The acceptance of registered nurses only, and the requirement of Civil Service Examination in addition, would do much to raise the level of efficiency. These requirements, however, valuable as they are, would by no means ensure the suitability of the applicant, or guarantee the selection of nurses best adapted to public health work. Over and above this, the Superintendent should have free choice in selecting her workers, not only from the point of view of education, but also that of personal worth. =“Politics” in the Co-operating Divisions.= Sometimes the Tuberculosis Division itself may not be on a political basis, but the various other divisions of the Health Department may be conducted in such a manner as to nullify much of the nurses’ work. For example: much depends upon the co-operation of the Fumigation Division. If the men employed to fumigate houses do their work badly or improperly—if they are too lazy to stop chinks and crevices, thus permitting the disinfectant to leak out; if too ignorant to properly measure the rooms, and unable to calculate the necessary amount of formaldehyde, this work will be valueless. Worse still if they are the kind that can be “bought off” and so shirk work entirely. Or the trouble may be with the Sterilization Division, where the duty of the employees is to carry mattresses, etc., from the patient’s home to the city sterilizer. When there is no law compelling this sterilization, and it is an optional matter with the householder, if done, its doing is altogether the result of the nurse’s teaching and advice. If the waggon drivers are lazy and do not wish to carry the heavy mattresses, they can shirk work by means of false excuses often difficult to detect. For example: they can report that when a certain mattress was called for, the family had changed their minds about having it sterilized and refused to have it done. Upon investigation, we find that this refusal was at the instigation of the waggon driver himself—he had assured the family that sterilization was an unnecessary and stupid proceeding. To ignorant minds, one Health Department employee is as good as another, and when the advice is conflicting, they choose that which best pleases them. Again, the fumigators or drivers may report that they cannot get into a certain house; the key could not be found; there was no one to admit them, or give them the articles to be removed. In innumerable ways they may compel the nurse to return again and again to the same house, to make arrangements which they try to frustrate by every conceivable device.