Nurse managers/leaders serve as first-line individuals responsible for enforcing changes in care settings. In the recent years, the role that nurse leaders play has grown in importance than any other time in history because of the rising demands for cost reductions, rationalization, reduced hospital stays, and the numerous progresses realized in medical technology (Murray, 2017) . Since the duties that nurse managers undertake are growing, diverse strategies have been deployed to improve the capabilities of nurses in instituting changes. Various countries have improved leadership programs of nurse managers (Xu, 2017) . In the U.S., for example, the government has instituted measures of establishing transformational leadership in the nursing environment. This has played a critical role in improving the nursing quality while at the same time having positive influences on the work environment. Other initiatives have revolved around approaches for developing leadership, particularly requiring nurse administrators to be certified (Kodama & Fukahori, 2017) . Furthermore, nurse leaders are required to rotate wards periodically to boost the services that nurses offer, enhance quality of care delivered, and encourage nurses to develop their careers (Murray, 2017) . Prior research reveals that such efforts show the capabilities of nurses in fostering change (Kodama & Fukahori, 2017) . Thus, the paper focuses on interview carried out on a nurse/manager at Princeton Health to understand the issues affecting nurse leaders, strategies of dealing with the issues, and evaluate the practices of nurse leaders/managers in terms of theory.
Choice of Nurse Leader/Manager Characteristics
In selecting the nurse leader/manager from Princeton Health, certain characteristics that classify the person as a nurse leader/manager prevail (Murray, 2017) . Firstly, the leader should show traits of self-awareness. To emerge as an effective leader, individuals should have the capacity of reading their own emotions and comprehend the manner in which their emotions influence others. The leader understands that the manner in which leaders react to emotional issues and stress affect how the team performs. Secondly, the leader emphasizes on time management. Here, two major ways prevail for managing time effectively. These comprise of ensuring that the work area remains organized. It is also essential to plan the day and create time for unexpected occurrences. In addition, it is essential to focus on prioritizing tasks to ensure that the vital ones are finalized first. Thirdly, social awareness is a vital trait to consider. The manager understands the importance of establishing good skills in social awareness, such as active listening and understanding emotions of subordinates and peers (Donner & Donner, 2016) . These play a critical role in attaining the trust of the workforce.
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Fourthly, there is a need for having skills for managing relations in the healthcare setting. The manager agrees that leaders should ensure to utilize their skills in relationship management to allow them to inspire others and boost their potential while addressing emergencies and conflicts and while managing project. Distinct individuals derive motivation from different sources while not all people would respond or perform in the same manner as others when in the presence of workplace pressure and environmental stressors. Leaders need to utilize approaches that the team would consider motivating while exercising flexibility to ensure that the entire team is included (Murray, 2017) . Furthermore, when establishing leadership skills, such as interpersonal and practical, individuals should make sure they remain authentic, create their unique styles, and respect the strengths they have. They should think of the things they represent and ways of communicating them effectively. In addition, they need to portray authentic commitment to listening and learning as well as receiving and giving feedback (Donner & Donner, 2016) . Doing so allows leaders to emerge successful in their leadership endeavors, especially when dealing with diverse teams.
Mission and Vision of Organization
By contacting the nurse leader/manager at the institution, a two-hour face-to-face conversation takes place while it discusses the mission and the vision of the organization. For the mission of Princeton Health ’ s, revolves around serving as the center for delivering all-inclusive healthcare within the community that addresses the diverse healthcare requirements of the individuals that reside in the area that the organization serves. Princeton Health offers outpatient and inpatient care, medical education, community health learning, and promotes scientific and medical research when deemed appropriate. The institution also embarks on improving the quality of the services delivered to its patients continuously (Princeton Health, 2018). It does this to ensure that all patients receive adequate care.
