Changes in patients' care mandate that nursing care be amenable to change. With the advent of new technology, systems of care delivery are evolving. Blood transfusion practices that were once considered standards are being reexamined and redefined. Nurses, in their roles as patients' advocates and educators, must be cognizant of changes in practice and be prepared to deliver competent care. The effectiveness of techniques of bloodless medicine and surgery originally designed to serve the needs of Jehovah's Witnesses is accepted today, and other groups of patients are choosing this type of care. Furthermore, as blood conservation strategies are refined and perfected, they most likely will be used by a greater number of patients undergoing cardiac surgery. Specific guidelines have been developed for point-of-care service for patients undergoing bloodless cardiac surgery. Nursing care throughout the hospital stay, from preadmission to discharge, is tailored to meet these patients' emotional and physical needs. Quality comprehensive nursing care is required to make bloodless medicine and surgery programs successful.