Experiences With a Substitution System for Clinical Nurses' Leave of Absence: A Qualitative Study

Insufficient staffing often makes it difficult for nurses in South Korea to adjust their schedules when they have illnesses or other health problems, resulting in presenteeism. This study aimed to explore the experiences of the Acknowledged Care Expert (ACE) team as a substitution system for clinical nurses taking leave because of illness or health problems from the perspectives of ACE nurses, nurse managers, and shift nurses. We collected data for this qualitative study through individual in-depth interviews with six ACE nurses, a focus group interview with five nurse managers, and two focus group interviews with five nurses who shared their experiences with the ACE team. Thematic analysis of the data identified the following four themes: expected and unexpected benefits of the ACE team; challenges in operating the ACE team; characteristics and competencies required of the ACE team; and recommendations for the ACE program. The findings showed that the ACE team was highly valued and received positive feedback from colleagues and administrators with whom they worked. Such positive impacts were made possible by team members' clinical expertise and the collective engagement of both coworkers and team members. Further research to evaluate such substitute systems is necessary to establish a more stable and encouraging environment for clinical nurses, as well as for patient care.