This article considers some of the challenging situations that children’s nurses may encounter when there are tensions and disagreements between the family of the child or young person in their care and the wider professional team. The focus is on disagreements about what some might consider futile critical care. It aims to equip children’s nurses with strategies for dealing with conflict and tensions, and support them to be proactive in identifying situations that might need de-escalation. The options available to support the healthcare team and therefore avoid litigation are explored, while avenues of support available to nursing staff are considered. Suggestions and examples of effective and skilful communication with families receiving challenging news are provided. The legal position designed to safeguard children’s nurses is reviewed and practical strategies are offered to support nurses to protect themselves from physical violence if the situation escalates.