There are a lot of leaders going round having visions but I think

There are a lot of leaders going round having visions but I think they are hallucinations The words are there but the behaviour is not… Imposed stress is when someone has the audacity to give it to you. You put it back in the box, tie it up with a ribbon and send it back labelled ‘wrong address’.”Her love of performance can be traced back a long way. She was raised by her great grandmother in the small southern town of Elizabethtown, Kentucky, after her mother took her six younger siblings to Louisville, leaving her eldest daughter behind. Her great grandmother, known to all as Miss Addie, had high expectations and Beverly did well in her all-black school until it was integrated when she was 12.”Suddenly I was in a bigger pond. My biggest disappointment was that I knew I was never going to be a cheerleader. There were no black cheerleaders in white schools at that time,” she told an interviewer.Four decades later, after obtaining three degrees, a series of academic posts and the presidency of the American Nurses Association, she has realised her ambition by becoming cheerleader for the biggest nursing organisation in the world.

The RCN has 340,000 members, and in a profession not noted for its oratorical skills, she shines.Her critics point out, however, that running the RCN, a labyrinthine organisation with many competing factions and interest groups, demands more than oratory. It demands a vision of the future and some idea of how to get there It demands ideas and policies. It demands insight, adroit management and rat-like cunning.On these fronts, Ms Malone has still to prove herself. That means nurses being prepared to take over work that has traditionally been the preserve of doctors, such as prescribing, while healthcare assistants take on more nursing tasks.Some argue that the changes required are yet more radical, involving a fundamental shift in the power relations between the staff groups to end the excessively hi-tech medicalised approach to care in the 21st century and switch back towards a lower-tech approach with greater emphasis on providing emotional and practical support alongside the new drugs and treatment that will become available.But the long-term future of the NHS is not the only concern There are also practical matters. The RCN is a major business enterprise with 800 staff and a turnover last year of £54m.

Ms Malone has not, so far as anyone can tell, had experience of running an enterprise on this scale before. She was dean of the school of nursing at North Carolina University from the mid- to late-90s, but she has otherwise held academic posts and served on advisory bodies and as president of the American Nurses Association (where, to be fair, she is credited with driving through a series of reforms).Last week she had the bruising experience of finding her attempts to reform the RCN flung back in her face. Her proposal to streamline the management structure by creating three new deputy posts, each with a salary of £70,000-£90,000, and reducing the number of people who report directly to her from the present 16 outraged the RCN council, which she failed to consult.The staff body of the RCN has taken out a grievance procedure against her, and the former RCN president, June Clarke, condemned the manoeuvre in a speech to congress. Ms Malone was accused of “misreading our national culture,” “doing things in an American way” and causing “serious concern”.Oddly, although she was present throughout the debate on Wednesday afternoon, she didn’t speak or offer any public defence of her actions. Indeed, observers say she seemed ill at ease in the early part of the week, though she relaxed later, as if still uncertain as to which buttons to press to get the right response.

She faces a tricky task to win back the confidence of those whose feathers she has ruffled, although she may have to pluck a few more if she is to get a grip on the unwieldy college.These are still early days for Ms Malone, but she cannot afford to dawdle Time for her and the NHS is running out. The political battle has, temporarily, been won, and billions in extra cash is flowing into the service. The challenge now is to deliver the necessary change and ensure that every pound counts. If the Government is to pull off its huge gamble, everything now depends on the vision, calibre and drive of people like Beverly Malone The honeymoon is over – now the real work begins. Life storyBorn: August 25, 1948, Elizabethtown, Kentucky.Parents : Dorothy Black, an auditor with the Internal Revenue Service, and Frank Malone, a train driver Five sisters and one brother Family: Married John Manuel 1972 (divorced 1978) Two children; Tosha (aged 27) and Jelani (25).