Early palliative care improves the quality of life for patients with hematological malignancies, yet the role of hematology-oncology transplant nurses in facilitating this care remains unclear. This study explored the experiences and understandings of 10 hematology-oncology transplant nurses from across Canada, working in both inpatient and ambulatory settings, regarding the early provision of palliative care for patients undergoing hematopoietic stem-cell transplantation. Findings revealed a complex understanding of palliative and end-of-life care, highlighting the emotional and moral challenges facing HOT nurses. The study provides new insights into how these nurses navigate the unique barriers to integrating palliative care into their specialized field, offering recommendations to improve interprofessional collaboration, education, and institutional support.