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ADVANCE Perspective: Nurses

Obesity in Nursing

Published January 30, 2012 10:21 AM by Pam Tarapchak

Twelve-hour shifts have gotten some bad press. They've been linked to medical errors, nurse burnout and, now, higher rates of obesity in nurses.

Researchers from the University of Maryland School of Nursing, Baltimore, surveyed 2,103 female nurses and revealed nurses with long work hours were significantly more likely to be obese compared with underweight or normal-weight nurses (55 percent of those surveyed were obese). The nurses who were obese also reported having jobs requiring less physical exertion and less movement.

"Long work hours and shift work adversely affect quantity and quality of sleep, which often interferes with adherence to healthy behavior and increases obesity," noted Kihye Han, PhD, RN, postdoctoral fellow at the school and lead researcher in the study.

That's a good point. I work an average of 8 hours a day and I still feel like I can't find time for exercise. And it's not uncommon that, after a day at work, I may opt for the drive-through because I'm tired and don't feel like making dinner (which no doubt would be healthier).

Han suggests a change to the 12-hour nursing shift. "Considering that more than half of nurses are overweight or obese, increasing availability of healthy food and providing sufficient time to consume it may reduce the risk of obesity and future health problems," Han noted.

Given how the 12-hour shift has become the default working pattern for so many nurses, maybe it's time to reevaluate its impact on nursing practice and the health of nurses themselves. Mandatory overtime in some organizations only compounds the situation. Is the convenience of a 3-day work week enough of a reason to continue the practice? The research seems to be telling us otherwise.

29 comments

I believe the connection between obesity and 12 hour shifts is related to a variety of factors: poor nutrition during shift (fast snacking, and loading up on big meals to last the entire 12 hours); carb and caffeine loading, (to fuel our bodies during the intensity of 12 hours); a decrease in RESTFUL sleep (how many ppl go right to bed after working? Not many); and decreased availability to exercise on the work days -- and on our days off, we rest and re-coop.

The key is, small frequent snacking on healthy foods (which, is easier said than done -- no eating at the desk but you can have an open can of Coke right?) and preplanning meals (No ordering out and stay away from the vending machines...)

Rhonda, ER RN May 4, 2012 2:04 PM
SC

I have read most of the comments. I concur. The problem is multi-sources. I worked 31 years in a hospital.I THINK anyone that has not been in a hospital, in the trenches working nurse ,does not even have a clue about all of the many  comments and how true all of the comments are. The comment I enjoyed the most was---about all the nurses not showing up for work on a given day--not that we nurses could really do that-------

Melissa Pethel, home February 20, 2012 5:17 PM
salisbury NC

Having been a nurse for going on 35 years, I've done the 8 hour and now the 12 hour shifts.  The 12's give you more time with your family, friends and you can plan your meals, activties much better.  While it is a crueling shift, I do believe it is the person's choice on how he/she eats.  I can't blame anyone but myself.  I've done day's and come home, eaten, and then to bed, and now back on my beloved night shift I come home, grab something and go to bed...what is the difference?  I feel I do get at least 10,000 steps in most of the shifts I am there (area can include L&D, Post Partum, Peds, Newborn Nursery) and at home keep busy with catching up on family,house work, errands, etc.  It is all a personal choice and even with bariatric surgery 11 years ago, I still struggle with my weight, but feel blessed that even at my "old age" I am still able to carry a patient load, give good nursing care and remember the important stuff!!!  Please don't take away the 12 hour shifts!

Sue Nyman, Women Health Care - RN , Indian River Medical Center February 13, 2012 6:08 AM
Sebastian FL

Sorry moderator,, wrong email Kathleen jones...kathleenJon@aol.com

Kathi Jones February 13, 2012 12:29 AM

I've done every shift, and currently doing mostly 7pm-7am. I have rheumatoid arthritis  and am in an inner city trauma unit. It's physically exhausting with no change in site the patients are obese and terribly injured or in tremendous pain. I don't eat much during work but the day or two afterwards, I'm too tired to cook or make a salad...etc. Sometimes I hurt so bad it's just heating pads and ice packs grabbing whatever I can find to eat so I can take motrin, prednisone etc. I'm pushing 34 years in nursing on and off, I had 5 kids, got divorced, kept the now almost adult kids and all the stress that goes along with that. I am always asked when I'm retiring...frankly, not to be morbid, but I think I'll die before I get to retire. You can't survive on SSI disability, with dependents. I have an adult son who needs more help, and the job market is very weak.  I've never prayed harder, for my patients ,my friends their families and my co workers. People are envious because the pay and benefits are excellent, but what's going to be left of us at the end?

