The days of the traditional school nurse are numbered, with only 46 now working full-time in Wales's schools.
According to the latest Assembly government school census, the number of school nurses has fallen by 9 per cent since 2002.
But officials have said they are working on plans for a more modern alternative this summer - the new-look "family nurse".
If approved, one will be placed in every secondary school as part of a national scheme that will phase out the traditional model by the end of 2011.
A government spokesperson told TES Cymru that the scheme would go to consultation this autumn. The commitment to the school-based family nurse is included in the government's policy paper One Wales.
A rise in the rates of binge drinking, suicides, obesity and sexually transmitted disease among the young has led to campaigns for the re- introduction of highly trained nurses to help pupils with "modern age" health problems.
The problem was targeted in the government's strategy, published earlier this year, for a school-based counselling service that would allow every student to have access to a school nurse.
The family nursing scheme is intended to provide more of a community role, working with parents to support young people with addictions or mental health problems. But their remits will be far removed from the matronly nit nurse, from whom every parent has traditionally dreaded a visit. Training will begin this September.
But the Royal College of Nursing (RCN), although supportive of the Assembly government's plans, said it doubted whether enough nurses would ever be trained.
In Wales, there are 222 secondary schools and 44 special schools to cater for.
Dr Peter Carter, RCN chief executive and general secretary, said: "If we are going to get children on to the right track, if we are going to end a growing obesity problem, we need to recruit the right numbers of school nurses who can identify unhealthy children and intervene accordingly."
The demise of the full-time school nurse has been going on in Wales for more than a decade.
At the end of 2007, there were 248 full and part-time school nurses employed by local health boards, the majority of whom were nearing retirement.
But the latest census figures, which were published by the government last week, also show record numbers of other support staff now deployed in schools in Wales.
In January 2008, there were almost 17,000, including teaching assistants, administrative staff, technicians and childcare staff, a rise of 90 per cent in six years.
Administrative staff numbers have also risen to 27 per cent since records began. The number of support staff with responsibility for childcare has increased by almost 70 per cent since 2002.
The rise in support roles in schools comes alongside a drop in the number of full-time teachers. At the latest census count there were 26,880 - 185 fewer than one year earlier.
Over the year, 879 teacher vacancies were advertised in secondary schools and 641 in primaries. But the number of trained teachers who are able to find jobs in Wales is in decline.