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What followers want in their nurse leaders

Why would anyone want you to lead them? That’s a question nurses rarely ask themselves before they take on leadership positions. But it’s an important one, because if you’re honest in reflecting on your strengths and weaknesses, you can probably find many reasons why nurses wouldn’t want you to lead them.

Developing yourself as a leader is a process. You can—and will—make many mistakes. Reflective questions help you frame your leadership journey so you can become the kind of nurse leader no one wants to leave.

Key leadership qualities followers expect

Successful leaders can’t achieve goals without inspired and motivated followers. Most of us have observed nurses who’ve been placed in leadership positions but failed to capture the hearts and souls of those they lead. John C. Maxwell, in his book The 21 Irrefutable Laws of Leadership: Follow Them and People Will Follow You, stresses that leadership is above all the ability to influence others. We know from research that these are the key qualities nurses look for in their leaders:

  • commitment to excellence
  • passion about their work
  • clear vision and strategic focus
  • trustworthiness
  • respectfulness
  • accessibility
  • empathy and caring
  • commitment to coaching and developing their staff.

Transformational leadership

While these key qualities are important for leaders to have, how you lead matters, too. Today nurses look for leaders with a transformational leadership style. James MacGregor Burns, a historian and political scientist who introduced the concept of transformational leadership in 1978, defined it as a process in which “leaders and followers help each other to advance to a higher level of morale and motivation.” This leadership style is a radical departure from the “command and control” style that formerly predominated in the United States.

Transformational leadership is now a major component of the Magnet® model developed by the American Nurses Credentialing Center. Nurse leaders in Magnet organizations are expected to have a transformational style. In today’s complex, rapidly changing healthcare environment, the ability to be a transformational leader is essential. Transformational nurse leaders are able to identify the changes their environment needs, guide the change by inspiring followers, and create a sense of commitment to change. Transformational leadership hinges on a high level of engagement between leaders and followers. In other words, it depends on followership.

Evidence-based research suggests transformational leadership enhances nurse satisfaction, promotes a positive work environment, and reduces staff turnover. Are you a transformational leader? Only your followers can answer this question. (See Four elements of transformational leadership by clicking the PDF icon above.)

What leaders need from followers

Effectiveness as a leader depends on having followers who are inspired to do great work. For instance, a new nurse manager stands a much greater chance for success if she builds a strong relationship with her followers. She needs to speak individually with each follower when she begins her leadership role to determine what each one expects of her and how she can help them achieve their goals. She should ask her followers to communicate frequently, be trustworthy, accept accountability for assignments, support leadership decisions, and provide encouragement.

Frequent communication

Leaders count on followers to be self-starters in their work and to keep them informed of what they’re doing and the challenges they’re facing. Leaders need good communication from followers to help them make the right decisions. Most leaders have preferred communication methods, such as a weekly briefing, e-mail, text messages, or frequent “huddles.” Let staff know your preferred communication method.

Also tell your followers which items to inform you of immediately—for example, medication errors, family complaints, and supply problems. Health care goes on 24/7, so be sure to tell staff which issues they should contact you about during your nonwork hours. Leaders grow frustrated when they hear a problem has gone on for weeks but were never informed of it.


Even great leaders can be undermined by followers who criticize decisions, are passive-aggressive, look to find fault, or use their influence to erode others’ support for them. Good followers need to be trustworthy and transparent in their actions. During their careers, followers at times may find themselves working for a leader who doesn’t earn their trust; this shouldn’t change how they behave.

Accountability for assignments

I once asked a nurse who has made remarkable career achievements for the secrets to his success. He told me he always follows through on what he’s committed to doing.

Similarly, leaders depend on followers to follow through on their assignments. This is an important tip to give staff when you do career coaching. When nurse leaders review staff to identify emerging leaders,
they consider accountability a key trait.

Support for leadership decisions

Health care is in a state of constant change. Even the most senior nurse leaders in an organization may need to make decisions that affect the work of staff in ways that will be perceived negatively. They may have no choice but to make these tough decisions and policy changes. In the wake of these decisions, followers should share their concerns with leaders. Once a final decision is made, followers need to support it—not blame their leader for unpopular organizational decisions the leader may have no control over.


It can be lonely at the top. Good followers recognize this and find ways to encourage leaders on their journey. Leaders value nothing more than authentic praise from those they lead. Let staff know you appreciate feedback, both negative and positive.

Seeking feedback from followers

Former New York City mayor Ed Koch was famous for walking into crowds and asking people on the street, “So how am I doing?” This is a brave question to ask your followers when you’re not sure how they’ll respond. But the only way you’ll learn and grow as a leader is to ask followers what you could be doing differently. Here are four good questions to ask followers regarding your leadership style, communication, and job performance:

  1. What should I keep doing as a leader?
  2. What should I do more of?
  3. What should I do less of?
  4. What should I stop doing?

If you get enough feedback, you’ll see trends in what you currently do well and where you need to improve. The key is to use feedback in a constructive way instead of trying to justify why you do what you do.

Leadership doesn’t happen in a vacuum. Authors Robert Goffee and Gareth Jones, who’ve studied followership, offer valuable advice. Successful leaders, they point out, can modify their behavior to respond to their followers and circumstances while remaining true to who they are.

Visit www.AmericanNurseToday.com for a complete list of references.

Rose O. Sherman is an associate professor of nursing and director of the Nursing
Leadership Institute at the Christine E. Lynn College of Nursing at Florida Atlantic University in Boca Raton, Florida. You can read her blog at www.emergingrnleader.com.

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