Kathi , ICU - RN, Temple February 13, 2012 12:28 AM
Phila PA

Wow ,reading through these spots reveals the current and constant state of nursing;the dispassionate non supportive and almost cruel attitude towards each other is clear.

I have been an Or nurse and now an endoscopy nurse for 38 yrs. If I include all the OT and "on call" hours it comes to roughly 48.5 yrs.! I too am a single parent who raised her kids alone with little support from my nursing community;even during pregnancy if I couldn't do the job I didn't have a job! While trying to leave an abusive marriage again do the job or don't keep the job. Even though we have come a long way from when I started;I feel that we as women and nurses need to stand together. I 've worked in different states and in different areas of the same state;and I still see the same problems among nurses -age gaps;weight gaps;advanced degree gaps! If you don't think that the emotion stress when endure sublimating our own feelings as caregivers to support patients;tolerate doctors attitudes;calculate from moment to moment other peoples needs from moment to moment before our own has no bearing on weight management-ever her of Coritisol? If U think that walking and average of 3-5 miles a day at work doesn't effect the kind of work out one would need to do to lose weight I think U need to speak o those who do that daily.  After menopause ;and 2 back injuries received on the job(again can't do job no job applied here). I need to lose a good 20 lbs. It is tough! Please believe that all the years of high stress;and continuous stress of nursing has an effect on adrenal glands;and when U are exhausted it is difficult at best to push forward to take care of oneself after along day at work! I grew up with an obese mother I know all the reasons why someone is obese;and has a nurse I feel it is difficult to help someone be healthy if U are not; but while I am on my own journey I do not feel I can sit in judgement and condemnation of others. I bring healthy lunches ;but that 30 minutes can suddenly be cut to 15 not enough to heat and eat or drink enough water so coffee or green tea and the snack portion of lunch. And who can ever drink enough water on the job when U can't run to the bathroom to pee?  How many of us have had UTIs and stones?When in the hospital the it was even worse and  on call U could be up working for  hours on end with no break- healthy?? I am a Reikimaster and I truly believe that if nurses supported each other we could be healthier ourselves in every way. I often thought that if for just 1 day no nurse went to her job the world would take notice of our importance and perhaps for once we would recognize how important we are to each other! Blessing and light to all who read here.

Pat , OR and Endoscopy - RN, Ambulatory Center February 12, 2012 12:13 PM
Raleigh NC

I am a registered nurse who works two 8 hour shifts & two 12 hours shifts. I occasionally pick up overtime as well. My floor is extremely busy, as are most units in a hospital. I use my three days off to plan accordingly. I take an hour out of one day to cook healthy meals and package them in advance so I'm not running around the house in the morning before work packing a lunch and to avoid the temptation of the vending machines (the wheel of death). I also use my gym membership faithfully on my days off and occasionally on working days too. Whether I have time to lift & go for a long run or squeeze in a quick swim in the morning before work, I cannot emphasize enough the importance of exercise to offset job stress. I understand not everyone has time to hit the gym, but surely there is enough time to plan out a healthful meal with grab & go foods like fiber bars, apples, yogurt, cheese sticks, etc.

Emily Fennick, Cardiopulmonary - RN, Heritage Valley Health System February 10, 2012 7:04 PM
Beaver PA

