Understanding the Relationship Between Followers and Leaders

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NURSING MANAGEMENT December 2011 | Volume 18 | Number 8 31

Feature

The Topic f ladrs rvs mu attntn

frm ly makrs, gvrnmnts, rsarrs and

rattnrs but, wl ly ars frquntly

mntn ladrs, wat xatly t s and w t

an b dvld rman lusv (hwsn and

Tagaraja 2011).

T rmnn f ladrs and ladr

dvlmnt was artularly vdnt undr t

rvus gvrnmnt, w nstgatd, fr xaml,

t dvlmnt f t NhS ladrs qualts

framwrk. Ts dfnd t attrbuts ladrs

at all lvls f t srv wr xtd t av

(NhS insttut 2005).

hwvr, t framwrk dd nt aly t t

mdal rfssn, w as dvld ts

wn mdal ladrs mtny framwrk

(NhS insttut 2009). T Nursng and Mdwfry

cunl (NMc) as nludd ladrs as

a sfd dman n undrgraduat nursng

urrula frm 2012 (NMc 2010).

T ladrs qualts st ut n bt NhSframwrks, and t NhS Stland ladrs

dvlmnt stratgy (Stts Gvrnmnt 2009),

nsst f tr lustrs:

■ prsnal qualts and bavurs.

■ Sttng drtns t av srv rrts.

■ Dlvrng t srv t av gals.

‘prsnal qualts’ ar ntral t bt framwrks

(NhS insttut 2005, Stts Gvrnmnt 2009).

ea ‘qualty’ s dfnd n t framwrks s, fr

xaml, undr ‘slf-blf’, t stats tat ‘utstandng

ladrs mantan a stv “an-d” sns f

nfdn w nabls tm t b sars ratr

tan fllwrs, n t fa f stn. T rm

rsnal qualty s bult n suss and larnngn a brad rang f vard stuatns vr tm’

(NhS 2005 insttut).

Rfrrng t ‘utstandng ladrs’ ndats

a ntnung blf n t ‘ladr as savur’, ws

urs t s t slv rgansatns’ rblms

(cllnsn 2005). T ladr-ntrty f bt

ladrs framwrks (NhS insttut 2005,

Stts Gvrnmnt 2009), and t sl fus

n qualts and bavurs f ladrs, furtr

suggst tat sussful ladrs an b attrbutd

t ndvduals.

T vdnt falur f ladrs framwrks,

ls r dvlmnt rgramms t rgns

t ntual dffrns btwn ladrs and

ladrs nrnt n ladrs framwrks

s rlxng. T nt f ‘ladr’ fuss n

ndvduals, tr bavurs and tr rsnalty

trats, wl ‘ladrs’ s sn as a rss tat

nvlvs ladng and fllwng, ladrs and fllwrs

(hartly and hnksman 2003, Grnt 2005).

Wl t ttls f framwrks, ls and

dvlmnt rgramms ftn rfr t ladrs,

Undrstandng t rlatns btwn fllwrs and ladrs

Susanne Kean and Elaine Haycock-Stuart argue that senior staff are not the only

movers and shakers in a team. They suggest organisations need to look beyond

research literature, which fails to acknowledge the influence of junior colleagues

AbstratContemporary healthcare policies tend to imply that successful leadership can

be attributed to a single leader. Such an understanding of leadership ignores

the significant contribution followers make to successful leadership and their

influence on leaders. In reality, followers rarely simply follow leaders. Following

is a complex process that depends on the context and involves followers making

judgements about prospective leaders while deciding whether or not to follow

them. This interdependence is ignored all too often or misunderstood by those

who see leadership as something that can resolve the problems of the NHS. Using

data from a study of leadership in community nursing in which the authors were

involved, they argue that senior staff who ignore followers and their contribution

to leadership do so at the peril of their organisations.

