Objective To observe the communication and contact behavior of mechanically ventilated patients and nurses, in order to provide reference for a deeper understanding and helping them to conduct effective communication. Methods Fifteen mechanically ventilated patients in the ICU were selected, and their communication behaviors with nurses were collected through live observation and panoramic video recording. The type and content of communication between them were observed and recorded on site, and the quality of communication was assessed using the Communication Interaction Behavior Instrument (CIBI) in conjunction with the video. Results Both on-site observation and video observation were conducted for 255 h. A total of 755 nurse-patient communication and contact processes were encoded and recorded, of which 697 were initiated by nurses and 690 were therapeutic in nature, and 3636 communication and contact behaviors were recorded, of which 2 094 were positive behaviors by nurses and 320 were negative behaviors by patients.The type of communication initiation and content of communication were positively associated with positive communication behaviors of nurses and patients, and positive communication behaviors of nurses were positively associated with positive and negative communication behaviors of patients (P＜0.05 for all). Conclusion There is correlation between the communication behavior of ICU nurses and patients.We should pay attention to the active communication behavior of patients, optimize the details of nurse-patient communication, reduce the negative communication behavior of patients, and concern the psychological pressure on nurses induced by it.