To me working  12 hr shift help me plan my days of the week including personal & family matters.If someone has a choice to run through drive through  every day after work,its their own decision not to be healthy.Also referring to 12 hr shift Nurse burn-out comes when they choose to work extra hours during their days off.And pt care is not compromised due continum of care by 2 nurses per day versus 3  8 hr nurses

sujata, PACU - staff nurse, CIH February 9, 2012 12:17 PM
BROOKLYN NY

It is not 12 hour shifts that cause nurses to become obese!  Obesity is prevalent in everyone these days, and it can't be blamed on anything other than the type of food being consumed- namely excess carbohydrates.  I advise everyone to read Gary Taubes 2011 book, Why We Get Fat And What to Do About It, which is excellent.  I have never worked a 12 hour shift, but in recent years have had more sedentary positions, and there have been many overweight and obese co-workers no matter where I have worked.  It takes a huge effort to eat correctly and exercise, but that has always been my priority, and it has paid off, because despite being in my 60's, I still weigh the same 110 lbs (at 5'2") that I did in high school.  I consume no more than 60 - 70 grams of carbohydrates daily- mainly in the form of vegetables and fresh fruit, and I wear a pedometer and make sure I get as close to 10,000 steps a day as I can, by using stairs instead of elevators, walking at lunchtime, again when I get home, and whenever possible.  I also do strength training on my own at home.  Again, it takes a huge effort and many people are not willing to do that, but it truly is worth it!

Mary Thompson, Case Manager - RN, MSN, Aetna February 4, 2012 8:47 PM
Collegeville PA

I agree, this is not research.  I speak with nurses all the time and they hate the 12 hr shifts.  The 20 something nurses are burning out at a fast rate, and the older nurses are barely hanging on.

The way nursing is run today...it's not about the patient or the nurse it's about the bottom line.  Patient satisfaction is secondary.

Keiffer, RN February 4, 2012 8:07 AM
Tampa FL

I worked 8 hours shifts and I have worked 12 hour shifts.  I LOST weight when I went to 12 hour shifts! You work 3 days a week, that leaves 4 days a week to exercise, plan a menu, and cook for the days when you work! I am tired when I come home from my shifts, so I do not do much on the days I work.  I am on my feet all shift as is everyone else.  If you want to know why nurses are fat look at what we put into our mouths! We know what to eat and what a portion size is.  Stop blaming everyone but yourself!!

amy, L&D - RN, BSN, TRHMC February 4, 2012 7:59 AM
Reading PA

This isn't research. This is putting a couple of facts together to support an opinion or suspicion. There may be so many other factors influencing obesity in nurses and obesity in nurses who work shifts. Maybe personality factors attract certain people to shift work. Maybe shift work causes depression. There are some pretty obese nurses working day shifts too. How does age factor in? I didn't choose shift work but I like the unit I work on so I accepted the shift. I have had to get over the isolation it fosters and start doing more physical activity. It's easy to fall into some bad habits if I work shift but it's also my responsibility to keep an eye on my behavior and be conscious of choices I make.

Denise Simon, detox - RN, hospital February 3, 2012 3:48 PM
Pittsfield MA

I found the research stated here astounding!  I cant imagine my 12 hour shift making me obese!!! I have worked in 4 hospitals in 2 states and cannot see any "floor" nurse having time to sit for any length of time.  We are mostly on our feet, running around like crazy!  A lot of our staff bring their meals in from home.  Many of us are single moms and still have time to prepare a healthy meal.  Many of us exercise, just not on the three days we work.  Thats okay!  And if you plan and go to bed at a decent hour you can get your 8 hours in too!!!  

I think this whole 12 hour shift argument has to do a lot with self responsibility, motivation, and accountability.  This is not just a nurses problem.  This is an American problem.

Lori Wilson, CCU - RN, RMH February 3, 2012 10:33 AM
Harrisonburg VA

Just wanted to add something after I read some of the other posts.  I have never heard such a bunch of whiners...If you are always tired, change jobs, or shifts, or facilities.  If you must work full time like i did as a single mother...it was better to work 3 shifts a week instead of 5.  Its a question of time management and priorities.  It was never easy, but i slept while they were in school, napped after their bed time, and did the best i could...the 4 days a week left plenty of time for housework, child time, and some amount of a social life.  It paid off in the end, with 2 pensions and Soc. Sec. I am comfortable...and will be more so after i get my knees done (occupational hazard)...but i wouldn't have given up a minute of it...it was challenging and rewarding.

