Thursday, October 09, 2014


Dan Clawson and Naomi Gerstel have written a book which has just been released which will probably be worth the read.  In the book, Unequal Time, the two: 

.. .explore the ways in which social inequalities permeate the workplace, reverberating through a web of time in which the schedules of one person shape the schedules of others in ways that exemplify and often exacerbate differences between men and women, the privileged and disadvantaged.

What the authors find is what we know.  Capitalism, global capitalism, is finding better and better ways to exploit those upon whose labor the system depends.  Hours not quite up to enough to qualify for this or that "benefit,"  schedules all over the clock, substitutions, part time, seasonal, you know all the words which describe all the ways capital finds to squeeze every last bit of surplus labor out of working people the world over.

Further, the squeeze put upon workers impacts every one of us, well every one of us who are not way up at the top.  This Clawson and Gerstel demonstrate and explain rather well in their discussion of low paid healthcare workers, the very workers who we depend upon when we are sick, or feeble, the very workers we depend upon to care for those we love in hospitals and nursing homes.  The squeeze which is put upon them goes far beyond dollars and cents.  It impacts their own health, it impacts the quality of care which they can provide.

This is class struggle.  This is the multitude verses global capital.  This is life and death.

I have to be moving along so I am going directly here to two different posts approaching the same subject but from slightly different perspectives.  The first, amazingly for Scission anyway, is taken from NBC News.  The second comes from Colorlines.


BY Seth Freed Wessler

For many workers, American medical care is going the way of fast food and retail: unstable schedules, punitive employers, and rigid management. That’s according to Unequal Time, a new book by University of Massachusetts sociologists Dan Clawson and Naomi Gerstel that was published on Tuesday. “Across the health sector, work has become increasingly unpredictable,” Clawson says. “And it’s low-wage workers and women whose lives are thrown most into chaos.”

Clawson and Gerstel interviewed dozens of workers, including one certified nursing assistant who she worked unpredictable hours in a nursing home and was expected to come in even when sick. “They say a sore throat is not really a sore throat,” the nurse’s aide told the authors.

In an interview about his new book, Clawson told NBC that the practices workers like this one described have become commonplace.

NBC: You studied doctors, nurses, EMTs and nursing assistants, and found that the sector has become increasingly unpredictable for workers across the spectrum. But you say that nursing assistants, overwhelmingly women and relatively low-paid, are hardest hit.
Clawson: The thing about health care is that there has to be someone on duty all the time. You can’t have a nurse walk off and have the patients not covered for an hour. That’s uncontroversial, but the way that plays out is unequal by gender and class, and it’s absolutely unsustainable for the lives of low wage workers and women.
We studied a high-end nursing home, for example. Most patients are in private rooms, there are a stable number of beds and a stable number of workers. Yet even in this highly controlled setting, we found that over a third of nursing assistant shifts were unpredictable: either they were working an unplanned shift or not working a planned shift. There’s a tremendous amount of unpredictability and churning in a workplace that should be the most stable of employment situations. It’s likely worse in other homes.
NBC: What does that mean for workers? Couldn’t that flexibility really be a good thing for workers with families? You call it unpredictability. But couldn’t it be a result of workers choosing to change their shifts?
Clawson: The question of choice or not choice is a false dichotomy. Employees in the nursing assistant position are usually scheduled for three or four 8-hour shifts a week. They know they’ll have these shifts. But that’s only 24 or 32 hours a week, and workers need 40 hours to be able to come close to supporting their families [nursing assistants, about 90 percent of whom are women, make an average of about $10 an hour]. So when they’re told to come in for a shift that they didn’t plan, they really have no choice. They know every week that they’ll work 8 or 16 hours unpredictably, and they have to work the shifts because they have to pay rent. Many of these workers are women with kids, often single mothers—they happen mostly to be women of color—and so they have to work as many hours as they can. It makes it very hard to schedule the rest of life, to make arrangements with other relatives to care for kids. The key thing is that their lives have to be always at the disposal of the employer, even when sick.
NBC: So how does this function differently for higher paid or more male-dominated parts of the health sector?

