My experience has been that the case management and needs of kids of high school age are much easier and less time consuming. At the high school level you would be spending more time teaching students about managing their diabetes and other health conditions where as in the elementary schools the needs of the kids may be greater, especially if the economic status of that area is lower(higher rates of asthma, and other untreated health conditions). It is also important to know if you will be responsible for the vision and hearing screenings in your building. If so, there are fewer mandated grade levels in high school. Good Luck! And consider yourself lucky, where I am, we do not have a nurse in each building. There are 2 of us for 5000 kids in general ed, and a profoundly handicapped program.