We’re familiar with the usual type of leadership that a manager at IBM, Bank of America or the corner grocery store shows when managing their operation and people. Usually these managers mistakenly try to manage people when they should be leading people. The important thing to remember is that we manage things and we lead people. We manage budgets, inventory and fleets.
It’s rare that the manager working at IBM, Bank of America or the corner grocery store need to lead people in a crisis. That isn’t true for the EMS manager. Not only do they have to lead people under normal everyday conditions, but they also may be asked to show their leadership during high-intensity events, such as tornadoes or mass-casualty incidents. EMS managers may be thrust into a leadership role during an active shooter attack.
The leadership skills that an EMS manager must exhibit during a crisis are much different from the leadership skills that they use in their day-to-day operations. In their day-to-day office operations, they have the ability to sit back and use discretionary time to make a decision. If someone comes into their office with a problem, the EMS manager has the luxury of requesting more information, maybe making some phone calls, sitting on it overnight or even checking with their boss before they make a decision.
Unfortunately, that isn’t the case on the scene of an active shooter or a bus crash. Sometimes split-second decisions must to be made. Sometimes decisions have to be made with limited information. And sometimes the EMS manager may have to make some tough decisions that have a direct affect on someone’s life. The leadership skills that an EMS manager must show during these critical times are crucial.
In my opinion, one of the finest examples of leadership was former New York City Mayor Rudolph Giuliani’s management of 9/11. Don’t forget, the U.S. president was sheltered away until late in the evening to protect the head of our federal government. President Bush wasn’t seen on television; it was Giuliani who became the face of reassurance on television for the American people. But 9/11 wasn’t the only time Giuliani was thrust into a crisis. He routinely showed up at emergency scenes in New York City.
Giuliani describes four steps for crisis leadership in his book Leadership. “It is in times of crisis that good leaders emerge,” he says.
He says the first step is to be visible. Giuliani says, “While mayor, I made it my policy to see with my own eyes the scene of every crisis so I could evaluate it firsthand.”1
Who can forget those scenes of Mayor Giuliani walking on the streets of New York with his contingent of staff and department heads while being interviewed by the news media? EMS managers must respond to scenes and take charge of their operation. Many times, they fall into the incident management structure. Although they may not have overall command of an event, EMS managers are still responsible for the medical operations branch.
Giuliani’s second step is to be composed. He writes in his book, “Leaders have to control their emotions under pressure. Much of your ability to get people to do what they have to do is going to depend on what they perceive when they look at you and listen to you. They need to see someone who is stronger than they are, but human, too.”
Many times in my career I’ve seen an incident commander yell or even scream into a radio. Yelling on the radio or at employees on a scene, or giving an appearance of being out of control, is a prescription for crisis—the situation EMS managers are trying to control.
Giuliani’s third step is to be vocal. He writes, “I had to communicate with the public to do whatever I could to calm people down and contribute to an orderly and safe evacuation [of lower Manhattan].”
EMS managers must demonstrate the same trait during a high-intensity event. You need to be able to give people firm directions and instructions. You need to give your employees or others clear and concise instructions or action steps.
Giuliani’s fourth step to crisis leadership is to be resilient. Giuliani describes himself as an optimist. With his words during some of his press conferences about 9/11, he gave Americans hope that they would meet this challenge and overcome it.
EMS managers must also show the same resiliency. They demonstrate through actions and words that whatever the challenge that the EMS organization and its employees are facing, they’ll be able to deal with it.
And, most importantly, always remember there are times to demonstrate everyday leadership and times during emergencies that you have to demonstrate true leadership skills. JEMS
1. Giuliani R: Leadership. Hyperion: New York, 2002.