The Foreign Exchange column launches a new approach to expanding the global understanding of oncology nursing challenges and concerns. Each issue will include a review of an article that appeared in the most recent issue of the European Journal of Oncology Nursing that is relevant to a shared, unique, or conflicting oncology issue or practice in the United States. This column reviews an article about the shared dilemma of distress caused by caregiver burden in the ever complex and shifting setting of care delivery.