The heart of high-quality pediatric palliative care (PPC) is communication. Major palliative organization have guidelines for effective palliative care communication. The National Consensus Project, American Academy of Pediatrics, National Hospice and Palliative Care Organization, and Hospice and Palliative Nurses Association have set standards and guidelines emphasizing the importance of effective, compassionate, and developmentally appropriate communication between the PPC team, child, and family. The palliative care advanced practice nurse registered nurse (PP APRN) works collaboratively with the interdisciplinary team, drawing on each member’s strength and expertise to establish rapport and trust with the young person and their family. Together, the team works to understand their collective perception of the serious illness, eliciting values and then integrating the family’s care preferences with medical recommendations to create an individualized care plan.