; high student-to-nurse ratios; and concerns with communication with parents and community. Thematic descriptions with illustrative quotes are presented as well as perceived challenges and barriers Utah school nurses faced during a disease outbreak. Conclusion: Utah school nurses face barriers that prevent them from working effectively during a disease outbreak. Most barriers are due to communication difficulties and lack of training for school nurses. Findings of this study have implications for standardized training, funding to decrease the high nurse-to-student ratio and for further education in the community to raise awareness of outbreak guidelines.