Learning to lead by listening: an autoethnographic reflection from my early months as a health and social care CEO

Background Transitioning into a new chief executive role within a large national health and social care provider prompted a period of systematic observation and deliberate reflection. Drawing on Schön’s concept of the reflective practitioner, I kept a journal during my first months to capture critical moments that tested my assumptions and revealed how organisational culture shapes leadership behaviour. Reflection This autoethnographic account integrates observation, intentional listening and reflective journaling to explore how leadership meaning is constructed in everyday practice. Six anonymised vignettes are presented, spanning board discussions, governance meetings and frontline encounters. Each vignette illustrates tensions such as silence vs intervention, urgency vs empathy and authority vs collaboration, analysed through frameworks including adaptive, situational and collective leadership, as well as psychological safety, motivation and organisational culture. Conclusion The reflections show that leadership is not confined to formal authority but emerges in presence, tone and everyday interactions. They demonstrate how listening, humility and adaptive behaviour foster psychological safety and collective leadership. While situated in health and social care, the insights are transferable to leaders at all levels and across sectors facing complexity and uncertainty.