Clawson: Some parts of what I’m describing are creeping into the work lives of nurses. One major hospital scheduled nurses for 40 hours per week but the hospital reserved the right to cancel the shift up to two hours before it began. It’s starting to affect higher paid workers too, but less so.
For doctors it’s a different situation, where rather than working an extra shift, they are much more likely to work late because they are working with a patient and are expected to stay until they’re finished. And the thing we found is that half of doctors—who are more likely to be men—had stay at home partners. Others have people they can pay to care for their children. They maybe eat dinner late, but there’s someone caring for the kids.
Another thing we found was that as unpredictability gets worse for lower wage workers, in the more privileged occupations, structural adaptations have been created to help address the problems of unpredictability. There’s now a whole doctor specialist called the “hospitalist” whose job it is to check on the patients and relieve other doctors of long hours.
NBC: You quote workers talking about coming to work while sick because they have so little control over their hours and sick days. There’s also been a lot of criticism of elder neglect in nursing homes, of patients who are not properly cared for. How do the scheduling practices you researched affect the well being of patients?
Clawson: Another gender and class difference in the health sector is about how punitive the scheduling policies are. In many workplaces, like the ones we studied, nursing assistants got six days a year of paid sick leave, but if they used more than four of those days in any 90-day period, they lost their jobs. If you think of it from the perspective of a single mother with kids, the younger kid gets sick and then the other kid gets sick and you get sick, you use up the time. One more, you’re fired.
Because of these practices, when workers got sick, they made every effort to come in anyway. In these jobs, a sore throat is not really a sore throat. Nursing assistants are coerced to come in when sick because otherwise they may lose their job. And this is while they are feeding, washing and caring for 90-year-olds who are in poor health.
And we can see that a hospital has every incentive not to collect information on sick workers. There is no record.

NBC: This sounds very hard for workers, but as you said before, healthcare is not a field where you can simply be understaffed. So how do you avoid the kind of destructive unpredictability?
Clawson: Within healthcare there’s a duty of care: you are required to stay with a patient and can’t leave till there’s alternative coverage. But what we know is that employers are staffing shifts in a very lean way, which means that there’s no slack in the system. The leaner the staff, the more you’ve cut to the bone, the more disruptive every change becomes. The staffing is leaner because increasing profits are central now to the success of the organization. But it would be better for patients and hospital and residents of nursing homes if there were more people available to take care of patients.
This is part of a shift toward greater inequality, toward jobs that are more insecure, and contracted out, and that don’t provide the stability and advancement that they used to. Everyone is vulnerable — some are more vulnerable than others.


A New Labor Issue: Control Over Time

Photo: Joe Raedle/Getty Images

In a new book, “Unequal Time,” sociologists Naomi Gerstel and Dan Clawson argue that workers’ control over their time is a crucial labor issue that deserves more attention. “Most the conversation about inequality is about wages—and that’s a really important discussion,” says Gerstel. “But time is a key way to talk about inequality.”

For “Unequal Time,” Gerstel and Clawson studied four professions within what they call the medical-health sector: doctors, nurses, emergency medical technicians (EMTs) and certified nursing assistants (CNAs). Their research emphasizes how class and gender impact who has the most control over their regular work schedules and time off.

Doctors had the most amount of control, and were the wealthiest and most male profession in the group. They had the most control over what schedules they worked regularly, and when they took time off for illness, vacation or caregiving. The CNAs, on the other hand, the lowest-paid employees and mostly female profession in the study, had very little control over any of these questions. They worked schedules determined by their employers, with little flexibility for time off.

Race is often considered in the text, but in their study, the authors didn’t look at race as a factor independent from class. Part of this was caused by the study design—they set out to look at how gender and class specifically impacted these workers differently. But the demographics of the so-called medical health professions they included also made it difficult to draw conclusions that were about race separate from class. The doctors, EMTs and nurses were all less than 13 percent non-white while the CNAs were 58 percent non-white. Because there were so few doctors, nurses and EMTs of color in those professions, the authors cite fear of violating their confidentiality if they discussed the racialized experiences of those individuals.

