Bottom line up front
Leaders, in much of my written work and podcast discussions, I have taken the opportunity to talk about the process of learning a lesson after an event. We often discuss the lessons learned from an operation, disaster or exercise, but what we really and usually mean is that we merely identified a lesson and have in no way learned from it.
In fact, identified lessons have a horrifying way of repeating themselves every time we go into the all-hazards response environment. Learning from lessons means we take steps to correct or mitigate the issue, so it doesn’t occur again.
Against my often-repeated statement, please look at the leadership lessons from Hurricane Katrina and ask yourself if you would have fared any differently or what lesson you would have identified, learned and prepared for.
| MORE: 20 years post-Hurricane Katrina: 3 lessons from local EMS
National Preparedness Month
September is National Preparedness Month, an annual event led by FEMA’s Ready Campaign to encourage every household and organization to strengthen resilience before disaster strikes. This year’s theme, Preparedness Starts at Home, is especially timely for ambulance service leaders and emergency managers. It serves as a reminder that readiness is not just a personal responsibility, it is an organizational mandate.
Few events demonstrate this need more clearly than Hurricane Katrina. When the storm made landfall in August 2005, it overwhelmed New Orleans, collapsing levees, destroying infrastructure, and leaving 80% of the city under water. For New Orleans EMS, Katrina was not just a storm; it was a crucible of survival, improvisation and leadership under duress.
The new documentary, filmed and produced by Prodigy EMS, “The ones who stayed: The story of New Orleans EMS during Hurricane Katrina,” gives us firsthand testimony from medics, chiefs and medical directors who endured the chaos. For today’s ambulance service leaders, their stories provide enduring lessons that align directly with the priorities of National Preparedness Month.
| MORE: Documentary review: No ambulances. No radios. No exit. ‘The ones who stayed’
1. Expect communications to fail
In the hours before landfall, EMS supervisors told crews bluntly that communications would collapse. “We would probably lose communications at a certain point and have to act on our own without any direction from leadership,” recalled Paramedic Cedric Palmisano.
- Leadership lesson: Build layered redundancy into your communications planning. Satellite phones, mesh radio systems and pre-scripted operational cards allow crews to function without command guidance. Preparedness Month is the right time to stress-test communications and assume: when, not if systems fail, will our personnel still know what to do?
2. Distribute assets — don’t centralize them
Before Katrina struck, New Orleans EMS wisely pre-positioned crews across the city at hospitals and key facilities. When the waters rose, those distributed teams became lifelines.
- Leadership lesson: Centralized staging is a vulnerability. Services should design pre-storm dispersal plans, ensuring personnel and resources are spread geographically. This echoes FEMA’s Preparedness Month advice: don’t put all your eggs in one basket. If one facility goes down, others remain available.
3. Redefine EMS roles in catastrophe
Traditionally, EMS stabilizes patients and transports them to hospitals. But during Katrina, the hospitals were themselves under water or failing. EMS became rescuers, logisticians and evacuation coordinators, moving thousands of civilians by boat and helicopter.
Paramedic Perry Lew put it simply: “Our job has never been to rescue people, as EMS. It was to pick them up and take them to the hospital. But we wanted to get out there and do stuff.”
- Leadership lesson: Services must prepare for role expansion in catastrophe. Shelter operations, mass casualty triage without transport and evacuation support may all become core responsibilities. National Preparedness Month is the time to integrate these roles into planning and training exercises.
4. Prioritize crew safety
Some of the darkest testimony from Katrina concerns responder safety. “The unsafe spot I’ve ever been in, in 25 years of my EMS career, was inside that Superdome. It was chaos. Complete chaos,” said Paramedic Keeley Williams-Johnson. Elsewhere, medics walked across the Crescent City Connection bridge in pitch black, hearing gunfire, fearing they would not survive.
