Institutional members access full text with Ovid®

Share this article on:

Resolving Moral Distress When Caring for Patients Who Smoke While Using Home Oxygen Therapy: A Case Study Using a Three-Step Process

Kayser, John W. RN, MSc(A); Nault, Diane RN, MSc; Ostiguy, Gaston MD, MSc, FRCP(c)

doi: 10.1097/NHH.0b013e31824c2892

More than 1 million people in the United States use home oxygen therapy and its demand is growing. However, there are dangers associated with its use, such as burns and home fires, and smoking is the most common cause of these incidents. As a result, home healthcare nurses feel intense emotional distress when caring for patients who smoke while using home oxygen therapy. This distress arises from the nurse's competing sense of moral duties toward these patients. The purpose of this article is to describe this distress, then to propose a 3-step process of taking concrete actions to resolve the distress.

John W. Kayser, RN, MSc(A), is a Doctoral Student in Nursing Sciences at l'Université de Montréal and the Montreal Heart Institute, Montreal, Québec, Canada.

Diane Nault, RN, MSc, is from Service régional de soins à domicile pour malades pulmonaires chroniques, Maisonneuve-Rosemont Hospital Montreal, Montreal, Québec, Canada.

Gaston Ostiguy, MD, MSc, FRCP(c), is a Chest Physician at the Smoking Cessation Clinic, Montreal Chest Institute-McGill University Health Centre, Montreal, Québec, Canada.

The authors would like to thank France Paquet RN, MSc, and Franco Carnevale RN, PhD, for their feedback on this article.

The authors declare no conflicts of interest.

Address for correspondence: John W. Kayser, RN, MSc(A), 5000 rue Bélanger, Research Module Room R-2225, Montréal (Québec) H1T 1C8, Canada (

© 2012 Lippincott Williams & Wilkins, Inc.