KeywordsLeadership, leadership frameworks, community nursing

Correspondence

[email protected]

Date of acceptance

October 10 2011

Peer review

This article has been

subject to open review and

has been checked using

antiplagiarism software

Author guidelines

www.nursingmanagement.co.uk



December 2011 | Volume 18 | Number 8 NURSING MANAGEMENT32

Feature

te fous remans on ndvdual leaders. Ts dffers

from ter ntenton and needs to be questoned.

Desrbng leaders as ‘saers rater tan

followers’ (NhS insttute 2005) oversmlfes

te omlexty of relatonss between leaders

and followers and msses te ont of leaders

develoment by fousng on leaders rater tan

on bot grous.

Tey redue te omlexty of leaders to

te ersonalty and qualtes of te leaders. it s

mortant to reognse tat suessful leadersn organsatons s te result of te atons of many

(pek and Dknson 2009).

Followers and followershipManstream leaders develoment frameworks

aear fxated on te dea tat leaders are always

n ontrol and leadng. At te same tme, leaders

develoment frameworks, and many ontemorary

leaders aroaes, make te assumton tat

followers make u a omogeneous grou tat

unquestonngly follows a leader.

Fneman (2003), wo examned leaders

from an emotonal ersetve, glgts

te nterdeendene of leaders and followers,

and argues tat tey are bound n a omlex

emotonal web. Not only are leaders sometmes

followers, and ve versa, but followng and

leadng are also nterdeendent atvtes found n

bot grous.

Understandng te nterdeendeny and

reroty between leaders and followers s

mortant beause leaders or followers,

and terefore leadng or followng, are roesses

tat aen between eole (Bnney et al 2009)

and affets all workng relatonss.

Study‘Followng’ emerged as a major teme of

leaders n an analyss of a leaders study

n ommunty nursng n tree ealt boards n

Sotland undertaken by te autors wt olleagues

(hayok-Stuart et al 2010, Kean et al 2011).

Te analyss onluded tat te onet of followng

ad four dmensons:

■ Soally o-onstrutng leaders. co-onstrutng

s a term used to desrbe ow eole onstantly

redefne ter envronments troug nteratng

wt, and reatng to, oters.

■ Dong followng.

■ Standng by.

■ Resstng followng.Tese dmensons llumnate te omlex roess

by w followers nfluene and o-onstrut

leaders and tereby nfluene an organsaton’s

ablty to aeve ts goals.

Te leaders study (hayok-Stuart et al 2010,

Kean et al 2011) used varous qualtatve metods;

t nvolved 31 ndvdual ntervews and dsussons

n tree fous grous, wt an overall samle of

39. Te study amed to dentfy ow leaders

s ereved and exerened by ommunty nurses,

and to examne te nteraton between reent

oly and leaders develoment n ommunty

nursng n te UK.

Mult-ste etal and management aroval fromall resear and develoment deartments of te

tree ealt boards was granted. Nurses workng n

te ommunty were nvted to artate. Te study

samle reresents ommunty nurses and ter

leaders n tree ealt boards and reflets a gly

exerened and older workfore, w s n lne

wt earler fndngs (Buan et al 2008).

Tables 1 and 2 sow te breakdown of

artants by rofessonal role and ter bandng

wtn te NhS knowledge and sklls framework

(Deartment of healt (Dh) 2004).

Te ntervew sedule was develoed after

a lterature revew and ntegrated wt questons

osed by te fundng body, wle te fous grous’

to gude was drawn u after te ndvdual

ntervews. Te ntervew and fous grou sessons

were audo reorded dgtally and transrbed

verbatm after artants gave wrtten onsent.

Data were gatered between Arl and Deember

2009. Furter detals on metods and data analyss

are gven elsewere (hayok-Stuart et al 2010,

Kean et al 2011).

C o r b i s




Feature

Findings and discussionit bcam vdnt n t ntrvws tat t ntrlay

btwn ladng and fllwng amng fllwrs

sgnfcantly affctd ladrs rcsss.