Sheila Morisette, Hospital and Corrections - RN, Retired February 3, 2012 7:05 AM
Waterbury CT

I am 68 and just retired.  I have worked full time in ICU & ER at an acute care facility and as a correctional nurse in a state prison.  I am obese, I was obese when I worked 23 years in the hosital on 12 hour shifts, and I was obese when I worked at the prison for 7 years on 8 hour shifts.  I began to lose weight when I retired and was able to eat better and on a regular basis instead of snacking and catching fast food on the fly.  ITS NOT THE SHIFT, ITS THE PERSON...AND THE DEMANDS OF THE JOB.  The 12 hour shifts allowed for full time work in only 3 shifts a week, time to recover mentally and physically.  I wouldn't have given it up for the world but myself and most of my peer friends are now getting new knees from the hard work and the obesity.  Go figure...we did this to ourselves.

Sheila Morisette, ER & ICU& Corrections - RN, Retired February 3, 2012 6:54 AM
Waterbury CT

All above nurses are right. You can eat well if you plan. The nurses with children at home never get enough sleep.

Still working in late 60s, know teachers who retired with a pension at 55 after 30 years, but nurses don't have that option.

And the nurse is right who says we do unspeakable things daily that no one else can even imagine coping with.  And do it with backs, knees, hips in pain!  And never go "out" for lunch-ha!

Marcia, , RN Hospital February 2, 2012 10:53 PM
Greenville SC

I am retired after 40 yrs. of bedside nursing. I too was lucky to be able to work flexible shifts when my children were young. Since I was basically a 8 hr shift employee, I did not do long term extended shifts and don't feel I suffered.

 However in my last yrs. the hosipital changed to manditory 12 hr shifts. It is too much for all but the young with no children or home responsibilities. I have always exercised but found I could not with 12 hr shifts. Way too mentally and physically tired. Yes, weight gain and poorer health and burn-out. It took retirement to get back to exercise and better health.

Marjorie Pastalaniec, Hospital - RN February 2, 2012 5:16 PM
Houston TX

Now that I am retired I will speak my mind.Nursing is the most unforgiving profession. You will heal many and struggle to heal yourself. You will work endlless hours doing unspeakable things and come home and have to pretend for YEARS that you had a normal day. No one wants to hear it nor could they handle the truth. Do not forget the endless re-testing and continuing education to prove your mentally fit to care for others. Finally comes retirement and if you do not manage it you will retire broke.

After 37years I am out and I am trying to make a new life and I am more happy.I spend my time encouraging my friends and children to enter anything but nursing. Obesity is only one of the side effects of working crazy hours and don't forgetyour holidays will be taken when it is convient for the staffing.(I had one week of Christmas off in all those years and was told I could never do that again when I got home) So I guess I am saying that nursing may put food on your table or inches on your waist but ENTER AT YOUR ON RISK..you are entering a toxic work enviroment.

Joanna Matry RN BC, Bariatrics/Supervisor - Retired February 2, 2012 4:20 PM
West Palm Beach FL

Now that I am retired I will speak my mind.Nursing is the most unforgiving profession. You will heal many and struggle to heal yourself. You will work endlless hours doing unspeakable things and come home and have to pretend for YEARS that you had a normal day. No one wants to hear it nor could they handle the truth. Do not forget the endless re-testing and continuing education to prove your mentally fit to care for others. Finally comes retirement and if you do not manage it you will retire broke.%0d%0aAfter 37years I am out and I am trying to make a new life and I am more happy.I spend my time encouraging my friends and children to enter anything but nursing. Obesity is only one of the side effects of working crazy hours and don't forgetyour holidays will be taken when it is convient for the staffing.(I had one week of Christmas off in all those years and was told I could never do that again when I got home) So I guess I am saying that nursing may put food on your table or inches on your waist but ENTER AT YOUR ON RISK..you are entering a toxic work enviroment.

Joanna Matry RN BC, Bariatrics/Supervisor - Retired February 2, 2012 4:17 PM
West Palm Beach FL

It's not only 12 hr shift, the whole reason for the wt. gain is because we don't get to eat at work due to the work volume, our metabolism slows down and when we get home tired, we eat and hit the bed .