About the vision, Princeton health serves as a premier and integrated health institution, which is driven by the urge for addressing the diverse healthcare needs of patients residing in Central New Jersey and other areas by offering amazing clinical care. The institution has received recognition based on the commitment it portrays in terms of boosting the community ’ s health, ensuring that clients receive superior services, offering amazing value, availing unique health and medical education, adopting innovations in healthcare, and promoting a skilled, knowledgeable, and caring employee and medical staff (Princeton Health, 2018) . Here, the mission and vision of Princeton Health play a crucial role in allowing the institution to deliver optimal care to its diverse client base in the areas that it serves.
Allocation of Resources
During the interview, we discussed the manner in which the nurse manager allocates the human, fiscal, and other resources within the institution. The leader revealed that the resource allocation approaches revolved around three major levels. The initial level was the policy level. This entailed providing the society with the opportunity of determining strategies of allocation via plans of health insurance, legislation, and government financing requirements. Here, the macro-allocation approaches entailed regulating resource allocation openly and directly. The second level of allocation revolved around the organization. The decisions were made by utilizing policies, protocols, and clinical allocation procedures. For instance, certain acuity scores were utilized to assess the resources that the nurses needed while prioritizing them based on the severity of the conditions of the patients. Thirdly, the micro-allocation approaches concerned where the leader needed to decide whether a treatment or investigation matched the requirements of the clients. The value of the treatment and investigation would then be balanced with the strategies of distribution (Ransom & Olsson, 2017) . These approaches allowed the nurse leader to avoid any conflicts regarding resource distributions.
Impact of Changes on Nurse Leader/Manager
The diverse changes occurring within the organization affected the nurse leader in various ways. The institution witnessed significant rise in costs whereas health corporatization has resulted to the transformation of the healthcare sector. As a nurse leader, the manager needed to offer care while at the same time making sure that patients realized positive outcomes despite lacking sufficient resources. For instance, there was insufficient time available for spending with dwindling budgets and every patient. As such, the nurse leader saw the need for establishing realistic approaches and plans that would foster effective care while utilizing the existing resources, including employees and equipment. The leader also argued that additional skills were needed in budgeting, organizational leadership information technology, and human resources reduce the increasing costs and improve patient outcomes effectively (University of Saint Mary, 2018) . Here, the process of acquiring all these skills presented numerous challenges to nurse leaders, hence the need for devising measures of addressing them.
An additional challenge that the nurse leader faced because of changes was related to ethical issues. As technology and medicine advance, humans direct their attention to ethical implications. For a nurse leader, it is vital to have sufficient understanding of different ethical principles, have awareness concerning the existing resources based on how they are related to ethics, deploy them in real care environment, and learn ways of communicating them to patients, nursing staff, and the families of the patients. Because of the diverse changes, the nurse faced various challenges on matters related to education, consultation, and development and review of the policies (University of Saint Mary, 2018). The changes posed challenges in communicating information effectively, thereby creating hindrances of ensuring that effective policies were put into practice.
Difficulties Faced by Nurse Leader and Approaches for Alleviating Them
The nurse leader revealed to experience various challenges within the organization on matters related to team building, delegation, quality management, risk reduction, and technology. For instance, whereas team-based care can assist healthcare organization to improve care at sustainable costs, most of the reforms in the care sector posed challenges in coping with them (Murray, 2017) . The nurse leader was forced to address the distinct problems among the team members who came from distinct backgrounds (University of Saint Mary, 2018). Hence, since the team members were diverse, the intense heterogeneity presented challenges to the manager in terms of defining optimal healthcare.
The nurse leader also experienced challenges in clarifying the team ’ s purpose. Whereas a team ’ s purpose might appear self-evident, it ends up being overlooked. This breaks up the spirit of the team members. This is mostly due to failure to talk about the purpose of the team for each identified opportunity. Individual purpose revolves around the reasons as to why people undertake certain tasks and why they prefer serving as nurse workers (Murray, 2017) . In the viewpoint of the nurse manager, challenges emerged in encouraging the team members to utilize their energy in handling the problems facing the organization. In this perspective, therefore, hindrances emerge in delegating tasks, managing quality, and reducing the risks that patients in the healthcare setting (University of Saint Mary, 2018). Hence, the nurse leader needed to embark on ways of handling the issues before they got out of hand.