Socially co-constructing leaders Wn askd wat

maks a gd ladr, artcants lstd svral

qualts, suc as bng lstnd t by tr ladr,

bng nst, bng vsbl, bng aracabl, and

avng a vsn. Ts qualts aard t cnfrm

wt a trat arac t ladrs and t undrln

t arac takn n many ladrs

dvlmnt framwrks.

hwvr, wn artcants wr askd w

ty rcgnsd ladrs, a mr cmlx attrn

mrgd. Ty argud tat rcgntn f a ladr

s nt mmdat, t taks tm and n ‘wuld av

t b wrkng wt smn fr a wl bfr yu

wuld rcgns… tat yur tam was runnng wll’(dstrct nurs 3.4).

partcants dscrbd a rcss f stng back

and bsrvng ladrs, wc ld t judgmnts

abut tm. T c-cnstructn f ladrs

and n an ndvdual as wll as gru lvl,

bcaus nurss wuld cm t cnclusns basd

nt nly n tr wn bsrvatns f tr ladrs,

but als draw n dscussns f tr vws wt

rs. Nurss n ladng stns wr awar

tat ty wr bng judgd and cmmntd

tat ‘ladrs s als abut… avng a vsn

and avng a drctn and yu can’t b a ladr

f yu avn’t gt fllwrs. S tr s smtng

abut ngagmnt and takng l wt yu’(lad nurs 1.2).

Data suggst tat, acrss t saml, fllwrs

rflctd n tr ladrs’ ablty t tak l

wt tm and carfully analysd tr ntntns,

cmtncs and actns bfr dcdng wtr

r nt t fllw. Ts suggsts tat t rstn

vdnt n many ladrs aracs, tat

fllwrs just fllw, s naïv. equally, ladrs

knw tat tr ngagmnt wt fllwrs and

‘avng a vsn and drctn’ was crucal fr

succssful ladrs.

Doing following Basd n tr judgmnt f tr

ladrs, nurss wr clar tat ty wuld ‘nt

fllw a numty’ (dstrct nurs 2.4) and tat, fr

tm t fllw, a ladr ad t b ‘smbdy tat

i wuld lk u t and want t fllw’ (dstrct

nurs 3.2). Analyss acrss data llustrats tat

fllwrs’ judgmnts abut tr ladrs wr mad

wtn scfc cntxts. Ts nsgt s mrtant

bcaus t undrlns fllwrs’ cntnuus

judgmnt f tr ladrs’ actns, wc n turn

nfluncs t fllwrs’ bavur twards ladrs

(hllandr 2009).

Ladrs undrstd ts. on lad nurs (3.1)

ntd ut: ‘…Yu nd t manag t cang

but, t mv t frward…yu nd t brng l

wt yu…yu can’t lad f l dn’t fllw… S

l av t av trust n yu… if yu say, “fllw

m, av a la f fat”, but yu av abslutly n

ablty t actually dlvr… l ar gng t b

a w bt, “wll, ld n”…’‘Fllwng’ trfr ccurrd wn nurss ad

‘trust’ and ‘fat’ n t ladr.

Table 2 NHS knowledge and skills framework band distribution of participants

Health board 1 Health board 2 Health board 3

Band 2 2 0 0

Band 4 2 0 0

Band 5 5 4 3

Band 6 6 0 3

Band 7 5 2 1

Band 8 2 1 1

Executive level 1 1 0

(Department of Health 2004)

Table 1 Participants’ professional roles

Position Number of

participants

District or community nurse 14

Community staff nurse 12

Health visitor 5

School nurse 0

Nursery nurse 2

Healthcare assistant 2

Acute care manager for

the community sector

1

Assistant nursing director 1

Director of nursing 2



December 2011 | Volume 18 | Number 8 NURSING MANAGEMENT34

Feature

hwvr, antr dmnsn f fllwng was

rasd by a dstrt nurs w argud tat ‘sm

l ar mfrtabl n tr ara… and dn’t

rally want t av tr bat rkd… Ty’r

nt gnna b s kn t lk at dffrnt ways f

wrkng’ (dstrt nurs 1.3). Ts massd tat

any suggstd ang was lnkd, and ndd t

rrsnd, t fllwrs’ valus and blf systms.

