Aim To explore the current state of nurses’ practical knowledge on advance care planning (ACP) for patients with hematologic malignancies (HMs).

Method We conducted qualitative semi-structured interviews with nurses who are, or had been, working with patients with HMs. Data were analyzed using content analysis.

Results A total of 10 nurses were interviewed. Four major themes were extracted, ‘Difficulties in exploring patient‘s value through their behavior’; ‘Building a multidisciplinary team that can cooperate while engaging the patient’s decision-making’; ‘Implementation of shared decision-making by bridging the gap between patients, families, and healthcare professionals’ and ‘Continuous conversations focusing on the planning for current care’. Lack of time due to continuous aggressive treatments and difficulties in understanding the pathology of HMs were identified as the main obstacles affecting ACP. The nurses reported the importance of building rapport with patients through daily care, bridging the gap between patients, their families, and healthcare professionals to find a middle ground, cooperation within a multidisciplinary team, and conversations about current values and preferences.

Conclusion The difficulties in ACP are related to the unique characteristics of HMs. Therefore, a strategic approach for nurses based on these characteristics, and the nurses’ practical knowledge, is needed.