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 but none providing a holistic and adequate

 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 class” could be leaders, that leadership

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 or could be an effective leader.

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 support its validity.

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 managers, who were asked to reflect on

 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.
 ■ Managing—keeping the system

 ■ 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 themselves.

 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

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 their worldviews” (Zaleznik, as quoted 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.