OACNS

Most nurses aspire to become better leaders. We pursue certifications, advanced degrees, formal leadership roles, and opportunities to influence change. We learn to communicate effectively, navigate conflict, inspire others, and move ideas into action. Leadership is a common professional aspiration; followership rarely is.

At first glance, that may seem reasonable. In a culture that celebrates influencers, thought leaders, and social media followings, being a “follower” does not sound especially aspirational. The term can suggest compliance, passivity, or simply carrying out what someone else has decided.

Yet when I think about the strongest leaders I have worked with, I often find myself thinking about the followers around them—not the people who simply agreed with them, but the people who challenged them.

The colleagues who asked difficult questions. The ones who identified blind spots. The people willing to say, “I see it differently,” or, “Is there a better way?” They strengthened good ideas, improved weak ones, and occasionally prevented poor decisions.

It raises an important question: what if one of the most essential leadership skills is learning how to follow well?

Think about the best leader you have encountered in your career. What made that person effective? Was it vision? Expertise? Communication? Those qualities certainly matter, but many successful leaders possess them.

What often distinguishes exceptional leaders is the environment around them. They cultivate people who are engaged enough to contribute rather than simply comply—followers who feel comfortable offering feedback and who care enough about the mission to challenge the process.

Now consider leaders who were less effective. Was the problem always a lack of vision? Or was it sometimes the absence of meaningful engagement from the people around them? Teams can execute instructions without truly contributing to improvement. Ideas can move downward without thoughtful feedback moving upward. Questions can be interpreted as resistance rather than participation. The result is compliance—and compliance, by itself, rarely drives progress.

Nursing should understand this dynamic better than most professions. Every day, nurses are expected to think critically, advocate for patients, identify risks, and question practices that may no longer serve patients or clinicians well. We call these professional responsibilities. Rarely do we recognize them as followership skills.

Clinical nurse specialists encounter this dynamic regularly. Much of the CNS role depends on influence without authority. CNSs often support organizational priorities while simultaneously questioning practices that no longer align with evidence. They advance ideas not because they hold positional authority, but because they ask thoughtful questions, facilitate dialogue, and help others see opportunities for improvement. That work requires leadership; it also requires followership. Perhaps that is where the distinction begins to blur.

The ability to follow well develops many of the same capabilities associated with effective leadership. It requires intellectual curiosity, humility, and enough confidence to challenge ideas without needing to own them. It teaches us to separate commitment to a mission from loyalty to a particular person, process, or tradition. It also requires a willingness to be influenced.

That may be one of the most overlooked aspects of leadership development. We spend considerable time learning how to influence others. We spend less time considering how open we are to being influenced ourselves.

The strongest leaders I know continue to learn from colleagues, frontline staff members, patients, and teams. They remain willing to change their minds. They recognize expertise in others. They understand when to step forward and when to step back. In many ways, their effectiveness as leaders is inseparable from their ability to follow.

Perhaps that is the paradox: leadership and followership are not opposing skills. They are complementary ones.

As nurses, we spend considerable time developing our leadership skills, and rightfully so. Leadership matters. But perhaps we overlook one of the most important opportunities for growth. Every committee meeting, practice change, quality initiative, and interdisciplinary collaboration gives us a chance to strengthen a skill that shapes every successful leader: followership. The question is not whether we follow. We all do. The question is whether we follow in a way that advances ideas, improves practice, and strengthens those around us.

The next time you think about leadership development, do not ask only, “How can I become a better leader?” Ask yourself, “How can I become the kind of follower great leaders need?” The answer may reveal one of the most powerful—and overlooked—leadership skills you will ever develop.

Dr. Hanks is a Perioperative Practice Specialist at AORN. She is an advanced practice registered nurse and holds national certifications as a pediatric clinical nurse specialist, nursing executive, and perioperative nurse. She has over 15 years of experience as a pediatric perioperative nurse in a variety of roles including OR circulator, transplant team lead, charge nurse, clinical nurse specialist, and APRN. Dr. Hanks also previously served in system-level leadership roles in including Director of Nursing Research and EBP, Director of Quality, and CNO. She is passionate about nursing leadership and perioperative nursing and has been involved with nursing education throughout her career, holding academic positions at schools of nursing including adjunct clinical instructor, clinical assistant professor, and adjunct faculty.