Modern matron struggling to fulfil role as leader

Researchers at the Institute for Science and Society say ‘modern matrons’ face organisational barriers to empowerment, and unless significant budgetary responsibility is made part of the role, personal skills alone may not be sufficient to sustain it and may not lead to achieving control over infection — the initial trigger for bringing back matron.

In a paper published in the British Journal for Infection Control researchers say there are gaps between aspirations and realities which may lead to problems in preventing and controlling infection.

Brigitte Nerlich, Professor of Science, Language, and Society, whose expertise lies in cultural foundations of expert and lay beliefs and attitudes to MRSA, said: “The research has shown that the modern matron does not always achieve the status of a ‘powerful figurehead’ who would be ’highly visible’ on the ward and who would have time and resources to effectively resolve issues in infection control.”

Using methods derived from linguistics and discourse analysis, researchers analysed policy documents and transcripts from ten interviews with modern matrons. By calculating word frequencies they were able to retrieve words frequently employed to prescribe responsibilities of the modern matron set out in policy documents and compare them with words used by modern matrons themselves to describe their vision of their role and responsibilities. This approach helped them to identify examples where matrons appear to disassociate themselves from the role of ‘an empowered manager’ who has control over human and financial resources to resolve problems in infection control efficiently.

Personified by Hattie Jacques in the Carry On films of the 1950s and early 1960s, matron was the formidable figure of authority on hospital wards until the 1970s.

Thirty years later as the National Health Service began to wage war on healthcare associated infections like MRSA and Clostridium difficile, ‘matron’ made a come-back.

Modern matrons were created in response to public demand for an authoritative figure that would not only provide clinical leadership, but who would also be easily identifiable, have close contact with patients and ensure delivery of care to the highest standards — ensuring prevention of hospital-acquired infections. The role was seen as enabling, rather than strictly authoritarian, using transformational leadership styles.

As part of an Economic and Social Research Council (ESRC) funded project entitled ‘Talking cleanliness in health and agriculture,’ which deals with MRSA and avian flu in the media, practitioner and public discourses, researchers at The University of Nottingham wanted to explore the impact of the ‘transformational leadership’ style in the role of modern matron with regards to infection control practices.

Nelya Koteyko, lead researcher, said: “The research was significant not only in terms of its findings but also in demonstrating the usefulness of methods from applied linguistics in social science research. Similar methods can now be applied to study other issues of public concern.”