BackgroundMeeting employer expectations is a challenge for new nurse graduates and their nurse educators. Designing studies to collect specific data on hospital expectations and new nursing graduate deficiencies is needed.SampleHospital-based educators and preceptors (n=13) participated in one of two focus groups, to identify problem areas. Senior nursing students (n=64) participated in simulations developed from data obtained in the sessions.MethodsAudio-recorded focus groups were conducted with the goal to identify deficiencies in new graduate nurses. Recordings were transcribed and analysed using thematic analysis.ResultsHospital employer expectation themes identified include attending to basic patient needs, organisational skills, anticipation of risks and consequences, higher order technical skills, communication and ownership/accountability. Two simulations for senior nursing students were developed to address identified deficiencies.ConclusionDeveloping meaningful simulations which address deficiencies prior to graduation, in collaboration with potential employers, has the potential to lower the cost of graduate nurse orientation, improve patient outcomes, provide a greater sense of readiness to the graduate nurse and ultimately meet the needs of both the student and employer.