Increasing complexity in critical coronary care nursing and advancements in medical technology have resulted in the need for clearly articulated competencies consistent with current practice. This need has been identified both in the literature and in practice. The problem addressed in this study was to determine what competencies, beyond basic nursing preparation, are essential for the beginning level coronary care nurse in order to provide safe nursing practice. A three-round modified Delphi Technique was used to elicit the authority opinions of 14 experienced clinical nurse specialists currently practicing in the coronary care unit. The nurse experts identified and verified the essential cognitive and technical skills required for nurses at the beginning level of practice in coronary care units. Nine domains and 63 competency statements were generated and refined. All were designed to be learner oriented, behaviorally described, and measurable. Implications are discussed for the design of an orientation program for beginning level coronary care nurses as well as implications for further research. / Ed. D.