A study compared the nurse-patient communication of native and non-native English-speaking nurses. Examination of the literature on nurse-patient relationships and a brief survey of native nurses yielded an instrument for observation of nurses. Ten nurses were observed for 3 hourse each. Transcripts of the observations of the five non-native speakers were examined to extract 46 communicative functions specific to this context. Transcripts of the observations of the five non-native speakers, together with informal interviews with hospital personnel, disclosed the problems that non-native speaking nurses experience in their nurse-patient relationships. The problems fell into six areas: explaining; commenting; expressing intention; direct questioning; eliciting information; and directing or instructing. Two additional areas of concern that emerged were: (1) some nurses' inability to notice patient anxiety or fear and deal with it; and (2) mistaken meaning. To remediate these problems, a course in oral communication skills for non-native nurses was designed. One fully developed unit is presented. Forms and materials used in researcher interactions with the participating hospitals and nurses are also included. (MSE)