The project studied the impact of cultural features in an ESP setting, more properly thought of as English for Medical Purposes. The EMP approach is used in this study as a focus on the teaching of English to nurses, and how that teaching should include cultural and pragmatic skills in interaction, not just technical vocabulary. Nurses in Taiwan have seldom received training in the range of varieties of English they may encounter, and they may not be aware that they can use more than one strategy in presenting requests or directives to patients. This study focused on Nursing English. By teaching appropriate cultural and pragmatic ways of handling requests and instructions, the researcher hoped to help the nurses to reduce intercultural apprehension.