Immigrants and multiculturalism in Finland have increased rapidly in recent years. According to the Finnnish Immigration Service, there were asylum seekers in 2015, more than 32 400, respectively, in 2016 there were more than 5 600. Now and in the future the challenge are the diversity of different cultures in society. Nursing interaction and communication hamper by the lack of a common language between the caregiver and the patient. Various communication tools, such as picture cards can be used. The aim of this thesis was to produce photo cards to support the nursing staff and patient communication and interaction. The aim was that the cards would be would be concrete, clear, and easy to use. Portability of the picture cards and long operating life were also the aim of our study. The photo cards were manufactured as a project work with Joint Municipal Authority of Wellbeing in Raahe District nursing director, ward 1, ward 3 and with the emergency care services and first aid. The planning of the project started early 2016. Information was sought literature, surveys and statistics to support the choice of picture cards of topics, we did a survey of Joint Municipal Authority of Wellbeing in Raahe District emergency care services and first aid, surgical ward and emergency department personnel and observation. Responses were compiled and analyzed on the basis of which we chose the topics on the cards, which were daily activities, nursing activities, examinations and medical treatment. On the card there is a picture and text both in Finnish and English about the operation or matter that is to be communicated to the patient. In addition, on the other side of the picture there are specific words or phrases in English to support the nurse´s communication. Photo Cards were laminated and are kept in a folder by subject. The project could continue later, to examine the extent to which the cards are utilized in practice, the situations in which cards work well and what kind of cards are not suitable for situations, with what kinds of patient groups the card are being used supporting communication cards are used and how nurses and patients feel the use of the cards. Keywords: Multiculturalism, Nursing, Communication and Immigrant