Standing by intally ‘standng by’ may aar t b

at dds wt wat t nt f fllwng. Ts s

a assv frm f fllwng and was vdnt wn,

fr xaml, n artant sad: ‘i am dfntly…

lk a fllwr ratr tan a ladr. i’ll d any

amunt f wrk, but i just nd smbdy tr

dng tat knd f rgansng t gt m nt t’

(dstrt nurs 1.4).

it s mrtant t rgns tat ‘standng by’

ds nt an ndntally but s an atvdsn by a fllwr. At frst sgt, su fllwrs

an sm aalng, but ty rsnt rblms

fr rgansatns and ladrs baus ty d

nt rvd ladrs and rs wt wat Grnt

(2005) dsrbs as ‘nstrutv dssnt’. it s tr

dsngagmnt tat s rblmat fr ladrs and

rgansatns; ts fllwrs stand n t sdlns

and nd t b tld wat t d, wn and w mu

t d t, wl rfranng frm gvng fdbak.

Ts data als ndat t mrtan f

ladrs rsss bng ngtatd atvly

btwn ladrs and fllwrs. Ladrs nd t b

flxbl and mak us f t ladrs ‘tlbx’

n rlatn t t fllwr ty ar wrkng wt.in ral lf, a gd ladr ds ts and w saw

xamls f t.

Resisting following organsatnal rars

rat wr asymmtrs btwn l su as

ladrs and fllwrs. As argud abv, fllwrs

mak judgmnts abut ladrs and av tr wn

slf-ntrsts; as a rsult, ty may rsst, rfus r

sdtrak attmts at ang by tr ladrs f, fr

xaml, ty nsdr tat t suggstd angs

ar nt n tr ntrsts.

Tat ladrs d nt ld all t wr – and tat

ts s a untr-ntutv blf (Brattn et al 2005) –

bam vdnt wn ladrs n mddl managmnt,

n artular, ad at frst nsdrd tat ‘bng

a srt f managr, i uld tll flk, suggst t flk

tat ty d tngs… But t dsn’t an. pl

just dn’t d tngs’ (tam ladr 1.1).

in ts as, t tam ladr ad attmtd t

adjust tamwrkng rat n a way tat mmunty

nurss ad nt xtd. T ang was surtd

by t lad nurs, but mmunty staff watd fr t

tam ladr’s tm ff t ras tr nrns abut

t angs wt t lad nurs, w subsquntly

rvrsd t dsn. pras, nt surrsngly, t

tam ladr rfltd n r wr n t rary

and nludd tat s dd ‘nt av any lut. T

lut ls at t nxt lvl u’ (tam ladr 1.1).

in ntrast, a nursng drtr dalng wt

snr ladrs w ngagd n ‘ftn vry rsnal

sabtagng bavur’ (nursng drtr 1.1) ad

t wr and mans t ass utsd surt by

brngng n faltatrs w ld sssns wt staff

and sussfully addrssd ssus f bstrutv

bavur and ang.

Wl ladrs aras argu fr t

transndn f ladrs, tat s, nablng anyn

at any lvl f an rgansatn t lad, data frm

arss t alt bards suggst tat ladrs s

basd n l’s stns n t NhS rary.

Fr xaml, f a nurs as a gd and nnvatvda, s wuld g t t nurs snr t r, but

wuld nt g bynd tat lvl. T rblm r

s tat wtr t da fls r s klld ff rgt

tr dnds n w s abv. W saw xamls f

gd das tat nvr rad t nursng drtrs

baus ty wr blkd n t way u.

