Leaders cannot practice leadership without followers. Almost all leaders act as followers at some point within an organizational system. Followers exert a great deal of power on a leader’s success or failure in achieving organizational goals.
Follower Contributions: Share specific examples from your nursing practice where followers have significantly contributed to achieving organizational goals. How did their actions or behaviors support the leader's efforts?
Consequences of Undermining: Describe instances where followers' actions or behaviors have undermined a leader's attempts to achieve organizational goals. What were the negative consequences for the leader, the team, and the organization?
Fostering Collaboration: Identify strategies that leaders can use to foster collaboration and trust with followers. Share personal experiences or observations where these strategies have been effective.
Ruiz's Four Agreements: Reflect on Ruiz's Four Agreements: Be Impeccable with Your Word, Don't Take Anything Personally, Don't Make Assumptions, Always Do Your Best. Which agreement resonates most with you as a leader and follower? Explain why, and discuss how you believe it will contribute to your personal and professional growth.
Full Answer Section
- Successful Implementation of a New Electronic Health Record (EHR) System: When a hospital decides to transition to a new EHR system, it's a massive organizational undertaking. The success hinges on the adoption by frontline nursing staff. As a simulated example, our unit's goal was a smooth transition with minimal disruption to patient care and accurate data entry within the first month. The nursing staff, as followers, contributed significantly by actively participating in extensive training sessions, embracing the new technology despite initial frustrations, and providing constructive feedback on system bugs and workflow inefficiencies. Many nurses volunteered to become "super-users," offering peer support and troubleshooting on the floor. Their willingness to adapt, learn, and assist colleagues directly supported the IT and nursing leadership's goal of a successful system rollout, leading to improved documentation, better care coordination, and enhanced data quality for the organization.
- Improving Patient Satisfaction Scores and Reducing Hospital-Acquired Infections (HAIs): A common organizational goal is to enhance patient experience and safety. In one instance, our hospital aimed to reduce central line-associated bloodstream infections (CLABSIs) and improve communication scores. The nursing leader initiated a "CLABSI prevention bundle" and a "hourly rounding" protocol. The staff nurses and nursing assistants, as critical followers, diligently adhered to the strict sterile techniques for central line care, consistently performed hourly rounding to address patient needs proactively (pain, potty, position, presence), and meticulously documented their interventions. They also actively engaged patients and families in their care, explaining procedures and listening to concerns. Their consistent, high-fidelity execution of these protocols directly supported the leader's vision, resulting in a measurable decrease in CLABSI rates and a noticeable improvement in patient satisfaction scores, contributing to both quality outcomes and financial incentives for the organization.
Consequences of Undermining
Conversely, when followers' actions undermine a leader's efforts, the consequences can be detrimental to the leader, the team, and the organization as a whole.
- Resistance to a New Staffing Model for Cost Reduction: Imagine a scenario where a hospital unit leader, facing budget constraints, proposes a new staffing model that involves cross-training nurses for different acuity levels or adjusting shift assignments to optimize coverage. The organizational goal is to maintain patient safety while reducing labor costs. However, some followers, feeling threatened by change or believing the new model compromises patient care (even if the leader has data to the contrary), begin to subtly undermine the initiative. This might involve passive-aggressive behaviors like deliberately slow adoption of new roles, frequent complaints about workload to colleagues and patients, spreading rumors about the policy's negative impact, or even subtly sabotaging the new schedule.
- Negative Consequences for the Leader: The leader faces immense frustration, increased stress, and a loss of credibility. Their ability to implement future initiatives is hampered by a lack of trust. They might be perceived by upper management as ineffective or unable to manage their team, potentially impacting their career progression.
- Negative Consequences for the Team: Team morale plummets due to internal conflict, resentment, and a breakdown in communication. The "us vs. them" mentality between leadership and some staff creates a toxic work environment, leading to burnout and increased turnover. Patient care can suffer due to inconsistencies in staffing and a lack of cohesive teamwork.
- Negative Consequences for the Organization: The organizational goal of cost reduction or efficiency is not met, leading to continued financial strain. Patient safety might be compromised if the resistance leads to errors or delays in care. The organization's reputation could suffer if patient outcomes decline or staff dissatisfaction becomes public.
Fostering Collaboration and Trust with Followers
Effective leaders understand that collaboration and trust are not optional; they are essential for success. Here are strategies leaders can use, supported by observations:
- Transparent Communication and Shared Vision: Leaders must clearly articulate the "why" behind decisions and changes, connecting them to the organization's overarching mission and values.
Sample Answer
The dynamic between leaders and followers is a cornerstone of any successful organization, particularly within the complex and high-stakes environment of nursing and healthcare. As an AI, I do not have personal nursing practice experience. However, I can draw upon extensive knowledge of typical scenarios and best practices in nursing leadership and followership to illustrate these concepts.
Follower Contributions: Specific Examples from Nursing Practice
Followers in nursing practice, from staff nurses and nursing assistants to specialized clinicians, consistently make significant contributions that are vital for achieving organizational goals. Their actions directly support leaders' efforts by operationalizing strategies, providing frontline insights, and maintaining the quality of care.
-