Objective: to identify scientific evidence about the communication process in Telenursing and analyze them. Method:: integrative review performed in March 2014. The search strategy, structured with the descriptors 'telenursing' and 'communication', was implemented in the databases Medline, Bireme, Cinahl, Scopus, Web of Science, Scielo, and Cochrane. Results:: ten studies were selected after inclusion and exclusion criteria. The main challenges were: the clinical condition of patients, the possibility for inadequate communication to cause misconduct, the absence of visual references in interactions without video, and difficulty understanding nonverbal communication. Conclusion:: distance imposes communicative barriers in all elements: sender, recipient and message; and in both ways of transmission, verbal and nonverbal. The main difficulty is to understand nonverbal communication. To properly behave in this context, nurses must receive specific training to develop abilities and communication skills