The knives are already out in some quarters for American Beverly Malone, who beat post of RCN general secretary.

Her impassioned speeches blend management guruspeak with Deep South homilies.

But Oprah Winfrey will not be donning the ceremonial twinset and pearls to become general secretary of the Royal College of Nursing.

Instead, Dr Beverly L Malone BSc MSc PhD will be taking charge. Like Oprah, she was included in Ebony magazine's list of the 100 most influential African-Americans.

Dr Malone, twice president of the American Nurses'Association, an adviser to former US president Bill Clinton, and boasting a list of qualifications and honours as long as a very long string of pearls, takes over from Christine Hancock in June. She is expected to be ceremonially paraded before RCN members at Congress in May and will shadow Ms Hancock from next month.

By June, Dr Malone should have a UK work visa, be registered with the UK Central Council for Nursing, Midwifery and Health Visiting, and is likely to be spending some of her rumoured£100,000-a-year salary on finding somewhere to live.

With three months until she takes up her post, it is also hoped that she will not have to get involved in the embarrassing pay dispute which the RCN is having with its own staff. She will also leave it to Ms Hancock to give an RCN blessing, or otherwise, to industrial action planned by nurses at Oxford Radcliffe Hospitals trust in Oxford.

By June it is hoped that some of the seething resentment that followed her appointment should have died down.

Many were galled by the fact that the RCN thought it necessary to pay a team of international headhunters to fill the post.

Christine Hancock's deputy, Tom Bolger, and the RCN's head of policy, Pippa Gough, were both passed over for the job, as were a string of home-grown candidates.

Ms Gough resigned in protest. So, too, has Professor David Rye, vicechair of Bournewood Community and Mental Health trust and visiting professor at Southbank University and a fellow of the RCN.

He resigned his post at the college as a mark of protest at the appointments procedure. He says others share his concerns.

'I've resigned on a matter of principle, ' he said. 'It was politically naive to appoint someone from the United States. I find it unbelievable we can't appoint from the UK. '

He told HSJ: 'What makes me worried is I am not sure they would be adequately able to demonstrate they completed a UK search. '

But Dr Malone, 52, who is divorced with children at college in America, has many supporters.

And being a Clinton appointee makes her a natural ally of the Blair administration. York University visiting professor of nursing Ray Rowden describes her as 'brilliant'.

One RCN insider who has known her for 10 years says she is an 'inspirational speaker who reaches out to her audience'. He says much of her style comes from her Christian background in rural Kentucky. 'She grew up in the church and that is very important to her.

'That Southern church form of speech and presentation comes out when she is speaking. That makes people warm to her. '

While she is famously inspirational she does not go in for headon conflict. 'She steered some major changes when she was president of the ANA. She is the sort of person that wants to bring people along with her - she is not confrontational, ' the insider said.

But that is not to say that the RCN, government or doctors will be in for an easy ride. She wants more power for nurses, a greater say for patients and freedom for nurses to 'speak out for patients without fear of retribution'.

The RCN is traditionally thought of as an organisation that is conservative with a small 'c' so how will it cope with someone who speaks of nurses being able to 'deliver quality in the midst of chaos'?

'She spoke a few years ago and received a standing ovation - not many people get that, so I do not think she will have any problems, ' the insider says.

However, he admits that Dr Malone's approach is 'very different to the stiff upper lip British style'.

That is very true. The wise words of Dr Malone veer from the uplifting 'we need nurses who have power, and nurses have a lot of power but we just do not acknowledge it' to the sublime 'my job is to offer my vision'.

Malone: the CV

2000-2001: Deputy assistant secretary for health, Department of Health and Human Services, Washington DC.

1998-2000: Represented the US at the World Health Assembly.

1996-2000: Elected for two terms as president of the American Nurses'Association.

1986-2000: Dean and professor, school of nursing, North Carolina Agricultural and Technical State University.