Marlene , BSN, RN February 2, 2012 1:01 PM
NY

i started working in nursing 41 years ago. i can tell you i have seen a lot of changes. some good, some not so good.%0d%0ai have worked 8's, 10's and 12's. typically nurses dont get 4 days off in a row, which would be just about enough time to recover from 3 12's. typically it is 1 or 2 days together. at which time you are cleaning the house, doin laundry and grocery buying...meal prep goes straight out the window. my highest weight was when i was working 12's...327lbs. bmi of 51. it took a long time but i am not 160lbs give or take 5 lbs. i still working long hours and mentally still take my work home in my head. sleeping is still an issue. but have developed healthier eating and exercise habits because i dont feel the exhaustion i felt when working 12 hour shifts it's more about nurses learning that they are important enough to take as good of care of as they do their patients.  without healthier nurses we have no health care. i propose a one hour lunch, 30 minutes of exercise and 30 minutes of healthy meal options in the hospital cafateria.

susan ault, hem/onc - cns.fnp, northbend medical center February 2, 2012 10:54 AM
coos bay OR

HELLO. I being an lpn for 9 years,when i started working  my weight was 30-40 pounds less. THE 12 hours shift "mandatory" are killing . Most of the time I feel tire and not energy to do anything after I get HOME. The long SHIFTS that sometimes end to be 14 hours. NOT energy TO EXERCISE. I  DO plan my  meals and include fruits and vegies all the time, just if I chance to eat...

Its taking A TOLL on my marriage already. " YOU ARE ALWAYS TIRED", my husband speaking. OBESITY is too stay, and because

we all have too work any shift   or day of the week without arguing ; afraid to loose the job with this economy.

maria, med surg - lpn, hospital February 2, 2012 10:40 AM
FL

I have worked 12 hour nights and I know it is grueling on a person's sleep schedulel and health.  But I think the overweight issues are not because of the working. It is because the people that do not eat healthy are not going to eat healthy no matter what. Several of the comments above talk about how the nurse plans her days and meals to ensure good nutrition. The people that are overweight are not doing that. I am a prime example. When I was working nights, I did plan for meals and did plan for breaks, but i still ate more than I should have, I still ate from the machines. Impulse eating is impulse eating no matter when or where.  I think the biggest issue is not getting enough sleep. that wears your health down more than anything.

My coworker and I thought a lot about our sleeping patterns on night. We came up with a theory.  If you are working 12 nights, you have 3 days a week you are not sleeping at night and 4 days a week you are sleeping at night.  This causes your biorhythms to get messed up. Your pituitary secretes growth hormone while you are asleep. By changing your sleep patter every day, your pituitary doesn't know when to secrete your GH.  Our theory was to ensure that a portion of any day, we would always be asleep.  For me it was the time from 6-10 every morning.  On days I worked, I would be home by 8 am and go to sleep in that time period. for days I was off, I would be asleep at least from 6-9 AM.  so after a period of time, my pituitary would know when to secrete the GH. It helped me cope with 12 hour nights for a long time.  Yes I was tired at times, but I felt better when I was awake.  It does not matter when that time period is for you, just try to have the same overlap of hours each day. It does help.

Janet , Peer Review - Manager, Kaiser February 2, 2012 9:39 AM
Atlanta GA

I've worked with my company for 35 yrs so 8 hr shifts were the norm. As the 12 hr weekends came available, I was at a point where I was working M-F Home Health and rotating weekends and nights on call. A reduction in force sent me back to 12 hr MIDNIGHTS! I had worked Evening shifts most of my life until Home Health. The 12 hr midnights about killed me. I could never sleep past noon. I only live 1 mile from the facility and could come straight home, to bed. I did have a co-worker who did fall asleep on the way home and had a horrible wreck and darn near killed her. I am morbidly obese, have had both knees replaced and a shoulder to be done next week. I take as many pills as most of my patients but continue to work as I cannot afford to quit. I know for sure that my chronic disease is related to shift work and the Nurses' Health Study is proving that with every discovery. Oh, for a retirement at rest in a warm place. NOT! Never will happen in this economy. God Bless all us old nurses.

jane Murray, RN - Clinical Analyst, Homecare February 2, 2012 8:19 AM
West Liberty KY

I am a single mom that works 12 hour night shifts. We also are required to pick up 8-11 4 hr shifts of call per month. I feel like a zombie most of the time. I feel that it is affecting my health. I am sick at least once a month. On my days off I feel like I am so tired that I have a hard time getting anything done, because I am so sleep deprived.  I drive 1 hour to work and I love my job, but the 12 hour night shifts are doing a number on my health.

