In recent years, there has been a growing emphasis on the delivery of English for Specific Purposes (ESP) courses to improve the English proficiency of nursing professionals in Taiwan. To support this effort, the aims of this research paper are twofold: to develop an understanding of nurses' English needs and challenges related to clinical nursing practice and to explore nurses' perspectives on ESP courses provided to them, with a focus on whether the courses reflect their actual English needs and challenges. This research adopts a qualitative approach, using data from two groups of participants: a group of nine nurses who participated in interviews and a group of 10 nurses who were observed in the workplace. All of these nurses worked in a large-scale hospital with an international care center in Taiwan. The findings revealed that the participants needed effective communication skills in English to build trusting nurse–patient relationships and provide quality nursing care. However, they experienced English communication difficulties in the areas of vocabulary, pronunciation, and accent, and developed negative strategies to cope with these challenges. The nurses considered their ESP courses ineffective, although somewhat useful, because the content failed to meet their language needs and challenges. © 2018 Elsevier Ltd
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