Dealing with Challenges
To deal with the diverse challenges faced, the nurse leader should ensure that patients contribute to healthcare teams and operations. As opposed to perceiving patients as passive care recipients, patients can contribute as active members of a team in the healthcare setting (Murray, 2017) . In literature targeting patients, certain authors have realized that patients have the capacity of making significant contributions in terms of identifying where errors emerge and can therefore hinder errors from taking place in the future. Still, various organizations struggle with ways of incorporating patients to serve as proactive team members (Kodama & Fukahori, 2017) . In this case, the leader agreed on the need for incorporating the insights of patients to address the diverse challenges faced in a healthcare environment.
Flexibility and accountability of teams make it possible to address the diverse challenges that organizations face. Leaders can focus on welcoming the viewpoints of the team members on how to meet flexibility in the healthcare setting while at the same time making sure they remain accountable for the outcomes and actions they undertake. They can realize this by establishing clear accountability lines and leadership tasks. However, they should refrain from equating leadership with the process of making decisions in the healthcare setting. In certain cases, the patients might serve as the ones taking the lead. Leaders should also make sure that their team members receive significant training. They should also ascertain that the institution revises educational approaches to enhance a teamwork spirit (Kodama & Fukahori, 2017) . Here, by making sure that nurses complete their training, the leaders would able to support collaborative work environments via inter-professional practice and education.
In addition, the leaders should share the major values driving the organization among the members of the team, including discipline, honesty, humility, creativity, and curiosity (Murray, 2017) . These would play a critical role in guiding operations within the organization, hence leading to shared goals, effective communication, mutual trust, clear roles, and measurable outcomes and processes (Ericksen, 2015) . For the nurse leader, therefore, it is essential to confirm that the organization supports these principles and values to assist in eradicating any issues that might affect the performance of the organization negatively.
Effects of Diversity among Staff and Patients
Diversity within the healthcare setting has various effects. When looking at the present workforce, for instance, it comprises of various generations. When it comes to nurse leaders, they are required to manage patients and nurses having distinct work habits, attitudes, and styles of communicating (Murray, 2017) . The nurse administrators are forced to learn ways of identifying the differences that prevail between the generations. This would allow the nurses from distinct generations to have the capacity of communicating in a clear manner concerning habits and expectations (University of Saint Mary, 2018). As such, it would be possible to eradicate incidences of conflicts among them and with the patients
The diverse range of experience and ages among nurses serves as an asset. However, this is essential when the nurse leaders are able to eradicate hindrances to learning and collaboration among the team members. For instance, older nurses can educate younger nurses because they have significant experience in dealing with probable issues and older problems. In addition, the younger nurses can educate the older nurses about newer as well as effective ways of offering care to patients (Murray, 2017) . Furthermore, nurses having solid leadership and interpersonal skills are capable of establishing environments and opportunities whereby individuals from diverse generations can feel appreciated based on the efforts they apply to grow and learn (Ransom & Olsson, 2017) . In supporting such an environment, nurse leaders would make it possible for nurses to offer effective care to patients while at the same time making patients to appreciate the care offered.
Recent Change on the Unit
The recent change witnessed at Princeton Health revolves around where UPHS (University of Pennsylvania Health System) acquired it. This served as a major initiative aimed at boosting access to care in the entire region. Before, Princeton Health, which comprises of the Princeton Medical Center, which is a major New Jersey ’ s teaching hospital, was assessing opportunities of making sure it realized future successes. However, it revealed it would collaborate with UPHS. The process took place in 2016, making it possible to access highly specialized care. The key benefit attributed to the partnership comprised of easier and increased access to care in the event of sophisticated situations, innovative trials, vital technologies, and advances in the medical care and specialized care providers. These played a critical role in improving the experiences of the patients at Princeton Health. It also provided an avenue for provision of superior treatment for a broad range of health situations (Shulkin, 2018) . Thus, the change was a key contributor to improved performance of Princeton Health.
