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Caring on the Clock: The Complexities and Contradictions of Paid Care Work

Caring on the Clock brings together research on paid care workers in health care, education, child care, mental health, and social services. Editors Mignon Duffy, Amy Armenia, and Clare L. Stacey note that with some exceptions, many jobs in the aforementioned occupations were historically regarded as unpaid work that women did in the home, and they continue to be economically and socially devalued due to the marginalization of gender, race, ethnicity, citizenship, and/or the class of workers who dominate particular segments of the sector. The book’s 23 chapters are divided into six parts; the editors introduce the topic’s significance and provide a historical overview of the scholarship of care in Part I. Chapter One, ‘‘On the Clock, Off the Radar’’ compellingly argues how the growing numbers of paid care workers and the intersections of their experiences with the critical needs of families and labor markets affect society and necessitate the understanding of paid care work in the contemporary United States. Duffy, Armenia, and Stacey reiterate some of the well-known aspects of the scholarship of care, such as the concentration of women and the clustering of immigrant workers and racial or ethnic minority workers in some of the lowest-paid and devalued sectors, while crossing disciplines to highlight lesser-known experiences such as physical and psychological hazards that care workers face in fields such as health care and social services. Through an eclectic yet informative range of empirical studies, the authors and editors strive to spark discussions on organizing and policy/practice changes that workers, employers, and the government can pursue collaboratively to improve overall work conditions and provide quality care for recipients and workers alike. The editors and contributors call attention to just how vast and complex the paid care work industry is in the United States. First, the authors do this methodologically. Some studies provide analyses of specific occupations (e.g., home health aides, nursing assistants, frontline health workers), drawing from quantitative analyses of national data and survey sets. Many of the qualitative studies with identified locations were conducted in urban metropolitan areas in the northeastern United States, such as Massachusetts and New York; others located in Washington D.C., the southwestern United States, Illinois, Portland, Oregon, and California offer welcome and necessary geographic diversity to illustrate intersections of local, state, and national settings and institutions. Additionally, two studies set in Canada and an article on parental leave in Sweden provide comparative global perspectives (albeit of other developed western nations) of how government policies influence structure and culture around work, family, and care workers/ systems. Second, the essays compare and contrast workers across different occupations, from nurses, home health aid workers, childcare providers, domestic cleaners, hospice workers, and social workers to lifestyle service providers such as interior designers, financial planners, and personal assistants. They work in different settings, such as hospitals, institutions, and residential homes, serving low-income to wealthy clients. Some are paid caregivers to their own family members (see, for example, Chapter Seventeen); others interact closely and regularly with a limited number of clients and their family members (see Chapters Four, Five, Nine, Thirteen, and Fourteen); while others have to contend with multiple clients under strictly enforced time constraints and a rapid work pace (as in Chapters Three, Five, Seven, and Sixteen). For example, Janette S. Dill (in Chapter Five) explores the low wages, high turnover rates, and the lack of job quality and upward mobility opportunities in frontline direct care, care support, administrative, and allied health (with some technical training) workers in some of the fastest growing healthcare occupations. Reviews 61