Imagine nurses caring for several patients. One uses genetic testing results to decide about prophylactic surgery to reduce cancer risks. The second nurse modifies dietary habits on the basis of a genetic test result and prevents long-term effects from impaired metabolism of the amino acid phenylalanine. The third nurse cares for a patient who recovers from a narcotic overdose after a gene alteration that affects drug metabolism. Due to the significant advances of the Human Genome Project and related genetics research, clinical applications of genetic technology are moving into nursing practice. Resources are available to help nurses meet this challenge. The National Coalition for Health Professional Education in Genetics has issued a set of competencies that mandates new directions for nursing education and practice. To ensure that patients understand both the promise and the limitations of genetic discovery, it is imperative to ensure the competence of critical care nurses.