my brilliant career - nurse management - After a 30-year absence, patients are welcoming matrons back to hospital wards. But how does the role, with its historic baggage, fit in with the demands of modern management, asks Lyn Whitfield

Published:25/04/2002, Volume II2, No. 5802, Page 30 31

Name: Marjorie Small Title: Matron for haematology/oncology, Birmingham Heartlands Hospital Age: 50 Salary:£27,700.

What do you think of the 'modern matron'?

I have mixed feelings. When I first read about it, I went to our head of nursing and said I wanted to be one because it fitted with my ideas of the way forward for nursing. And it has been well received by patients and staff. But the other side is that the old, negative persona of matron is there: all starchy and stiff. When we had the launch at Birmingham Heartlands it was a really nice day, but the press couldn't help mentioning Hattie Jacques.

How have staff and patients reacted?

Staff know there is someone to go to for support, someone who will take a pro-active approach towards patient care and get things done. Patients love it. I got called to see four of my patients recently because they had trouble with their toast. It was made of thin-sliced bread and became very hard. The solution was to use thicksliced bread. When I went back, they were very happy. I can do things like that: things I was doing anyway, but now there is a bit more belief from patients and relatives that things will be done.

Describe your job:

My operational responsibility is for the haematology and oncology unit. At the moment, we are going through a very exciting time because the two specialties are merging and moving into a new building. I get little clinical hands-on input, although I like to keep my hand in and maintain my clinical credibility.

But my office is right on the ward.

What was your career path?

I started as an enrolled nurse back in the 1970s and fought for years to get my RGN. Then, finally, in 1989, I was given the opportunity to take part in the first conversion course here at the hospital. There were just 15 of us: the same number as Florence Nightingale started out with.

Then I did a diploma and two years later I took up a junior sister post. Since then I have done a diploma in management and various other specialist courses. In 1996, the ward manager post in haematology was advertised. I wanted to go back to haematology because it was my first love, and much to my surprise I got it.

What is so special about haematology?

It is the type of patients we have and the type of nursing. You really get to know people and their relatives over a long time. They almost become friends, although you have to keep a certain professional distance. There is also a core group of staff here from when I was a junior nurse, which is nice to have.

What skills do you bring to the job?

I like to think I am approachable and a good people manager. I like to get staff involved in the running of the ward; it gives them a sense of value and commitment. I also like developing people. It gives me a sense of achievement to see people doing well and making a difference.

What has been the high point?

The high point was getting my RGN because since then the sky has been the limit. Without it, I would not be where I am today. On a personal level, the high point was the birth of my grandbaby. I cannot remember life before her.

And the low point?

We get some every day. But I think my lowest point was a couple of years ago, when I had to take a member of staff through the disciplinary process and she was dismissed.

What else might you have done?

Years ago, I wondered about being a designer. I fancied designing clothes and making trips to Milan and places like that. But I did not have the talent. My talent is with people. I couldn't imagine just sitting at a desk and doing the books.

How do you relax?

I enjoy going out and having a nice meal with friends. There is my quest to lose weight, which has been going on for some years now. I also have a new flat that I am decorating - I want to stamp my personality on it.

Do you have any careers advice?

Nursing has got a negative image because people used to go into it because they wanted to care for people; now they are looking for a career. It can be a very rewarding job and it is getting better paid now. My advice is to persevere. If you want something, keep on going until you get it. You have to believe in yourself. l Just the job Title: 'Modern matron'.

Salary: I grade: about£30,000 per year.

Numbers: 500 had to be in place by April.

Status: According to health secretary Alan Milburn, the clamour for matron was so loud during consultation on the NHS plan that she had to be brought back 'after an absence of 30 years'.

What's the job? Modern matrons are part of the government's stated aim to deliver 'more power to frontline staff ', with a remit to sort out cleaning and catering, drive up standards, resolve problems and empower nurses.

Defining characteristics: The Royal College of Nursing says the initiative is being implemented in diverse ways.

Some trusts are giving senior nurses the title, without changing their jobs very much. Others are creating exciting posts but not using the title. There is still concern that 'matron' is 'retrogressive' and, indeed, 'sexist' - there are male modern matrons.

Future prospects: A further 1,500 modern matrons must be appointed by April 2004.