The provision of trained preceptors, orientation and supernumerary time on the ward/unit all assist the early graduate and provide a supportive environment.

Support is best provided in the first four weeks and with each clinical rotation.

Providers of best practice EGP need to consider coverage by experienced staff for supervision of early graduates especially out of hours.

Provision of a best practice safe, learning environments lowers the likelihood of graduates making mistakes.

If clinical skills and competencies are part of the graduate program, ensure that these are achievable.

EGP providers that encourage nurse unit managers to foster a relationship with new graduates on their unit assist the graduates to feel part of the team.

Best practice EGP monitors graduates for signs of isolation, alienation and stress,

Group debriefing sessions provide effective psychosocial support

Provide early graduates with  education and protection from harassment, criticism, unfair rostering and excessive demands 

Review of graduate programs throughout Australia suggests that supportive clinical environments in practice settings could be as effective as formal transition programs.

Adequate support has been proven to ease anxiety for early graduate nurses and enhance job satisfaction. Other studies have proven that support is critical to transition and integration to the hospital. It is best provided in the first four weeks of the program and again with any ward rotation.

All studies showed that preceptors play a key role in developing confidence and competence in nursing graduates. It has been suggested that the provision of preceptors can influence significantly the graduates job satisfaction and completion of the graduate program. There is evidence that adequate support leads to confidence and satisfaction with the RN role.

Experienced staff and trained preceptors assist the early graduate to feel safe and increases graduates ability to consolidate their skills.

Graduate nurses need to be able to ask questions and not discouraged from seeking direction when they need it. Provision of a good learning and safe environment assists with lowering the likelihood of graduates making mistakes.

There is some evidence to suggest the nurse unit managers are viewed as leaders by new graduates and very influential in setting the tone of the work environment.

Research outlined in the Sweeney Report 2006 described a supportive culture as

• nurturing
• allows time to learn
• clear objectives
• provides feedback on performance
• peer and mentor support

A qualitative study of group debriefing demonstrated that these sessions provided nurses with peer support and a sense of belonging. It also assisted with developing confidence in nursing competence.

Australian Universities Teaching Committee Report found the key goals of a transition to work was to increase intrinsic motivation, socialisation into the role and resultant increased job satisfaction; It suggested these requirements were better addressed by creating a supportive work environment.

Cowin, L. S. (2001). Measuring nurses' self-concept. Western Journal of Nursing Research, 23(3): 313-25.

Cowin L S, The effects of nurses job satisfaction on retention: An Australian perspective. Journal of Nursing Administration, 2002. 32(5): p. 283-291.

Levitt-Jones, T and Fitzgerald, M 2005, A review of graduate nurse transition programs in Australia, Australian Journal of Advanced Nursing, vol.23, no.2, pp. 40-45.

McKenna, L and Newton, J.M, 2008 After the graduate year: a phenomenological exploration of how new nurses develop their knowledge and skill over the first 18 months following graduation, Australian Journal of Advanced Nursing, vol.25, no.4, pp. 9-15.

Evans, J and Boxer, E and Dr Sanber, S 2004 The strengths and weaknesses of transitional support programs for newly registered nurses, Australian Journal of Advanced Nursing, vol.25, no.4, pp. 16-22.

National Nursing Research unit, Kings College London, Policy 2009, Providing preceptorship for newly qualified nurses: What are the components of success?, issue.16, http://www.kcl.au.uk/schools/nursing/nnru/policy.htm

Clare, J., Edwards, H., Brown, D. and White, J. 2003. Learning outcomes and curriculum development in major disciplines: Nursing phase 2 final report: Australian Universities Teaching

Sweeney Research report prepared for Victorian Department of Human Services, Qualitative Research on Allied Health & Nursing Graduates. Reference No 15790- May 2007