Background The nurse‐patient communication is a dyadic process involving the transmission and recognition of information and feelings. However, communication difficulty is a common phenomenon among mechanically ventilated patients which causes distress among patients and may compromise the quality of patient care that nurses provide. Aim To explicate the communication preferences of registered nurses towards mechanically ventilated patients. Design Cross‐sectional, choice‐based conjoint analysis Methods From August to November 2017, 201 purposively selected registered nurses with prior experience in caring for mechanically ventilated patients were surveyed and ranked 12 choice bundles with four selected attributes of the communication process. Results Family participation was the most important attribute (40.40%) while communication initiator was the least important attribute (15.44%). Registered nurses prefer to communicate with mechanically ventilated patients if family members are involved (utility = 1.03), if conventional communication equipment are used (utility = 0.24), if open‐ended questions are asked (utility = 0.13), and if nurses are the communication initiator (utility = 0.22). Conclusion The model of communication preferences highlights the importance of involving the family in the communication process and can inform family‐centered policies for mechanically ventilated patients. Unit policies on the use of conventional communication equipment should be considered to maximize the nurse‐patient communication and potentially improve patient care.