Telephone counselling in medical care has been used for many years, but there are several challenges and pitfalls. The counselling nurse must rely on what the patient tells him or her, and the description of symptoms may be biased by the patients' worries or thoughts. Furthermore, communication difficulties due to insufficient structure in the conversation may also cause problems. The same goes for situations where a nurse seeks counselling from the doctor. To reduce the risks of errors in these situations, the nurse must have good knowledge and skills in the evaluation of the patient's condition and vital functions, use a standardized model of examining and/or questioning and a structured way of communicating. By using the same instruments for clinical evaluation and communication, different care givers will also increase the patient safety when patients are transferred between them.