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the operators. The observer has a board which is called an observation board and from which she can plug in on any operator, follow her work in detail, time her calls, hear her remarks and also those of the subscriber.

There is no doubt that close supervision is necessary. It is true, however, that this close double supervision which the Company gives the girls plays a very large part in the nervous strain on the operator. One supervisor has been reported as walking back and forth behind her 8 or 10 girls saying in low monotonous voice, "Hurry girls, hurry girls." With a girl answering calls as rapidly as possible, and with lights flashing in front of her eyes continually, and the buzzing in her ears, the fact of being driven from behind irritates many of the girls to the extreme.

The Public's Part.

The impatience of subscribers is the next important cause of nervousness. With each call a light flashes in front of the operator, several of these lights flashing simultaneously show that a number of subscribers are calling for numbers at the same time. The operator is expected to give the quickest possible attention to each, and to remember which light flashed first. When several signals come at once, and others come before these can be cared for, the order is necessarily lost and her effort is concentrated on clearing the board. When an impatient subscriber jiggles his receiver he not only flashes the signal light in front of the operator, but when the operator opens her key to learn his wants, a clicking sound is caused in her ear every time the subscriber moves the receiver up and down.

Consciousness that a number of subscribers are waiting to have their calls attended to, their growing impatience emphasized by the constant flash of lights before her eyes, and the incessant buzzing in her ears, together with the knowledge that the supervisor is standing behind her either hurrying her or asking other operators to attend to her numbers, and that the observer may plug in to criticize at any moment, causes strain which might in some degree be lessened if subscribers learned to be a little more patient.

The operator is allowed to respond in certain set phrases such as "Number please," "Excuse it please," etc. She may not "talk back" no matter how much she is being abused by a subscriber, and any abuse which the subscriber may heap on the operator only delays her operations and clogs her switch board.

Rest Periods.

The policy of the New York Telephone Company requires a 15 minute break during the first half of the day's service and another 15 minutes during the second. During the year 1919, because of the shortage of labor, this policy has not been universally practiced. In some New York City exchanges and in the exchanges of the up-state cities it has been possible to adhere to this rule, but in far too great a number of the exchanges the rest periods have been entirely eliminated or only one period of rest given during the entire working day.

Telephone operating, entailing as it does such physical and nervous strain, shows imperative need of establishing 15 minute rest periods in each half of the shift. That four hours operating without any cessation from work or any let-down is too long, is the testimony of the medical authorities of Toronto on the study of telephone operating made by the Royal Commission. The strict observance of rest periods would materially benefit the efficiency of the telephone service

MEDICAL DEPARTMENT

The records of the Medical Department are considered by the Company as strictly confidential and very little information can be obtained about the girls reporting disabilities of various kinds and seeking medical treatment. Certain it is that the Medical Department should play a very important part in determining standards of any sort in the telephone industry. The operators are subjected to peculiar conditions because of the nature of the occupation. They are employed at an age when they are particularly sensitive to strain and nervous exhaustion. The telephone industry imposes upon the girls conditions which subject them to eye strain, ear strain, and nervous tension. Rest periods have been found essential from the point of view of service. The Medical Department of such an industry has a peculiar responsibility in adding constantly to the scientific knowledge now available on the relation of working conditions to health. This knowledge at the present time is all too meager and is largely composed of the opinions of medical men rather than carefully worked out studies covering periods of time long enough to make the results of great value.

Dr. Richardson, of the New England Telephone Company, found in examining the Benefit Fund records of the New York Telephone Company for 1917 that there had been 631 cases of nervous disability, including neuralgia and neurasthenia. Among the employees of the Company this was a rate of 55.8 per 1,000 employees per annum eligible for sickness disability. The rate for the total Bell system was only 33.4 per 1,000. The need is very obvious for special study of fatigue in an industry in which nervous tension is so omnipresent.

At the present time in the New York Bell Telephone Company the Medical Department is made up of 27 physicians, each of whom is on duty for three hours a day, and 15 graduate nurses, who are on duty for full time. The doctors and nurses are centered in New York, Brooklyn, Newark and Mt. Vernon, one to ten doctors in each district, and from one to seven nurses.

In the parts of the State where no regular Company physicians are employed arrangements are made by the Directors of the

Medical Department with practising physicians in the different districts. These physicians are then on call for the necessary emergency work in connection with accidents and examinations of Telephone Company employees. Outside New York City and its outlying districts the Company's medical service has not been extensively developed.

The Medical Department in New York City has compiete equipment for making blood tests, taking X-rays, etc., and where examinations of this sort prove to be needed, the Company makes them. In special cases, also, the Company supplies needed medical care from outside specialists when the employee is unable to afford such care.

The cost of these special cases is not included in the budget of the Medical Department. In 1918 this budget amounted to ap proximately $93,000.00. $75,000.00 of this went into salaries and wages, $3,000.00 was spent for equipment, and $15,000.00 was charged to miscellaneous items such as printing, house charges, etc.

If

The Medical Department has complete supervision of the health of employees. Every employee of the Company is eligible to medical service and a medical examination is one of the requirements of employment. These physical examinations are given for the operators in connection with the training school by women physicians. If the applicant for a position is employed at the time of her application, she is given a physical examination before she enters the training school, so that she will not have left her other work while there is a chance that her physical condition will bar her from employment with the Telephone Company. she is not employed at the time of her application, however, she enters the training school immediately and some time during her training course an appointment is made for her physical examination. The examination is short and of necessity superficial, lasting usually about 15 minutes and rarely more than 30 minutes. A brief medical history of the girl and of her family is made out by the nurse before she is examined by the doctor. Particular emphasis is placed on heart and lung conditions and ear and eve trouble. An eye test is always given either by the interviewer in the Employment Department or by the physician examining her.

Very often the girl is advised concerning slight disabilities which can be easily remedied by proper treatment — such as bad condition of teeth or throat.

In 1919, of the 9,428 applicants examined for operating positions 815, or 8.6% were rejected because of physical disability. One-fifth of these rejections were on account of lung conditions, one-tenth on account of nervous disorders, and 18% were rejected because of under-development; yet at the present time the examining physicians are taking girls who are obviously below par physically if they think the girl is at all able to do the work, and can be gradually brought up to physical standards while she is employed.

No treatment other than emergency treatment is given by the Medical Department, the work is confined to diagnosis and the employee is referred to her own private physician for whatever treatment is needed.

Additional physical examinations can be made from time to time in individual cases whenever the doctor feels it necessary or when an employce requests it. Often these examinations are in connection with employees receiving medical benefits where any question arises concerning their exact physical condition.

The Medical Department is also supposed to serve in an advisory capacity concerning the general sanitation of the Company's plants, but does not have direct charge of such things as disinfecting rooms, buildings, etc.

It is extremely unfortunate that the records of the Medical Department and those of the Employment Department are so unstandardized that very little material of significance can be secured from them. Losses because of physical condition form such a large proportion among the students in the training school that careful analysis and records would seem essential, yet the largest number of these losses are classed with the miscellaneous group of reasons for resignations and dismissals from the student force. An analysis of the miscellaneous group of causes for dismissals for the year 1919 discloses the fact that among 618 students who were dismissed, 473 had to leave because they were physically unfit. In addition to these there are six other groups

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