Purpose To explore communication behaviors of nurses and parent dyads of hospitalized children with home ventilator dependency (HVD). Method This study is a secondary data analysis of interactions of nurses with thirty parent dyads of hospitalized children with HVD [ n = 73 encounters (9 admissions, 14 discharges, and 50 after rounds)] at a quaternary Midwest United States of America pediatric hospital. Thematic analysis of communication among nurses and parent dyads was performed in NVivo qualitative software (Version 12). Results Communication themes for nurses and parent dyads were: (1) inquiry and clarifying communication, (2) collaborative communication, (3) compassionate and caring communication, and (4) chaotic communication. Role based differences included nurses frequently demonstrated negotiating, asking and explaining behaviors, and infrequently advocating, whereas parents often displayed behaviors including inquiry, negotiating and advocating for their child. Conclusions Parent dyads experience multiple burdens as the primary caregivers of children with HVD at home. The child's hospitalization increases stress resulting in unique patterns of communication with nurses. Future research is needed to develop and pilot structured communication tools for admission, rounds and discharge interactions between nurses and parents of children with HVD. Further research is needed regarding structured communication tools and support for parents in different settings and types of dyads including other family members that directly care for the child. Implications to practice Nurses' use of collaborative communication and integration of parent expertise in care planning and delivery fosters child outcomes.