On the Clock: The Local Angle

Earlier this year, acting on a tip that ambulances were being called quite frequently to what is now known as the Sydney Call Centre (although for most of the period for which I requested figures, it was the ServiCom call center), I FOIPOPed the Nova Scotia Department of Health to ask how many times ambulances had been dispatched to the call center on Prince Street, how many of those calls resulted in transport to hospital and what types of emergencies were involved.

To compare the results to another call center, I asked for the same figures for the Convergys center in Glace Bay for the same period.

And to compare the call center results to another employer of a similar size, I also requested the figures for the Canadian Citizenship & Immigration Case Processing Center, on Dorchester Street in Sydney.

Media reports around the time of the ServiCom bankruptcy put employment at the local call center at around 600. I’m not sure how many people work at what is now the Concentrix center in Glace Bay. As for Citizenship & Immigration, a spokesperson told me:

While the number of employees fluctuates throughout the year to address the peaks and drops within various programs, the Case Processing Centre in Sydney Nova [S]cotia (CPC-Sydney) has seen growth over the past year. At the end of March 2019, it employed 680 people, today [10 September 2019] CPC-Sydney employs approximately 800 people (an increase of 18%).

I figure all three businesses are drawing on the same pool of workers, so while this his hardly a scientific study, you would expect levels of illness and injury to be roughly similar.

I put a timeframe of 1 January 2017 to 30 January 2019 on my request, so just over two years (25 months).

The Department of Health responded, noting:

The Sydney Call Centre (Formerly ServiCom Call Centre) shares the same address as the Sydney Shopping Centre. To differentiate between calls to the Call Centre and the mall, the results were restricted to calls where either the location name, or the ePCR free text comments specified “ServiCom” (and potential misspellings) or “Call Centre”.

I’ve put the information I received into the table below. (Note that a Code 1 response means emergency lights and siren while a Code 2 means no lights and siren.)

 

 Servicom/Sydney Call CentreConvergysCitizenship & Immigration
Emergency (Code 1)50272
Urgent (Code 2) 1450
Total64322
Transports by Priority
Emergency (Code 1)37251
Urgent (Code 2)950
Total46301
Chief Complaint
(Code 1)
Abdominal Pain/Problems
Allergies/Envenomation
Back Pain-Non Traumatic
Breathing Problems8
Chest Pain136
Choking
Convulsions/Seizures
Diabetic Problems
Falls
Heat Problems/Internal Defib
Heat/Cold Exposure
Hemorrhages/Lacerations
Pregnancy/Childbirth/Mis/
Sick Person
Stroke (CVA)
Unconscious/Fainting
Cause not revealed2
Total50272
Chief Complaint
Code 2
Abdominal pain/Problems
Back Pain-Non Traumatic
Chest Pain
Convulsions/Seizures
Diabetic Problems
Falls
Psych/Abnor. Beha/Suicide Att
Sick Person
Unconscious/Fainting
Total1450

 

The first thing to note is that 64 ambulance calls — the figure for the Servicom/Sydney Call Centre — works out to 2.6 visits per month.  And 62% of those calls resulted in transport to hospital.

The Convergys figures, while better, are still not what I’d call good — 32 calls over the period works out to 1.2 per month, 92% of which resulted in transport to hospital.

That the figures for the call centers are high is demonstrated, I think, by the figures for Citizenship & Immigration — a similar-sized (if not bigger) workplace with workers drawn from the same labor pool. Over the same period, ambulances were called there twice and only one of those calls resulted in a transport to hospital.

Much of the data I’d requested was redacted on the grounds that releasing it would be an unwarranted invasion of privacy, but the complaints for which there were enough incidents to release the numbers without fear I’d be able to (somehow) identify the people involved are Chest Pain and Breathing Problems. Both can be symptoms of panic attacks, which reminded me that in her book  On the Clock, What Low-Wage Work Did to Me and How It Drives America Insane, (which I’ve discussed at length elsewhere this issue) author Emily Guendelsberger begins her section about working in a Convergys call center in North Carolina with a description of a co-worker being taken away in an ambulance:

A couple of days after the ambulance takes Butch Patty away, she’s back on the phones. I hear through the grapevine that it was just a panic attack, not a heart attack, but our minutes of break time don’t line up enough for me to actually get to talk to her. So I just write GLAD YOU’RE BACK !! on my whiteboard and hold it up for her to read across the aisle. She gives me a thumbs-up.

 

 

Fight or flight

I wanted to talk to someone local about workplace stress, so I contacted Jenna Brookfield, the health and safety representative for CUPE Atlantic Regional Office and she told me this has been an area of focus of her work for a couple of years now. She started by discussing our sloppy use of the word stress:

I think when we talk about workplace stress people automatically assume all the wrong things about what we’re talking about…We use the word stress in such an ambiguous fashion, to start with, which is problematic — you know, “I’m stressed because of the bills, I’m stressed because my kids are back in school, I’m stressed because I have so much work to do.” We associate the word stress with everything, but the word stress is actually referring to a physiological reaction in the body. If you and I were walking down the street and a dog jumped out at us barking and running towards us, we’d have that stress response. We used to call it the “fight or flight” response.

Angry cat, photo by Hannibal Poenaru https://www.flickr.com/people/54832206@N00

Stress response, feline-style. (Photo by Hannibal Poenaru from near Paris, France, CC BY 2.0, via Wikimedia Commons)

If you’ve read my article about Guendelsberger’s book, then you are already familiar with this concept, but I find it so interesting that I’m going to quote Brookfield in full on what happens when something triggers your fight-or-flight response:

[O]ur brains release a whole bunch of adrenaline and cortisol and the effect of that on our body is it draws all the bloodflow away from vital organs and our brains, pushes it all out to our arms and legs to get us ready to fight off the perceived threat or run away from it. This is kind of a product of evolution, this is why humans survived so well for so long, we had all these existential predatory threats on this planet, and this response allowed us to either flee from them, fight them off, or otherwise physically deal with them.

