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

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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."