Explaining Job Hours and Schedules: Individual, Familial and Organizational Processes in Four Health Care Occupations

摘要：解释工作时间和日程安排：四种医疗保健职业的个人、家庭和组织过程麻省大学的naomi Gerstel和Dan Clawson工作时间和日程安排一直是近年来一些最尖锐的政治冲突的主题，在国会、法院、总统选举和媒体上进行了激烈的辩论。研究的重点是确定美国人平均花在有偿工作上的时间，在过去的一代人中，平均工作时间是增加还是减少，以及阶级和性别差异的程度。这项研究的结果构成了我们研究的起点，我们的研究考察了产生这些时间和时间表的个人、组织和家庭过程。提出的研究借鉴了组织和工作-家庭关系的理论来检查过程塑造工作时间。我们认为这些在许多交叉的层面上运作：在员工个人层面，通过对优先事项和必需品的个人选择；在组织层面——通过行政命令、雇主和工会之间的谈判，以及工人、主管和同事之间的现场谈判；最后，在家庭层面——配偶和子女鼓励或阻止员工加班或加班。虽然之前的研究很少关注产生工作时间和日程安排的社会过程，但它证明了阶级和性别是时间不平等的关键相关因素，它们是我们研究设计的核心：两个职业主要是男性（医生70%是男性，EMS 79%是男性）；两个主要是女性（护士94%为女性，护理助理90%为女性）。两个是专业职业，两个是工人阶级职业。研究卫生保健职业提供了实质性和方法学上的优势。从本质上讲，医疗保健之所以引人关注，是因为它占美国经济的很大一部分，涉及服务业和白领工作，这些都是典型的增长领域，每周7天24小时提供服务，并且涉及到工作时间和日程安排方面的重大争议。虽然卫生保健的这些特征并不适用于所有经济部门，但许多时间过程可能以类似的方式在其他部门中运作，这些部门具有许多相同的广泛特征。从方法上讲，我们能够随机抽取样本，因为一个人必须得到国家的认证才能在四种医疗保健职业中工作；这意味着我们可以从完整的登记名单中抽取样本。在之前的一项试点研究中，我们就抽取了这样一个样本，并对四种医疗保健职业的200名成员进行了调查。在本研究中，我们将使用该试点调查的样本和结果进行多方法定性研究。以前对工作时间的研究要么是基于大规模的调查数据，要么是基于单个组织的案例研究。相比之下，拟议的研究考察了密切相关的四种职业和多个组织。从已完成的随机抽样调查中抽取受访者，我们将对从事这四种职业的员工、他们的配偶和直接主管，以及决定员工选择结构政策的人进行访谈。此外，我们将收集有关政策的文件，并进行观察，以调查这些不同群体之间的相互作用。这将识别上下文问题，这些问题可能很重要，但被受访者认为是理所当然的，因此在访谈中不容易引出。本研究具有一定的现实意义。随着越来越多的经济转向全天候运营，工作时间成为一个越来越重要的问题。工作时间在医疗保健行业尤为重要：美国的医疗成本远高于其他国家，医疗保健成本的增长速度超过了消费者价格指数的增长速度，美国医学研究所（Institute of Medicine）的一份报告发现，“长时间工作是对患者安全构成最严重威胁之一。”

ABSTRACT Explaining Job Hours and Schedules: Individual, Familial, and Organizational Processes in Four Health Care OccupationsNaomi Gerstel and Dan Clawson, University of MassachusettsWork hours and schedules have been the subject of some of the sharpest political conflicts of recent times, vigorously debated in Congress, the courts, presidential election, and media. Research has focused on establishing how many hours the average American spends in paid employment, whether average hours have increased or decreased during the past generation, and the extent of class and gender variation. The results of this research form the starting point for our research, which examines the individual, organizational and familial processes producing these hours and schedules. The proposed research draws on theories of organizations and the work-family nexus to examine the processes shaping work hours. We argue these operate at a number of intersecting levels: at the level of the individual employee, through personal choices about priorities and necessities; at the level of the organization-- through administrative mandate, negotiations between employers and unions, and through worksite negotiations between workers, supervisors, and co-workers; and, finally, at the level of the family--as spouses and children encourage or discourage workers from putting in extra hours or particular shifts. Although prior research rarely looks at the social processes producing work hours and schedules, it documents that class and gender are key correlates of inequality in time, and they are central to our research design: Two occupations are predominantly male (physicians 70% men, EMS 79% men); two are predominantly female (nurses 94% women, nursing aides 90% women). Two are professional and two are working-class occupations. Studying health care occupations offers both substantive and methodological advantages. Substantively, health care is of interest because it includes such a large fraction of the U.S. economy, involves service and white collar jobs that are typical of growth areas, delivers services 24 hours 7 days a week, and involves significant contestation over work hours and schedules. Although these characterizations of health care do not apply to all sectors of the economy, many of the temporal processes likely operate in a similar fashion in other sectors which share many of these same broad features. Methodologically, we were able to draw a random sample because a person must be certified by the state to work in any of the four health care occupations; that meant we could draw a sample from complete lists of those registered. In a prior pilot study, we drew just such a sample and conducted a survey of 200 members of each of the four health care occupations. In this research, we will use the sample and findings of this pilot survey for a multi-method qualitative study. Previous studies of work hours have been based either on large scale survey data or on case studies of a single organization. In contrast, the proposed research examines four occupations and multiple organizations that are closely connected. Drawing respondents from the completed random sample survey, we will conduct interviews with those who work in each of the four occupations, their spouses and immediate supervisors, as well as those who determine the policies that structure employee options. In addition, we will collect documents about policies and do observations to investigate the interactions among these various groups. These will identify contextual issues that are likely to be important but so taken for granted by respondents that they are not easily elicited in interviews. The proposed research has practical significance. Hours of work are an increasingly important issue as more of the economy moves to 24/7 operations. Hours of work are particularly crucial in the health care industry: U.S. costs are far higher than those in other countries, health care costs are increasing more rapidly than the consumer price index, and an Institute of Medicine report found that "Long work hours pose one of the most serious threats to patient safety."