Context: When a patient receives a cancer diagnosis, existential issues become more compelling.Throughout the illness trajectory, cancer patients could be cared for on oncology wards, by home care teams or in hospices. Nurses working with these patients are sometimes aware of the patients' existential needs but do not feel confident when discussing these issues.Objectives: To determine the effects of a training intervention, where the focus is on existential issues and nurses' perceived confidence in communication and their attitude towards caring for dying patients.Methods: This was a randomised, controlled trial with a training intervention consisting of theoretical training in existential issues combined with individual and group reflection. In total, 102 nurses on oncology wards and hospice wards and in palliative home care teams were randomised to a training group or non-training group. Primary outcomes, confidence in communication and attitude towards the care of dying patients were measured at baseline, immediately after the training and five to six months after.Results: Confidence in communication improved significantly in the training group from baselinebefore the training -to both the first and second follow-up, i.e. immediately after the training and five months after. The attitude towards caring for the dying did not improve in the training group.Conclusion: This study shows that short-term training with reflection improves the confidence of healthcare staff when communicating, which is important for healthcare managers with limited resources. Further studies are needed to explore how patients experience the communication skills of healthcare staff after such training.