Analyss f ur data sws tat t stn

f ladrs n t rary sas tr rsnss

t fllwrs w rsst, untrat r sdst f

suggstd atns d nt rrsnd wt fllwrs’

valus r blf systms.

in ntrast t ls tat s nurss as

ntrrnurs sang t systm, n ur xrn,

t suss f gd and nnvatv das frmrvng rat dndd n l’s stn n

t rary. An da ut frward by a altar

assstant tat wuld, fr xaml, nvlv a ang

f wrk fus and addd ffrt n t art f

rgstrd nurs llagus t mak t an may

wll b gnrd. Svral gd das nvr rad

nursng drtr lvl baus f barrrs btwn

ts w ad t das and an ntrst n mrvng

rat and ts n stns f wr.

Conclusion

Nurss and mdwvs ar t largst gru f

altar rfssnals n t NhS and ty ar

targtd rutnly by ly makrs t av

ltally dsrd angs t nabl mrvmnts

n alt ar (Stts exutv halt Dartmnt

2005, Stts Gvrnmnt 2007, Dh 2008).

Ladrs s ssntal fr mrvng ar and

avng a ‘bttr and farr altar systm’

(Dh 2008). hwvr, tnkng ‘ladrs’ wtut

tnkng ‘fllwrs’ s, as Kllrman (2008) uts t,

‘nt mrly msladng, t s mstakn’. Furtrmr,




Feature

ladrs and fllwrs ar rsss nt

l, a fat gnrd r msundrstd all t ftn

by ts w s ladrs as smtng tat an

al all t lls tat bfall t NhS.

Fllwrs, lk ladrs, s a mlx

rss and s basd n fllwrs’ -nstrutn

f tr ladrs. As t ladrs study arss

tr Stts alt bards (hayk-Stuart et al

2010, Kan et al 2011) ndats, fllwrs d nt

smly fllw – ‘fllwng’ s an atv, ntxt-bund

dsn. Ts nsgt suggsts dndn and

rrty btwn ladrs and fllwrs and,

mr mrtantly, assums t trgnty

f fllwrs.

Lak f nsgt nt w fllwrs fllw as

srus mlatns fr ur undrstandng f t

ladrs and fllwrs rsss.

T ntnung blf tat ladrs ar t nly

mvrs and sakrs n rgansatns lads ta ‘dndny t rdt sussful vnts t ladrs,

bsurng t sgnfant ntrbutn f fllwrs’

(Yukl 2010) and gnrs t nflun tat fllwrs

av n ladrs rsss. if snr staff gnr

fllwrs and tr ntrbutn t ladrs, ty

d s t t dtrmnt f tr rgansatns.

T auty f rsar nt fllwrs suggsts

tat tr s a nd t ay mr attntn t t as

art f t ladrs stry.

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Conflict of interest

None declared

Acknowledgments

We wish to thank the participants

of this study and the Queen’s

Nursing Institute Scotland for

financial support. Thanks also

to Sarah Baggaley and Maggie

Carson, lecturers in nursing

studies, School of Health in Social

Science, University of Edinburgh,

for their work on the project. Wewish to dedicate this article to the

memory of Susan McMeel who

acted as an independent observer

Susanne Kean is a research fellow

Elaine Haycock-Stuart

is a senior lecturer

Both at the School of

Health in Social Science,

University of Edinburgh

onln arv

For related information visit our online archive

of more than 6,000 articles and search using

the keywords.

imlatns fr rat

■ Followers do not simply follow. Leaders

in community nursing should be aware

that successful leadership is the result ofa co-constructive process involving leaders

and followers.

■ Leadership and followership are interdependent

processes, yet the current focus of research

continues to be centred on leadership.

The integration of followers and followership

into leadership research, and specifically into

leadership and followership research that

originates in the UK, is absent from the

research canon.

Paying attention to these dimensions, namely,

focus and location, would offer better understanding

of how the leadership and followership processes

interact and, therefore, how they contribute

to better services.



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