One afternoon in mid-August, Senator Hillary Clinton visited a Nevada hospital to participate in a union-sponsored "Walk a Day in My Shoes" program for presidential candidates. There she learned firsthand about the new realities of work schedules for nurses--and many other wage-earners.
Clinton expressed amazement at the workload of a typical healthcare professional. "Your mother worked me to the bone today," she told the children of Michelle Estrada, RN, during a dinner-table conversation at their home later that evening.
What's really amazing--and appalling--is that Estrada's twelve-hour days are not unique. Americans today spend far more time on the job than workers in any other advanced capitalist country. Whether unionized or not, most lack the legal protection necessary to resist forced overtime and "nonstandard" shifts. As a result, one of labor's greatest twentieth-century achievements--the eight-hour day and forty-hour week--is rapidly becoming a thing of the past for millions of people, with neither the AFL-CIO nor "labor-friendly" Democrats doing much about it.
For unions, the decline of the eight-hour day is no minor embarrassment. Their ninteenth-century movement to shorten ten, twelve and fourteen-hour work days spawned general strikes in the 1880s, the Haymarket Martyrs  and worldwide celebrations of May Day ever since. Until the New Deal, US workers rallied, marched and lobbied for humane work schedules that would--in the words of the old labor song--provide "eight hours for work, eight hours for rest, eight hours for what we will." When Congress finally enacted the Fair Labor Standards Act (FLSA) in 1938, the eight-hour day became standard, thanks to union bargaining and the FLSA requirement of "time-and-a-half" pay for any hours worked in excess of forty during a single week. Well into the 1970s, some union activists--particularly in the auto industry--even sought a reduction in the forty-hour week.
Extra pay for overtime hours--whether legally mandated or privately negotiated--was not intended to fatten weekly paychecks. It was supposed to be a financial penalty, encouraging employers to expand their workforce rather than rely on overtime to meet production needs. But as Kim Moody and Simone Sagovac explain in Time Out: The Case For A Shorter Work Week: "When job-based benefits like health insurance began to bulk up labor costs, premium pay ceased to be a deterrent to overtime. It became cheaper for employers to schedule overtime than hire new workers."
Offering lots of overtime--and creating worker dependence on the additional income derived from it--paved the way for today's widespread "alternative work schedules." These can require ten and twelve-hour days as part of a "compressed work week" or regular weekly shifts that include Saturday and Sunday, with no extra pay for weekend work (as once required in most union contracts). The FLSA doesn't impose any limit on daily or weekly working hours (and excludes millions of workers, such as home-care providers, from its overtime pay requirement). In the absence of union contract language making overtime voluntary at some point in the day or week, workers such as nurses in understaffed hospitals often face management pressure to work beyond their basic twelve-hour shifts.
Job safety and health studies have long documented the connection between longer hours, worker fatigue and increased rates of workplace accidents and injuries. That's why the schedules of interstate truckers, train crews, nuclear power plant operators, air traffic controllers and pilots are federally regulated. But even legal limits on working hours in stressful, high-risk occupations can be undermined in the Bush era by corporate lobbying. For example, freight carriers persuaded the Federal Motor Carrier Safety Administration (FMCSA) to let long-haul truckers spend eleven hours a day behind the wheel of 70,000-pound tractor-trailers, rather than ten (a cap in effect for decades). Fortunately, a federal appeals court didn't ignore the link between commercial driver drowsiness and hundreds of fatal crashes every year. In July, it struck down the agency's "hours of service" rule change, which applies to both Teamsters and nonunion truckers. Since then, however, the American Trucking Association got a stay of the court's decision, which leaves the new eleven-hour limit in effect for now.
Like truck drivers on the highway, tired nurses can hurt other people, as well as themselves, when they make errors. In 2006, RN Julie Thao was in her sixteenth hour of work when she connected the wrong bag to an IV tube in a teenage girl about to give birth in Madison, Wisconsin. The baby survived, but the mother died after a painkiller designed to ease her labor stopped her heart instead. An experienced nurse with a good record, Thao was fired, then prosecuted by the state. After a negotiated guilty plea, her license was suspended and she can never again work in critical care.
With healthcare union backing, nurses have won curbs on mandatory overtime in a few places. But even one of the best state laws, in Maine, gives them the right to refuse additional work only after twelve hours. And there's a big difference between leaving overtime decisions up to individuals and capping everyone's permissible hours to protect patients from any hospital staffer--nurse or doctor-in-training--unable to work safely. Nurses are allowed by hospitals, often with union acquiescence, to work as many shifts, twelve hours or longer, per week as they wish. Meanwhile, American Medical College Association guidelines allow notoriously sleep-deprived interns and residents to be on duty eighty hours every week. Both practices fly in the face of studies showing that, among nurses, error rates increase after ten hours on the job, plus personal health suffers because of more back, neck, shoulder and needle-stick injuries, stress-related illnesses, smoking and drinking, and after-work car accidents.
The Take Back Your Time  organization--which celebrates "Take Back Your Time Day" October 24, a national campaign for shorter hours and more paid time off--is sponsoring teach-ins and other events around the country aimed at getting presidential candidates to take up these issues. That's not likely to happen, however, until organized labor rejoins the fight and politicians hear from union members like Michelle Estrada that over-work puts us all at risk.