- Leadership lesson: Responder safety must be a command priority. Integrate law enforcement support, rest/refuge provisions, and exit strategies into disaster deployment. September’s Preparedness Month messaging focuses on protecting families at home — the same principle must extend to protecting crews in the field.
5. Partnerships are force multipliers
New Orleans EMS did not survive Katrina alone. The New Orleans Fire Department ultimately rescued EMS crews trapped in the city. Later, military air assets joined to orchestrate one of the largest helicopter evacuations in U.S. history, airlifting 19,000 civilians in a single day.
Chief Carl Flores remembered: “People started cheering when they saw our patch. We had been called ambulance drivers all our lives. Now they said, ‘That’s our EMS.’”
- Leadership lesson: Disasters demand pre-existing partnerships. Build relationships with fire, police, National Guard, Coast Guard, hospitals and emergency managers before the storm. Preparedness Month is an opportunity to refresh MOUs, conduct joint exercises and align plans.
6. Plan for mental health and workforce attrition
Two decades later, Katrina responders still carry scars. “I’d rather go back to war than to do Katrina again. It was that bad,” admitted Lew. Others described nightmares, the trauma of tagging bodies and the despair of losing homes.
- Leadership lesson: Post-disaster mental health support must be structured and sustained. Peer support, professional counseling and decompression protocols should be embedded in every disaster plan. Leaders must also expect and plan for attrition — some staff will not return after catastrophic events. Preparedness Month conversations should include not just equipment and plans, but also long-term workforce resilience.
7. Recovery is part of the mission
After Katrina, New Orleans EMS operated out of FEMA trailers for nearly a decade. Staffing was sparse, neighborhoods were deserted and infrastructure was slow to recover. Yet leadership pushed forward. “Every effort I had was to rebuild this to the best service it could be. That became the impetus for the whole service,” reflected Flores.
- Leadership lesson: Disaster leadership does not end when the floodwaters recede. Ambulance leaders must prepare for years of recovery work: rebuilding fleets, rehiring staff and restoring community trust. Preparedness Month is a reminder to plan not just for the first 72 hours, but for the months and years beyond.
8. Preparedness is personal and organizational
Perhaps the most inspiring takeaway from “The ones who stayed” is the sense of renewed mission. “Knowing that we’ve been through the worst disaster, there was this sense of camaraderie, of renewed honor and drive,” said Palmisano. Crews bonded through hardship and emerged more determined to serve.
- Leadership lesson: Preparedness is not just about supplies or protocols; it’s about culture. Leaders who foster trust, camaraderie and shared responsibility before disaster are better positioned when crisis comes. This is exactly the spirit behind National Preparedness Month: preparedness starts at home, but it thrives in the workplace and the community.
Leading for the next “unthinkable”
Katrina showed us how quickly modern systems can fail and how much depends on EMS leadership when they do. For ambulance service leaders and emergency managers, September’s National Preparedness Month is more than a calendar observance. It is a call to action.
- Assume communications and infrastructure will collapse
- Train for expanded roles in catastrophe
- Protect your workforce as fiercely as you protect the public
- Build and maintain cross-agency partnerships
- Plan for the long, grinding recovery
Preparedness truly does start at home; but for EMS leaders, it also starts in the station, the dispatch center, the operations manual and the culture of the agency. The stories of New Orleans EMS remind us that when the next storm comes, leadership will be measured not by technology or resources alone, but by resilience, foresight and the will to keep serving.
Additional disaster preparedness resources
Get all the resources needed for National Preparedness Month via: https://www.ready.gov/september
- Catch the documentary “The ones who stayed: The story of New Orleans EMS during Hurricane Katrina,” Paywall and registration free via the Prodigy EMS YouTube Channel: https://youtu.be/ksx6zIIKYvU?si=akrTwj5Xf3s6nGWd
- Hurricane preparedness guide: 7 key steps to stay safe
- How AI is helping responders shift from reactive to proactive disaster planning
- Commanding a natural disaster that impacts your crews
