Karen Graf, MSN, RN-BC, APHN-BC
Karen Graf, MSN, RN-BC, APHN-BC, is a highly experienced nursing leader with more than 38 years of service in the nursing profession. She currently serves as a Nursing Education and Practice Specialist for the National Association of School Nurses (NASN), where she supports the advancement of school nursing practice nationwide. Throughout her career, she has been dedicated to improving child and adolescent health through evidence-based school health programs, leadership, and professional education.
Karen began her nursing journey after earning her Bachelor of Science in Nursing from Montana State University-Bozeman (1983–1988). She later completed a Master of Science in Nursing Leadership and Community/Public Health at Stanford University School of Medicine. Her early clinical career included critical care, ICU, CCU, and flight nursing at Deaconess Billings Clinic, where she built a strong foundation in high-acuity patient care and emergency response.
Over time, Karen transitioned into specialty areas including ophthalmology surgical nursing and ultimately school nursing, where she discovered her long-term professional passion. She served as a school nurse in Billings Public Schools for over seven years before becoming the Rural School Nurse Program Manager III at RiverStone Health, a role she held for more than a decade. During this time, she expanded access to school health services across rural communities and strengthened school-based healthcare systems.
Karen’s leadership extended into state and national professional organizations. She served as President of the Montana Association of School Nurses and was a member of the Board of Directors for the National Association of School Nurses before joining NASN in a full-time leadership capacity. Her contributions have been recognized with multiple honors, including School Nurse of the Year (2022), School Nurse Administrator of the Year (2020), and the Montana Public Health Association Exemplary Service Award (2018), reflecting her impact on public health and school nursing practice.
In addition to her national leadership role, Karen continues to serve a small rural K–6 school in southern Montana, where she provides direct care to a remote student population. She is deeply committed to mentoring school nurses, advancing workforce development, and advocating for equitable student health services. Her career reflects a lifelong dedication to clinical excellence, education, and improving the lives of children and families through school nursing.
• Montana State University-Bozeman - B.S. in Nursing,
• Stanford University School of Medicine - M.S. in Nursing
• RN-BC (Registered Nurse–Board Certified)
• APHN-BC (Advanced Public Health Nurse–Board Certified)
• Medical-Surgical Nursing Certification (ANCC)
• CPR / American Heart Association Instructor Certification
• 2023 Salute to Nurses (Billings Gazette)
• School Nurse of the Year (2022, NASN/MASN)
• President, Montana Association of School Nurses (2021)
• School Nurse Administrator of the Year (2020, NASN/MASN)
• Montana Public Health Association Exemplary Service Award (2018)
• National Association of School Nurses
• Montana Association of School Nurses
• American Public Health Association
• American School Health Association
• Sigma Theta Tau
• Ongoing service in a remote rural K–6 school in Montana
• Long-term rural school nursing program leadership
• Advocacy for school health access and nursing workforce development
• Mentorship and training of school nurses nationwide
Regular contributor to NASN professional communications and school nursing advocacy materials
Involved in policy-related publications and educational resources on school health systems, rural nursing, and student wellness initiatives
Areas of Specialization/Expertise
- Nursing Education and Practice Specialist
- School Nursing
- Critical Care
- Public Health Nursing
- School-based healthcare systems and student wellness
- Rural and underserved healthcare delivery
- Nursing workforce development and education
- Public health nursing programs
- Emergency, ICU, and critical care nursing (early career)
- Policy advocacy for school health services
- Professional mentoring and leadership development
What do you enjoy most about practicing medicine?
What I enjoy most about nursing and school health is the opportunity to be present with people during some of the most meaningful moments of their lives—whether during times of wellness, illness, the beginning of life, or end-of-life care. It is truly an honor to walk alongside patients, students, and families in both joyful and difficult seasons.
I also deeply value my role in rural school nursing. I continue to serve a very small K–6 school south of Billings in a remote area, where access is so limited that you sometimes have to hold onto the flagpole just to get a cell phone signal. Despite its isolation, I have built strong relationships with the students and families there. I have never wanted to let that school go, and I made it a priority to continue serving them even as my professional responsibilities expanded.