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Nursing leadership & followership reflections on the importance of followers.

I contend that if you want to be a great leader, you must first become a great follower.

~John Hyatt

One of the most sacred relationships among teams of people is that between leaders and followers. This relationship, so central and crucial, depends to an extraordinary degree on the clearly expressed and consistently demonstrated values of the leader as seen through the special lens of followers. (i) We know this to be true and yet an enormous amount of research, thinking and writing has addressed issues relating to leadership, much less attention has been paid to followership. In a quick internet search of both terms, leadership yielded 755,000,000 results and followership, 578,000 results. This seems a rather perplexing oversight as it is difficult to imagine leadership without attention being paid to the followers for there is a widespread perception that to succeed at leadership one must first master followership. Aristotle has been quoted as saying, He who cannot be a good follower cannot be a good leader.

The motivation for writing this article was to explore the connection and relationship between leaders and followers and move away from my preoccupation with leadership. It began with the question: "What is followership?" Gibbons and Bryant (2012) define followership as a social relationship between the leader, followers and the group. (ii) It is not subservience or passive obedience to orders. Rather it is a process whereby followers engage in constructively critical thinking, and interact with and support the leader to help achieve a task. Good followers are accountable for their actions. They can also influence and mold the leader's views. When necessary they can substitute for the leader.

What distinguishes an effective from ineffective follower is enthusiastic, intelligent, and self-reliant participation--without star billing--in the pursuit of an organizational goal. Effective followers differ in their motivations for following and in their perceptions of the role. Some choose followership as their primary role at work and serve as team players who take satisfaction in helping to further a cause, an idea, a product, a service, or, more rarely, a person. Others are leaders in some situations but choose the follower role in a particular context. Both these groups view the role of follower as legitimate and inherently valuable, even virtuous. (iii)

By walking in the shoes of a follower one learns the sometimes startling differences between the perceptions of leaders and everyday realities of followers.

~Max DePree

Following provides a complex dilemma because our society incorrectly stereotypes followers in a condescending manner as docile, passive, obedient, conformists, indifferent, weak, dependent, unthinking, failures, and helpless. (iv) Fortunately in the nursing profession there is a movement to abandon those stereotypes progressing into the awareness and understanding that followers are vital to ensuring the success and strength of the nursing workforce. Whitehead, Weiss and Tappen (2007) offer that being an effective follower is as important to the new nurse as is being an effective leader. In fact, most of the time most of us are followers as members of a team, attendees at a meeting, staff of a nursing care unit, and so forth. (v) Significant shifts in technology and culture have changed that dynamic, giving followers more power. And there's a lot you can learn about being a good leader by learning to be a good follower. (vi)

Followers are more important to leaders than leaders are to followers.

~Barbara Kellerman

According to Robert E. Kelley, who has conducted extensive research on followership, "Effective followers think for themselves and carry out their duties and assignments with energy and assertiveness. They are risk takers, self-starters and independent problem solvers. Effective followers can succeed without strong leadership. Furthermore, effective followers are critical thinkers who will allow their talents to be utilized, but who will refuse to be used and abused by leadership." (vii)

Followership is not only about the individuals who follow within a team; it is about the relationship between these individuals and their leader. A good leader is responsible for creating an environment conducive to an exemplary followership style. In creating such an environment the leader should be prepared to:

* Explain why

* Welcome challenging questions

* Seek regular feedback from members of their team

* Delegate responsibility

* Utilize the expertise within their team

* Lead by example

* Know their team

* Share the credit with the entire team. (viii)

When I think about those who devalue followership and fail to make its connection to leadership, I get visons of their impending flawed leadership running through my head and the unnecessary suffering and agony of those who will be tasked with trying to follow them.

~ Terina Allen, ARVis Institute

It is believed that 70% of our lives is spent in the role of follower. Even so, the focus in formal education and seminars remains leadership issues because of the unfavorable stereotypes that accompany the term follower. Nurturing effective followership requires doing away with the misconception that leaders do all the thinking and followers mindlessly heed orders. Can followers and leaders ever be deemed separate but equal? It is vital to understand that, without effective followers in nursing, our leaders face severe limitations. Current leaders and educators must share and promote the vision of enlightened followership if nursing is to achieve its potential. (ix)

Reflection on the Importance of Followers

Needless to say this was an eye-opening journey researching the importance of followership. I was amazed that it had taken me so long to fully explore this subject. Followership is personal and professional. On any given day at any given moment nurses are changing their roles as leaders and followers depending on the situation. If healthcare organizations want nurses to invest their time, energy and talents in the success of its vision, mission and values, the organization must invest in developing positive relationships between followers and leaders. It is the essence of the 21st century work contract. It is a two-way agreement between leaders and followers. Organizations must see followers as assets and invest in nurturing those assets by being partners in helping build each nurse's knowledge, skills and behavioral effectiveness. In this challenging healthcare environment, common sense dictates that the most successful organizations are those that recognize the importance of understanding the nature of the follower's role and the human qualities that allow effective followership to transpire.

I am reminded of how hollow the label of leadership sometimes is, and how heroic followership can be.

~Warren Bennis

Priscilla Smith-Trudeau MSM RN BSN CRRN CCM HNB-BC is an author, speaker and healthcare leadership management consultant specializing in workforce diversity. Priscilla's fascination, research and consulting has been focused on understanding nursing work group culture.

Characteristics of Effective Followers

They see themselves as the equals of the leaders they follow.

They manage themselves well.

They build their competence and focus their efforts for maximum impact.

They are courageous, honest, and credible.

They do not have to be on constant observation. They are enthusiastic, well balanced, and responsible.

They are committed to the organization and to a purpose, principle or person outside themselves.



(i) De Pree, M. (2008). Where do ethics and leadership intersect? In Leadership jazz: The essential elements of a great leader (p. 126). New York: Doubleday.

(ii) Gibbons a, Bryant D, Followership: the forgotten part of doctors' leadership, BMJ Careers, 19, Oct. 2012. Retrieved August 10, 2016 from: http://www.medicalprotection. org/uk/casebook/casebook-may-2013/followership-theforgotten-part-of-leadership

(iii) Kelley, R. (1988), In Praise of Followers, Harvard Business Review. Retrieved August 10, 2016 from: https://hbr. org/1988/11/in-praise-of-followers

(iv) Raffo, D. (2013), Teaching followership in leadership education, Journal of Leadership Education Volume 12, Issue 1, 263

(v) Whitehead, D. K., Weiss, S. A., & Tappen, R. M. (2007). Essentials of nursing leadership and management. Philadelphia: F.A. Davis.

(vi) Kellerman, B. (2008). Followership: How followers are creating change and changing leaders. Boston, MA: Harvard Business Press. Retrieved August 16, 2016 from:

(vii) Kelley, R. (1988), In Praise of Followers, Harvard Business Review. Retrieved August 10, 2016 from: https://hbr. org/1988/11/in-praise-of-followers

(viii) Gibbons a, Bryant D, Followership: the forgotten part of doctors' leadership, BMJ Careers, 19, Oct. 2012. Retrieved August 10, 2016 from: http://www.medicalprotection. org/uk/casebook/casebook-may-2013/followership-theforgotten-part-of-leadership

(ix) DiRienzo, S. (1994), A challenge to nursing: promoting followers as well as leaders, Holistic Nursing Practice, Oct. 9 (1): 26-30.
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Author:Smith-Trudeau, Priscilla
Publication:Vermont Nurse Connection
Date:Jan 1, 2017
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