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Leadership, Management, and Supervision in Health Care

This paper relates to a shadowing exercise that took place in a mid-sized hospital. The hospital is about five years old and is in the process of expanding to regional markets. I spent an afternoon shadowing the nurse and at the end of the day, we sat down for a thirty-minute interview. The first section presents the notes gathered in the preparation exercise and the insights gathered during the shadowing exercise. The second part presents a reflection on the experience.

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The action plan for the exercise was as follows.

  • First, I needed to identify a professional who is currently handling management responsibilities.
  • The second step was to secure an interview with the professional. I was open to either an interview with the professional, or spending some time shadowing the professional while at work.
  • Thirdly, I sent an advance copy of the questions I planned to ask during the interview.
  • The professional that I identified is the matron of a mid-sized hospital. She works as the Head of Patient Services in the hospital, and reports to the Nursing Director. Fifteen nurses report to her on a daily basis. Her main role is to ensure that the hospital’s clients get the care they need upon admission.
  • I had the opportunity to discuss the assessment with the matron a few days in advance. We held this discussion over the phone. In this discussion, I secured time with her for the assessment. I also discussed my expectations and the nature of information I needed. We agreed that I would shadow her one afternoon, and then hold an interview for about thirty minutes at the end of the day.
  • My personal objectives during the shadowing exercise were as follows.
    • First, I wanted to understand the role a leader plays in an organization. In my view, leadership is a skill that differs from the technical abilities of a professional.
    • Secondly, I wanted to see for myself what constitutes the daily activities of a professional. Thirdly, I wanted to develop a road map for my career growth based on the insights gleaned from the assessment.

The main questions I wanted to ask in the interview were as follows.

  • First, I wanted to know how the matron prepared herself for this role.
  • Secondly, I was interested in knowing how her current work differed from her original expectations.
  • Thirdly, I wanted to know what she would have done differently based on her current understanding of the demands of her job.

Results from the Discussion

  • The person I interviewed works as matron in a mid-sized hospital. The hospital offers both inpatient and outpatient services. In addition to medical care, the hospital also runs educational programs and community outreach programs. The matron supervises the implementation of nutritional programs, and diabetics programs that target young mothers and vulnerable people in the society.
  • The hospital also offers training for its patients. In her current role, the matron that I interviewed coordinates the work of the community workers attached to the hospital. This entails getting all information regarding the medical needs of vulnerable members of the community, and scheduling support activities for execution by community nurses.
  • The educational background of the matron is as follows.
    • First, she holds a Bachelors of Science Degree in Nursing. This gives her the requisite technical knowledge to manage the Department of Nursing Services in the hospital.
    • The matron also holds a Master’s Degree in Business Administration (MBA). This explains why the hospital appointed her as the Nursing Supervisor.
    • In addition, she has a certificate in customer care management. She acquired this certificate after her appointment as the nursing supervisor.

When I asked her why she chose this profession, she gave me two main reasons.

  • First, she stated that she had a passion for nursing since her days in high school. She felt moved by the work of nurses. In this regard, she chose to pursue a Bachelor of Science Degree in Nursing.
  • After she completed her first degree, she decided to pursue an MBA to give her the qualifications needed to become a leader in nursing.
  • The main role played by the Matron is to ensure that all the nurses have the resources they need to provide support for patients in their care. She also prepares the schedules used by the nurses and assigns shifts to the nurses.
  • The hospital also uses online tools to provide support for people involved in the outreach programs. The hospital has a mailing list consisting of all the people who register to benefit from the outreach exercise. The matron coordinates the work of the outreach nurses to ensure that they provide adequate information to the beneficiaries of the outreach program.
  • The Matron told me that she has to work with other supervisors from other departments to serve clients effectively. This is not very easy because of the differences in professional orientation of the other supervisors. For instance, the supervisor in charge of the Finance Department is an accountant. Nurses tend to act compassionately and therefore find it difficult to relate to other professionals who handle the business elements of the operations of the hospital.
  • The main thing that I learnt from this experience is that professional growth is a journey. The matron I interviewed did not arrive at her current position through a direct route. Rather, she grew into it.
  • After getting a Bachelors Degree in Nursing, the matron saw the need to register for an MBA and thereafter to get a certificate in customer care. This was a process of growth. The process required adjustments as she went along.
  • This is my main lesson from the interview and the shadowing activity. While I have set my professional goals, I should be ready to adapt as I go along, in tandem with the opportunities that come my way.
  • The role of the matron was in many ways similar to my expectations. What was surprising was the number of issues that are unrelated to the primary duties of the matron. I realised that the Matron also doubled up as the financial controller for the Nursing Services Department, as well as the administrator over all employee issues in the department. She approves leaves, and recommends nurses for promotion. In this manner, I realised that her day-to-day duties exceeded the ones I had in mind.


I chose to use Gibb’s Reflective Cycle to reflect on my experience during the shadowing exercise. Gibbs cycle has six stages. The six stages include description, feelings, evaluation, analysis, conclusion, and action plan.


The main events that took place were a shadowing exercise and an interview with the Matron in charge of Nursing Services in a mid-sized hospital. I shadowed the matron one afternoon and observed her at work. At the end of the day, I interviewed her in regards to her work and her professional development. My objective was to learn from her in order to plan for my own career development.


At the beginning of the exercise, I was feeling nervous because I could not predict how the exercise was going to unfold. I was wondering whether I was welcome, or whether I was a distraction to the matron because I was going to spend a lot of time observing her at work. However, I found the atmosphere to be cordial because the matron is an easy-going person. The shadowing activity went on very well and I am happy with the outcome. The interview was also very informative.

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The main aspects of the shadowing exercise that went on well were as follows. First, I was happy with the process and outcome of the shadowing exercise as well as the interview at the end of the day. Secondly, I learnt a lot during the exercise. The lessons I learnt exceeded my initial expectations. The two elements that did not work out were as follows. First, I underestimated the amount of time I would need to shadow someone in order to learn effectively. I prepared to shadow the matron for a whole afternoon. I now realise that this window was very small for useful shadowing. Secondly, I was not satisfied with the fact that I had no opportunity to see the Matron interacting with any other supervisor in the hospital.


My contribution in the failure to get more out of the exercise arose from underestimating the time I would need to form a more detailed picture of the duties of the matron. If I had known that one afternoon was not sufficient, I would have attempted to get more time to shadow the matron. I also feel that I should have insisted on observing at least one meeting between the matron and other supervisors in the hospital. On the issue of lessons learnt, I was surprised at how much I learnt within that short period. Observing the matron at work gave me a very useful frame of reference in regards to the duties of a middle level matron.


The main things that I could have done differently are as follows. First, I could have prepared better for the shadowing exercise by finding a time slot when the matron was busier. This would have given me a wider view of the activities handled by the matron in the course of the day. Secondly, I could have asked for more time to shadow the matron. I believe this would have enriched my experience.

Action Plan

The main things that I would do differently in the event that I have to shadow someone else are as follows. First, I would request more time to shadow the person. Secondly, I would try to shadow them on a busy day to ensure that I get the widest possible view of events in the day of the person being shadowed.

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