Advanced clinical practice invites curiosity, rationalising the reasoning behind clinical symptoms. Developing one's own style of critical thinking is a journey that is influenced by a variety of factors including stress, risk, time and knowledge. There has been significant scrutiny in practice around making a clinical judgement when a person is entering the terminal phases of life, yet little clarity exists for clinicians regarding what information is required to make this decision. Within the role of advanced clinical practitioner (ACP) in palliative care there is an expectation to offer guidance and support to persons and families as well as junior nursing and medical staff of the changing phases of a person's illness. There is 'one chance to get it right', yet predicting death and dying remains predictably unpredictable.