Palliative sedation is a treatment of last resort to relieve intractable suffering that can be ethically controversial. There has been very little research into the nursing perspective. This study explored the knowledge, perceptions, and experiences of hospice nurses with palliative sedation. Semistructured interviews were conducted with a convenience sample of five hospice nurses in a Scottish hospice. Data were collected over 3 months and analyzed using Burnard's thematic content analysis method. The major themes were suffering, courage, and peace. Patient suffering was multidimensional and had an impact on families and staff. Decisions about palliative sedation were courageous because of the ethical implications and collaborative practice, respecting patient autonomy. Trust, experience, and special communication skills were necessary. When other measures failed, palliative sedation was essential to provide a peaceful death. Patients preferred sleep, and families were left with memories of a peaceful death. Nurses play an important role in the provision of palliative sedation. Training, clinical supervision, and support from an expert multidisciplinary team should be available.