A follower is someone who worships a god, but is not a member of the priests' guild. If you're not a priest, being a follower is the only way to gain access to rituals.
Pishe does not accept followers, only priests. All other deities do accept followers.
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You can only follow one god at a time. Also, wizards and witches cannot become followers.
You can only perform rituals while in alignment (meaning that your god is "very happy with", "pleased with", or at worst "a little concerned about" you). You can check this with "score align" or "score alignment", which indicates how happy (or not) your god is with you.