Purpose: The purpose of this study was to analyze metacommunicative episodes comprised of nurses' metacommunicative behavior and children's responses occurring in the dyads of nurse-child within the context of an inpatient pediatric unit. Methods: Twelve dyads of nurses and children were videotaped for four hours each day over a two-day period as they interacted with each other on the inpatient unit. The metacommunicative episodes were recorded from the videotapes. The metacommunicative

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... was categorized within Shin's metacommunicative behaviors. Results: The total number of episodes between the nurses and children included in this study was 242. The most frequently used metacommunicative behavior was 'reflection', followed by tagging, baby talk, approaching, mediating eye level, friendly demand, encouraging, description of acts, symbolization, turnabouts, touching, and mimic voice, respectively. The most common response to the nurses' metacommunicative behavior was agreeing, followed by tension release. Conclusion: Young children responded positively to metacommunicative behavior by the nurses. Understanding metacommunicative behavior may help nurses approach their young patients more easily and with confidence.