This article is the second of a three-part series describing a project undertaken by a task force at the National Institutes of Health Clinical Center, a 541-bed research facility in Bethesda, Maryland. The task force's purpose was to develop a Management Progression System for Nurse Administrators. Part 1 depicted the actual work of nurse administrators according to their managerial responsibilities, defining such work as decision making. This second installment singles out the skills and competencies required for effective decision making at each of three basic levels of managerial responsibility.