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Lecturer – Olena Bidovanets
 Today’s climate demands individuals who
are flexible, creative, and able to empower
others to be flexible and creative. With the
nursing shortage, managed care, higher
patient acuity, fewer resources, highly
diverse demographics, and outside
influences, nurses need to be more effective
leaders than ever as they manage patients in
various settings.
 But what is an effective leader without
effective followers? This is also a time when
nurses need to be effective followers,
knowing who to follow, when to follow, how
to follow, and how to use the follower role
most powerfully. Because most of us are
followers more often than we are leaders,
the art of followership is a concept that
needs to be explored in any contemporary
discussion of leadership and management.
 Burns (2003) viewed leadership as “a master
discipline that illuminates some of the
toughest problems of human needs and
social change” (p. 3). Others suggest that
leadership is about having a vision and
getting people to follow, using the art of
persuasion. Then there are some who equate
leadership with management and use the
words interchangeably. Bennis and Nanus
(1985) described the phenomenon of
leadership as well studied, with each
interpretation providing a sliver of insight
 Sashkin and Sashkin (2003) took a rather
simplistic, but helpful, perspective on
leadership, stating that leadership that
matters is the critical factor that makes a
difference in people’s lives and
organizations’ success. Many experts have
described leadership as encompassing the
leader’s personality, the leader’s behavior,
the talents of the followers, and the
situational context in which leadership
takes place.
 These experts also tend to agree that
leadership can be learned. Knowing that
leaders are not necessarily born but made,
therefore, is an important concept when one
considers that all nurses must be looked to
as leaders in and for the profession.
Nursing’s focus today is on delivering quality
and cost-effective patient care rather than
on accomplishing a list of nursing tasks.
 This focus requires that nurses fulfill both
leadership and follower roles effectively.
This chapter will explore the concepts of
leadership and followership and discuss how
nurses can improve their abilities to lead
and follow.
 In order to understand the phenomenon of
leader-ship and how contemporary
perspectives shape leadership behaviors, it
is helpful to know how views about leaders
and leadership have changed over time. A
brief outline of several of the more
significant leadership theories provides such
a context.
GREAT MAN THEORY
 Just by reading the name of this theory,
Great Man, one can imagine that it is not
widely accepted today. Yet this was precisely
how the world thought of leaders for many
years. This theory assumed that all leaders
were men and all were great (i.e., of the
noble class). Thus, those who assumed
leadership roles were determined by their
genetic and social inheritance. It was not
conceivable that those from the “working
TRAIT THEORIES
 During the early part of the 20th century,
several researchers studied the behaviors
and traits of individuals thought to be
effective leaders. Studies revealed that these
leaders possessed multiple characteristics.
Although there were commonalities among
them (e.g., they tended to be taller, be more
articulate, or exude self-confidence), there
was no standard list that fit everyone or that
could be used to predict or identify who was
SITUATIONAL OR CONTINGENCY THEORIES
 These theories embodied the idea that the
right thing to do depended on the situation
the leader was facing. The most well-known
and used situational theory involves
assessing the nature of the task and the
follower’s motivation or readiness to learn
and using that to determine the particular
style the leader should use. Despite
widespread discussion and use of this
theory, however, little research exists to
TRANSFORMATIONAL THEORY
 A new way of thinking about leadership
emerged in the mid-1970s when James
McGregor Burns asserted that the true
nature of leadership is not the ability to
motivate people to work hard for their pay
but the ability to transform followers to
become more self-directed in all they do.
 Transformational leaders, therefore, “look
for potential motives in followers, seek to
satisfy higher needs, and engage the full
person of the follower. The result is a
relationship of mutual stimulation and
elevation that converts followers into
leaders and may convert leaders into moral
agents” (Burns, 1978, p. 4).
 Barker (1990) asserted that transformational
leaders need to have a heightened selfawareness and a plan for self-development.
This positive selfregard satisfies the leader’s
self-esteem needs and tends to result in
“self-confidence, worth, strength, capability,
adequacy, and being useful and necessary”
(Barker, 1990, p. 159).
NEW SCIENCE LEADERSHIP
 Wheatley (1999) took this paradigm a step
further when she described leadership as a
method of thinking in a different way, a way
that is not standard, orderly, or goaloriented, Instead, she suggests we think
about leadership in a way that reflects
naturally occurring events: free-flowing,
dynamic, and accepting of an anything-canhappen philosophy.
 She recommended we think of leadership
through a new perspective. Leadership
comprises naturally occurring events in
which leaders have knowledge and serve as
leaders when needed. Thus, there is no need
for others to direct and control what we do.
Leadership Practices and Tasks
 Kouzes and Posner (1995) asserted that
leaders should follow five practices of
leadership to assist in transforming
followers to realize their own visions and
become more self-directed: challenging the
status quo, inspiring a shared vision,
enabling others to act rather than to react,
being a role model, and encouraging the
heart. These practices were identified from
an analysis of the memoirs of hundreds of
 The findings from this research were similar
to Bennis and Nanus’ (1985) notions of what
constituted leadership strategies: the
management of risk; the management of
attention; the management of
communication; the management of trust,
or credibility; and the management of
respect.
 In addition, the work of Kouzes and Posner
and Bennis and Nanus is consistent with
that of Sashkin and Sashkin (2003) who,
after 20 years of research, designed a fourdimensional model of transformational
leadership that addresses communication
leadership, credible leadership, caring
leadership, and risk leadership (a concept
they later renamed: creating opportunities).
 Gardner (1990) also researched the concept
of leadership and identified several tasks
that leaders perform. Those tasks are as
follows:
 ■ Envisioning goals—pointing the group in
a new direction or asserting a vision.
