How do Registered Nurses Understand Followership?

BACKGROUND: Despite a consensus that followers and leaders are interdependent, the focus of nursing education, practice, and research has been leader centred. This has spawned calls in the nursing literature for increased scholarship on followership in nursing. PURPOSE: To develop a grounded theory of followership in nursing. METHOD: This study addressed the question - how do registered nurses understand followership? 11 registered nurses participated in online interviews that were later transcribed and analyzed following Charmaz's approach to Constructivist Grounded Theory. RESULTS: The core category of trusting informal and formal leaders was co-constructed from the data. A conceptual model, titled Followership as Trust in Acute Care Nursing Teams, illustrates that the nurses’ decision to trust (and subsequently to engage in following) hinges on sharing the load (understanding one's role, accepting one's role, and working together); demonstrating knowledge (having experience, modelling, and mentoring); and connecting through communication (knowing the goal and communicating clearly). When participants fully trust formal and informal leaders, they engage in following as proactive members of the team, provide solutions to problems, and take initiative. Conversely, when they are less trusting of informal and formal leaders, they are less willing to follow. CONCLUSIONS: This study underscores the importance of trust between followers and leaders for effective team function and safe patient care. More research on the follower-leader dynamic in nursing is needed to inform education, policy, and practice so that every nurse possesses the knowledge and skill to be both a follower and a leader.