This study was conducted to investigate ICU nurses` perceptions of communication difficulties, the importance of and satisfaction with communication with doctors, other nurses, patients, and family, as well as to explore communication barrier with patient families. Methods: Investigators developed a 15-item communication perception questionnaire and 58-item communication barrier questionnaire. Communication barrier included 4 domains: nurses, family, environment, and patient condition. A total of 151 ICU nurses with a minimum of one year of ICU experience participated. Results: ICU patients (3.38±0.73) were the most difficult group to communicate with, followed by family (3.32±0.72), senior nurses (3.25±0.74), doctors (3.21±0.68), and nurse colleagues (2.64±0.73). Doctors (4.61±0.53) were the most important group to communicate with, followed by nurse colleagues (4.52±0.54), patients (4.49±0.58), senior nurses (4.44±0.55), and family (4.43±0.61). Satisfaction with communication was the highest with colleague nurses (3.60±0.68), then senior nurses (3.37±0.74), family (3.18±0.71), patients (3.09±0.75), and doctors (3.06±0.83).The total score of the communication barrier was 2.83±0.52, where each domain was scored as follows: patient condition 3.13±0.74, nurses 2.83±0.60, environment 2.81±0.66, and family 2.76±0.57. The ICU nurses reported that communication was difficult due to ``sudden deterioration in the patient`s condition``, ``being too busy``, ``a noisy environment``, and ``information not being shared between family members.`` Significant differences were noted by age, clinical experience, and marital status of nurse respondents. Conclusion: The findings indicated that development of a protocol on communication between nurses and doctors as well as development of an educational program on communication skills are necessary.