Internationally recruited nurses (IRNs) provide valuable resources to address existing and predicted nurse shortages. Once in employment many IRNs experience difficulties due to differences in language and culture in their new country of practice. Barriers to effective communication have implications for all nurses but particularly those functioning in a second language and culture. This article suggests strategies for IRNs, UK-educated nurses, managers and policy makers to improve the experience of IRNs and to ensure patients receive the best possible care.