The purpose of this paper is to outline and discuss some of the fundamental theoretical and practical considerations bearing on the teaching of communications skills to nurses. Although evidence exists that communications training is needed, and welcomed by both nurses and nurse managers, implementation of training schemes without consideration of a number of critical issues is likely to result in only partial success, or even complete failure. The issues identified and discussed in this paper are the need for accurate assessment and evaluation, the need to understand and take into accountresistance to change at the level of both the individual and the organization, and most pervasively, the need for a clear relationship between theory and practice.