But what helped us for millennia as hunter-gatherers (living what Guendelsberger explains were surprisingly low-stress lives) has proved something of a bug in the modern, low-wage workplace.

Says Brookfield:

[T]he human body has not evolved from that point and our brains are really bad at distinguishing between an existential physical threat and any other kind of threat, so the workplace stressors that we’re encountering today trigger the same sort of reptilian brain response in us. When we get stressed at work, it triggers — on a smaller degree than the barking dog, but it still triggers — a release of cortisol and adrenaline, which makes us think slower and prepares our body for physical action. And in most workplaces today, that’s absolutely counter-productive, because if you work in a call center, you can’t run away from the call volume and you can’t fight it off, you actually have to think your way through those kinds of responses. So, the fact of having the pedal to the metal all the time, of having our brains constantly releasing cortisol and adrenaline, causes a lot of psychological and physical injuries to people.

 

Autonomy

But there’s an additional factor at play here and that is how much control you have over your stressful situation, as Brookfield explains:

Simple example: if I come home from work, my kids have made a terrible mess in the kitchen, I’ll feel some stress, but it’s well within my control to make that stress go away — [I can] clean the kitchen, I can yell at my kids and I feel much better after that.

Contrast that with a work scenario where we really can’t often control the source of stress. If I’ve been told I arbitrarily need to answer 20 phone calls and I know how long a call takes and I can really only do 15 in that time period, I’m going to be in a constant state of stress I can’t make go away… I’m constantly having this physiological stress response that’s in my body, having both a psychological and a physical effect on me and I can’t turn it off. A call center is a prime example of that high stress environment.

Brookfield noted that jobs like hers (and mine), although they may involve a lot of work, also come with a lot of autonomy:

We’re both very self directed. I don’t have a boss saying “Be here at this time, be here at that time.” My boss might say, I want you to work on this project, maybe work with these people, but then I’m given some autonomy to schedule meetings and work with them as I see appropriate and bring the final product back to my boss…[W]e might both consider our jobs to be stressful, but it’s not causing that physiological stress response because we’re not having that fear response that we’re not going to meet this arbitrary deadline.

Guendelsberger says most of our understanding of the effects of chronic stress on human comes from “intentionally doing unpleasant things to rats,” and this research has:

…nailed down the crucial elements of body-and mind-wrecking stress: lack of predictability and lack of control.

I haven’t explored the lack of predictability aspect of low-wage work, but employees in such positions often receive their schedules at the last minute, making it impossible for them to plan more than a week (or a few days) ahead.

As for the lack of control, Brookfield noted that one difference between unionized and non-unionized workplaces is that unionized workplaces tend to have “better direction and job descriptions” because “at some level, they’ve been negotiated.” That can have a spillover effect to the non-unionized workers in the same workplace, says Brookfield, they may benefit from “the fact that the workplace has that more sophisticated level of organization.”

We then discussed the lack of unions in places like call centers. Brookfield, after noting that the subject was outside of her area of expertise, said she could imagine few things more stressful than trying to bring a union into a workplace hostile to unions.

 

Moral hazard

It’s ironic, really, that one of the biggest bonuses touted by the Sydney Call Centre is “free health benefits.”

I get why that would be attractive, even in a country with a single-payer healthcare system, chiefly because that system doesn’t cover prescriptions or dental care. But I also have to weigh it against the health problems associated with high-stress work environments.

I asked Brookfield if keeping employees stressed wasn’t, ultimately, counter-productive for employers. Guendelsberger had suggested that the high turnover in low-wage jobs makes financial sense to employers, because training people is cheaper than paying higher wages or improving work conditions. But Brookfield said you also need to ask if the employer is paying the price for the injury they are causing people:

[I]f you are, as an employer, funding sick leave and short- or long-term disability, you actually have a financial incentive not to hurt people in this way, because if you do, if you burn them out too quickly, then you’re going to be paying financially the cost for that as they’re unable to work and you’re also paying someone else to do that job.

I’m not sure what the call center’s pay system looks like, but a lot of non-unionized workplaces don’t have access to the same kinds of benefits, so…there’s often no financial penalty for the employer to have this kind of high-stress environment. They get all the benefits of pushing people to the extreme, they actually kind of push the adrenaline response, get the most out of people and then society, as a whole, has to deal with the consequences because when those people can’t work, their options might be EI, it might be the social welfare system, and obviously the health outcomes, we’re all collectively paying for through a publicly funded medical system.

That’s classic moral hazard — why would you worry about injuring employees if you won’t bear the cost of those injuries? Although the term implies there is some sort of morality associated with corporations, like they can be evil, which Guendelsberger says they cannot:

They just are what they are. They aren’t capable of being anything else.

But right now, we treat them like the guy in Grizzly Man treated bears — like they have the capacity for compassion, mercy or shame. But believing that human social norms will constrain a corporation’s behavior when it smells money in the water is just begging to get eaten alive.

Brookfield has a little more faith corporations and says there are tools available to employers looking to address workplace stress, like the new Canadian Standards Association standard on Psychological Health and Safety in the Workplace and a sort of tool kit put out by Simon Fraser University called Guarding Minds at Work. (The federal government also offers guidelines for Psychological Health in the Workplace. 

(I would like to think corporate CEOs would read these documents and take them to heart but to be honest, I find it easier to picture them eating them. That Grizzly Man analogy has had a powerful effect on me.)

My next step will be to contact the call centers and get their side of this story. My hope is that my call will be very important to them and I will be able to report their responses next week.