Pediatric palliative nursing care, both stressful and rewarding, requires coping skills, confidence, and other attributes for successful patient care and nursing practice. Through a thorough literature review, clinical workshops, direct observations in pediatric palliative care settings, and personal nursing experience in the neonatal intensive care, pediatric intensive care, and oncology wards, this author confirmed the necessity for studies to clarify the needs of dying pediatric patients and their families, as well as the needs of nurses who provide their care. This article briefly reviews the history and current status of pediatric palliative care, describes the experiences of nurses caring for dying children, explores the impact of providing palliative care on the hospital staff, and seeks to discover possible interventions by the advanced practice nurse to influence more positive patient care and nursing staff job satisfaction and retention.