The objective of this study was to examine the practical opportunities and challenges of using the advanced Excel VBA skills in resolving the unmet informatics need for nursing from the perspective of end user computing. Three information system projects, which were developed by clinical nurses using Excel VBA, were studied by the questionnaire based interview and word by word cording approaches which were designed based on the principles of qualitative study. The data and information of personal experiences and insights of clinical and head nurses during the process of developing the Excel-based projects were collected. The results show that the learning effectiveness highly relied on the availability and capability of technical tutors; the primary projects focused on improving the work performance; the most valuable rewards came from their superiors’ recognition and support; continuous technical support was generally concerned of; and the nurse programmer expected they could reallocate more of their clinical service hours to develop the projects. We found the head nurses could quickly understand the opportunities of using Excel VBA in nursing. The systems developed by the nurses did not only have better customized interfaces but also better meet their own informatics’ needs. The combination of the simplicity and powerfulness of a programming tool, the clear and stable system requirements, the assured availability of system developers and the supports from all related sources determines the success of nursing informatics projects. As a conclusion, having the advanced Excel VBA skills is valuable in nursing.