Unpredictable schedules take a toll on nursing home workers, UMass authors say in new book

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Even at nursing homes with stable staffing and occupancy, a large percentage of workers struggle with highly unpredictable schedules, according to findings in a newly published book from researchers at the University of Massachusetts, Amherst.

Unpredictable schedules are “pervasive” in healthcare, the authors wrote in an American Prospect op-ed published Friday. They focused in particular on what they found at a nursing home when researching their book, Unequal Time.

“This was a high-end nursing home, with much lower than average staff turnover, where almost all beds are occupied all the time so that the nursing home has the same number of staff each day,” they wrote. “Nonetheless, in this most stable of situations, roughly one out of every three shifts was not according to schedule; that is, either someone was working when they weren't scheduled in advance to do so, or someone was not at work when the planned-in-advance schedule said they should be.”

The authors heard repeatedly from long-term care nursing assistants on the topic of additional shifts. The assistants said they were desperate to supplement meager paychecks.

Stating that these staffing practices “create havoc in workers' lives,” the authors called for action. They noted that policymakers have begun to take note, and already have introduced some measures such as the “Schedules that Work Act.” But government metrics also should better capture scheduling unpredictability, to give an idea of the economic costs of an exhausted and stressed workforce, the argued.

Unequal Time is now available from the Russell Sage Foundation press. It was written by Dan Clawson, Ph.D., and Naomi Gerstel, Ph.D., both professors of sociology.