Identifying patients who would benefit from palliative care is a major barrier to providing palliative care. In acute care hospitals, physicians make palliative care referrals, but nurses identify and recommend patients for referral. Because nursing knowledge is essential to the appropriate utilization of palliative care, we assessed palliative care knowledge among 143 oncology, intensive care, and heart failure nurses. The overall mean percentage of correct responses was 67.6%, indicating that nurses were moderately but not fully knowledgeable about palliative care. Eight of 10 nurses correctly understood that patients do not need to be in acute decline to be appropriate for referral, but 7 of 10 did not understand that palliative care is compatible with curative treatment. The latter observation suggests that nurses may overlook patients who might benefit from palliative care. Variations in findings are examined in relation to experience in oncology and hospice, awareness of the palliative care program, having recommended a patient for palliative care, having had a recommendation result in a formal referral, and years of nursing experience. For palliative care to become a standard of care, nurses who often know patients and families best due to increased interpersonal exposure must understand palliative care.