Personal Attributes of a Nurse Leader
The interaction with the nurse leader made it possible to identify several personal attributes of a nurse leader. Nurse leaders should exercise strong communication to allow them excel in the nursing environment, but is usually crucial in leadership initiatives. When dealing with diverse health care professionals daily, individuals should be able to communicate their needs, strategies, and instructions easily and, clearly (Murray, 2017) . Nurse leaders should also be able to delegate. Leaders need to understand their team members thoroughly and trust them. The reason for this is that they are not capable of doing all things on their own. Each individual has weaknesses, strengths, and specialties. When nurse leaders are able to delegate tasks based on their understanding of the team members, they can provide others with an avenue of becoming more efficient in the tasks they undertake. Making informed choices when delegating can play a vital role in improving overall patient care (South University, 2014). These would allow the team to remain happy and utilize their strongest skills to meet organizational goals.
Exercising empathy serves as an additional attribute that nurse leaders should portray. They apply empathy to team members when interacting with them. Leaders understand the pressures and stress that nurses face when performing their duties. The reason for this is that they have been there before. Thus, nurse leaders should allow this understanding to serve as a guide based on the manner in which they interact with people who approach them while having a certain issue (Murray, 2017) . Moreover, nurse managers should be able to address conflicting situations. They should be able to apply a proper approach for addressing conflict once they identify it. They should be comfortable when facing problems to allow them to control the issues before they become uncontrollable (South University, 2014). By understanding ways of handling conflicts and offer constrictive criticism, leaders would be able to establish strong teams, which would be committed to working efficiently within the organization.
Skills/Attributes in Professional Nurses
When it comes to professional nurses, they portray certain values, which are accorded significant value in the healthcare setting. For instance, flexibility is a valuable trait because it makes it possible to prepare for unforeseen occurrences. Changes during the last minute keep interfering with heavy paperwork, workloads, patient ’ s families, and physicians (Murray, 2017) . The capacity for adapting to the ever-evolving nurse schedule provides them with an opportunity for realizing success. Therefore, professional nurses should have mental flexibility to allow them to devise alternative ways of addressing challenges that occur on a daily basis and allow each person to remain happy (Ericksen, 2015) . Here, lack of flexibility poses challenges for nurses in keeping up with changes that might take place in the healthcare setting
Professional nurses should also have the ability to think creatively. A critical and sharp mind plays a critical role in allowing nurses to succeed in the field. Nurses should have the capacity for evaluating situations and make vital decisions instantly (Murray, 2017) . In the nursing environment, various treatment options prevail, indicating that critical thinking plays a critical role when it comes to assessing situations and determining the ideal solution that should be implemented, they should be able to come up with the best resolutions to issues, especially when experiencing tremendous pressure (Ericksen, 2015) . Thus, critical thinking skills are vital in the nursing field.
In addition, the desire for learning makes professional nurses realize increased value in the healthcare setting . Nurses are avid learners while at the same time curious to undertake their duties in the healthcare settings effectively. Attaining a nursing degree does not indicate that they are not students anymore (Murray, 2017) . Effective nurses are the ones who keep exploring, questioning, and developing in their entire careers. Since the medical profession is always evolving and realizing numerous changes, nurses should be adequately prepared by ensuring that they continue learning (Ericksen, 2015) . To realize these, they should make sure to ask questions always to allow them to learn new things in the profession, which would allow them to become more productive and efficient in their tasks.
Conclusion
In conclusion, nurse managers/leaders play a critical role in enforcing changes in care organizations. The interview with a nurse leader from Princeton Health made it possible to identify various things that affect the profession. Nurse leaders should portray certain traits to allow them to be classified as administrators. The interview also made it possible to understand the mission and vision of Princeton Health and the manner in which the nurse leader allocated various kinds of resources within the institution. Diverse changes also affect the roles that nurse leaders undertake while they also face certain challenges in undertaking their daily operations. Furthermore, diversity has significant impacts on the staff and patients in healthcare organization. The recent change that occurred in the organization also contributed to positive impacts at the institution. Therefore, the paper provided an avenue of understanding the attributes of nurse leaders and the skills/attributes that influence professional leaders. These have considerable influence on how they handle their duties.
