Moral distress experienced by staff has been well documented in the intensive care work areas, but less described in oncology nursing. Factors that contribute to moral distress include ethical dilemmas, mismatched goals of care among patients and their families and providers, and perceptions of futility of care. This article describes recognizing the risk of moral distress in a newly formed medical-surgical oncology unit and steps taken to mitigate developing moral distress, illustrating that moral distress is present in oncology nursing and warrants further study.