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The recognition of the advanced cancer patient's suffering forms the basis for the nurse's ability to acknowledge and alleviate suffering. But little is known about how this is practised, and several studies indicate that the professionals' knowledge about the advanced cancer patient's suffering is inadequate. This study focuses on the question: How are verbal cues/signs of suffering expressed and responded to within palliative nursing? Using Peirce's semiotic and phenomenological grounded theory of potential and actual signs, passive and descriptive participant observations were performed focusing on setting, actors, time factors and the verbal incidents that took place at the patient's room in a palliative care unit. Giorgi's phenomenological method has been used to describe the typical structures of the signs of suffering, which were: a.a. Potential signs of suffering expressed by the patients and responded to by the nurses, but in which the meaning of the signs were neither described by the patient nor demanded by the nurses. b.b. Potential signs of suffering expressed by the patient, but not shared with the nurses in any way. c.c. Signs of suffering whose importance and meaning the patients were given a narrow space to express. d.d. Signs of suffering expressed spontaneously by the patients when the nurses had left the room. e.e. Potential signs of suffering that the nurses sought to identify on their own initiative. The study calls attention to the problem that while suffering is produced collectively, it is rarely expressed, perceived, attached importance and meaning to, lived or prevented in this space; This is because it typically was conceived as a mute, intrapersonal — and not interpersonal - or collective phenomenon, which is the criteria that must be met for the nurses to have the ability to perceive and respond to the lived suffering.

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