 ■ Affirming values—reminding the group
members of the norms and expectations
they share.
 ■ Motivating—promoting positive attitudes.
 ■ Achieving a workable unity—managing
the conflict that inevitably accompanies
change and growth.
 ■ Explaining—teaching followers and
helping them understand why they are
being asked to do certain things.
 ■ Serving as a symbol—acting in ways that
convey the values of the group and its goals.
 ■ Representing the group—speaking on
behalf of the group.
 ■ Renewing—bringing members of the
group to new levels.
 These tasks provide specific guidelines for
people interested in increasing their
leadership ability, and they highlight the
importance of leaders working
 closely with followers.
Perspectives on Followership
 Although Gardner (1990) and others have
acknowledged the importance of leaders
and followers working together in order to
realize a vision, the literature typically pays
little attention to the concept of
followership, and there are no “theories” of
followership.
 Perhaps one of the earliest discussions of
followership was presented by Kelley (1992,
1998), who outlined four types of followers:
sheep, “yes” people, alienated followers, and
effective or exemplary followers. Sheep are
passive individuals who comply with
whatever the leader or manager directs but
are not actively engaged in the work of the
group.
 “Yes” people, in comparison, are actively
involved in the group’s work and eagerly
support the leader; they do not, however,
initiate ideas or think for themselves.
Alienated followers do think for themselves
and often are critical of what the leader is
doing; they do not, however, share those
ideas openly, they seem disengaged, and
they “rarely invest time or energy to suggest
alternative solutions or other approaches”
(Grossman & Valiga, 2005, p. 47).
 The individuals who are engaged, suggest
new ideas, share criticisms with the leader,
and invest time and energy in the work of
the group are referred to as effective or
exemplary followers. Pittman, Rosenbach,
and Potter (1998) also described four types
of followers: subordinates, contributors,
politicians, and partners.
 Subordinates are similar to Kelley’s “sheep,”
doing what they are told but not actively
involved. Contributors are like Kelley’s “yes
people,” supportive, involved, and doing a
good job, but not willing to challenge the
ideas of the leader. Politicians are willing to
give honest feedback and support the leader,
but they may neglect the job and have poor
performance levels.
 Like Kelley’s effective or exempry followers,
the partners described by Pittman, et al.
(1998) are highly involved, perform at a high
level, promote positive relationships within
the group, and are seen as “leaders-inwaiting” (p. 118). Because leaders cannot be
leaders unless they have followers, the role
of the follower is extremely important in any
discussion of leadership. In addition, the
characteristics that describe effective/
exemplary followers or partners are quite
similar to those outlined for effective leaders
 Although the term “follower” “conjures up
images of docility, conformity, weakness,
and failure to excel” (Chaleff, 1995, p. 3),
those who are effective in the role are
independent, critical thinkers, innovative,
actively engaged, able and willing to think
for themselves, willing to assume ownership,
self starters, and able and willing to give
honest feed back and constructive criticism
(adapted from Grossman & Valiga, 2005, pp.
49–50).
 Effective followers are not employees who
simply “follow the rules” and accept
whatever management decides. In fact, the
concept of effective followers may not even
be compatible with perspectives on
management that assume a complacent,
nonquestioning employee. But it is clearly
aligned with the concept of leadership,
because effective followers are seen as
partners with the leader, working
collaboratively to realize the vision they
share. Thus, it is helpful to outline the
Differences Between Leadership and Management
 Leadership and management are related
phenomena but they are not the same. It is
important torealize that (a) not all
individuals in management positions are
necessarily leaders, and (b) leadership is not
necessarily tied to a position of authority.
While only those in management positions
are expected to be managers, leadership can
and needs to be exercised by each of us
wherever we may be.
 In other words, even though an individual
does not hold a management position, she
can still be a leader on a clinical unit, in an
institution, in her community, or in the
profession as a whole. In a classic article
written in 1977, Zaleznik asserted that
“leaders and managers are very different
kinds of people: they differ in their
motivations, in their personal history, and
in how they think and act; they differ in
their orientation toward goals, work, human
relations, and themselves; and they differ in
 For example, leaders are creative,
innovative, and risk-takers; managers often
are more concerned with maintaining the
status quo and taking few risks. In addition,
managers often have a short-range
perspective and are concerned about the
“bottom line,” whereas leaders have a longrange, visionary perspective and are
concerned about moving toward realization
of that vision.
 It is important to remember that these
distinctions point out the extremes of
perspectives to illustrate the points that not
all managers are leaders and not all leaders
are managers. Despite the differences
outlined by Zaleznik and others, however,
many individuals are able to function as
both leaders and managers simultaneously
and effectively. Indeed, our practice world is
greatly enhanced when leaders are able to
manage and managers are able to lead.
 Bennis and Nanus (1985, p. 21) have been
quoted often as saying “leaders do the right
thing, and managers do things right.” In
nursing practice, we must both do the right
thing and do that thing right. For example,
we apply standards of care to our practice
that must be followed and acuity quotients
that, in most cases, must be assessed in
order to make decisions about staffing,
admissions, and supports needed.
 Thus, we must do the thing right. But
perhaps we also need to ensure that we are
doing the right thing by evaluating if the
standards fit our patient population and if
the acuity and staffing ratios are relevant to
our needs. If they are not, leaders need to
step forward to create standards that do fit
and that are relevant.
 . All nurses need to lead and manage
effectively in patient care settings in order to
accomplish tasks and achieve maximum
care quality. All need to share their visions
of how patient care can be improved, and all
need to learn from the leaders who have
gone before them.