The one place where they were able to extrapolate more about race was within the group of nursing assistants. They studied two different nursing homes in the same region of the country; one had a predominantly black staff and the other a predominantly white one. “The black women faced much more rigid regulations and were distrusted by management,” says Gerstel. “The white women at the [predominantly white] nursing home were not [treated in the same way].” But the authors say that the differences between the two nursing homes also made it difficult to definitively say what conditions were about race and which were caused by institutional differences. Ultimately, Gerstel and Clawson argue that class is the common denominator between the conditions they witnessed, while acknowledging that class is also racialized. “White working-class women, black working-class women and Latina working-class women faced many of the same deficits of time and unpredictability, an inability to control their time,” says Gerstel. 
“Unequal Time” also addresses the ways family structures create pressures on women of color at work and at home.”So you’re a single mother, with two kids at home, one of whom has asthma, and you’re in a job where you’re unexpectedly offered an extra shift [that] you need to take because you need the money. You’re facing unpredictability in two arenas,” says Gerstel. “Your life is chaotic.”
As if to prove her point, news of the untimely death of Maria Fernandes, a 32-year-old mother and employee at three different Dunkin’ Donuts locations, was reported by the New York Times on the morning I interviewed Gertsel. Fernandes’ presumed accidental death from gasoline fumes and carbon monoxide occurred as she napped in her car between jobs with the motor running. In that instance, it was likely a combination of low wages and scheduling—of needing to juggle shifts at three different locations to make ends meet while not being able to schedule in sleep between shifts.
Economic factors such as increased unemployment post-recession have exacerbated the situation for the low-wage workers. “The CNAs more than any other group have relatively high rates of unemployment. We know the rates of unemployment among people of color are much higher than among whites,”says Gerstel “If the unemployment rate is higher, what happens is that employers can staff lean—hire you for 24 to 32 hours [per week]. Then on any given day they can say ‘I’ve got an extra shift. Can you take it?’,” says Gerstel. “They’re not mandating overtime. They’re offering overtime that you can’t refuse because of the conditions of employment that they’ve provided. It’s that kind of lean staffing and unpredictability that we think is the new normal.”
The conditions described in the book, particularly for the CNAs, create a precarious situation where workers struggle to make ends meet but also face punitive policies that restrict how often they can miss work for things like illness or caregiving. In the other professions studied, particularly the doctors and nurses, there was much more flexibility and control in the hands of the employees to help them manage these responsibilities, not to mention financial means to pay for childcare or have a stay-at-home spouse.
Recently there has been a policy push to address employer scheduling practices. In July, Senate Democrats introduces the Schedules that Work Act. “By creating a right for all employees to make scheduling requests, and protecting employees who make requests from retaliation, the Schedules That Work Act would give employees a say in their work schedules. Employers would be required to consider scheduling requests from all employees and provide a response,” reads a fact sheet from National Women’s Law Center about the law. Unless there is a bona fide business issue, employers would be required to grant requested schedule changes for things like caregiving, pursuing education and workforce training, or for the employee’s own serious health condition.
Gerstel expressed mixed feelings about the potential legislation: “It is important and could, if passed, deal with some of the worst issues raised in “Unequal Time” and some important aspects of the unpredictability that creates havoc in the lives of low-wage workers who are mostly women and often women of color,” says Gerstel. “It is good, for example, that it not only includes pay for those who come to work but are sent home, but it also covers workers at establishments with 15 or fewer workers.”
Among the bill’s limits, Gerstel says it overlooks the service sector, that the definition of family may be too limited to encompass everyone and that it may give the employer too much leeway to deny requests for time off. And of course, enforcement of any legislation becomes a major issue once it’s been passed. Gerstel and Lawson point out in the book that it is the women of color in the nursing assistant roles who were least likely to take advantage of the benefits of the Family Medical Leave Act, a major policy meant to improve worker protections.
“One of the arguments we’re making is that we’re led to believe that the retail sector is the place where there are unpredictable schedules creating chaos. What you read about in the media is the unpredictability of the lives of young people in retail jobs—Starbucks or clothing stores or restaurants,” says Gerstel. “But that really understates the pervasiveness and the new normal of unpredictability. In the health sector, in the service sector, across class there is a huge amount of unpredictability. And it’s the CNAs, the women of color, who have the least amount of control over this unpredictability.”

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