The first day of Telluride had a strong focus on communication and not to assume that people are understanding what you mean. The domino game reinforced how hard communication is and how easily a conversation can be misunderstood. This game reminded me of a mistake which I made as new nurse. I received an admission from the emergency department. The patient was experiencing dyspnea due to stage four lung cancer with multiple metastases. After settling the patient into their room I received a call from the patient’s family asking for an update. They asked how the patient was and I told them that the patient was doing well and was going to be resting for the night. What I meant was that the patient was critically stable and was not in severe distress at the moment. However the family member took it as there was no health problem with the patient. The following day the family came and talked to the physician who told the family how bad the cancer had become and that they should consider hospice. The family was very upset that I had told them the patient was doing well and did not understand. I never meant to mislead the family but as an ICU nurse the phrase the patient is doing well has a completely different meaning than the family had. The domino game was a great reminder and reinforcement on continually working on communication and always making sure others understand what you mean. This game will be very useful in teaching nursing students about communication and the need to be a clear communicator.