Tina, L&D - RN February 2, 2012 7:54 AM
Urbana IL

I work the 12 hr night shift.  I would be unhappy working 8 hr shifts.  I am lucky enough to get uninterrupted sleep during the day, as my kids are grown & gone. I pack nutritious snacks for myself & make sure I get up in time to eat a good supper before heading for the hospital. I also eat a light breakfast before taking a shower & heading for bed. This may not work for everyone, but it does for me.

Margaret, ICU - RN, Jamaica Hosp. February 1, 2012 11:36 PM
Jamaica NY

For 23 years I worked night shift in Critical Care and ER. I would say half of that was 12 hour shifts. Because I had 5 children, I could never come to dayshift 12 hrs and be able to get them to school with needing to be at work at 0630 or do homework, get supper for them, and get them in baths and in bed if I got off at 1930-2000. It was just easier for me to suffer and go without sleep to get things done in the day and do their activities. My husband worked rotating 24 hr shifts as a firefighter. In the beginning of my nursing career, I was blessed to be able to work flexible shifts. I mixed and flexed 4hr, 8hr, 12hr, and 16hr shifts to meet FT and never placed my children in day care!!! It's not that way now. I have seen my older collegues suffer with joint, back, and knee problems and barely complete a 12hr shift. Also, I firmly believe the 12 hrs shifts have worn and is wearing down our nursing profession! It is difficult mentally and physically. In Critical Care/Emergency areas, many times you may not get a chance to stop to eat, you resort to quick snacks that are usually not healthy to make do. I am not over weight and have always ate healthy so I made the effort to pack healthy snacks, but many do not. 12 hrs shifts were adopted to make staffing easier, but our nurse's health and home lives are suffering in the long run. The one's that made those decisions then to work 12 hr shifts work M-F 8 hrs and do not realize or have forgotten what 12hr shifts are like. I was blessed to finially go to day shift about 1 1/2 yrs ago, M-F 8hrs. in an OutPt position, so I also have weekends and holidays off too :)! I keep in touch with my 12 hr cohorts and still feel in my heart for the health and happiness of our profession, 8 hr shifts and shift flexibility should again be an option and considered and not just the convience of the employer.

Karen Strickland, OutPt GI - RN, Piedmont Heartburn Treatment Center February 1, 2012 10:12 PM
Newnan GA

I live an hour from my work. So I get up early and take my vitamin and probiotic. I then have a hot tea with splenda and a splash of milk in a travel mug on my way to work. I pack breakfast and eat it when I get to work since I am usually not hungry when I first wake up but will be when I get to work. I always try to pack a lunch (my largest meal of the day). I try to pack a vegetable and a fruit and then either a sandwich or leftover from when I do have a day off and decide to cook. I also include a diet soda (only one a day) I need a mid day caffeine kick to keep me going. I also pack a yogurt or a healthy snack to eat as my dinner in the car on my way home from work. I don't eat a large dinner because it is late when I get home and I usually need to go to bed. I would say I probably don't get enough to eat because I may only get one serving of each food group in each day while at work. The bext advice is to pack a lunch and don't buy snacks or sodas from vending machines. Grab a glass of water if you are thirsty.

Carime, Med surg - RN, Geisinger January 31, 2012 8:11 PM
Halifax PA

I am for the 12 hour shift.  I always bring my own lunch and dinner and pack healthy options like lentil soup or a side salad and healthy snacks for the day like hummus and multigrain pita chips, sliced apples, etc.  I also make sure to drink a lot of water.  I also like the flexibility of the 12 hour shift because on my days off I go the gym or dance classes and workout.  I have a membership at the local YMCA and take advantage of my free time to get my exercise in early.  I also take the bus to work and get off two stops early on my workdays and walk the 20 blocks home which helps me get a mile of walking in on my days of work when I can't make it to the gym.  I do understand that some nurses don't have the time to be as active as I am (I do not have kids or other responsibilities) but I do make my health a priority and it does take effort.  I also do not order out like a lot of the nurses do.  I find it helps me save money and inches!!  I also joined Weight Watchers last October and it helped me stay on track and fine tune my eating habits.  I also learned that it is important to be organized and plan ahead with healthy snacks and meal options so that I won't be tempted to hit the snack machine at 4pm when there are 4 more hours to go.  It also helps to be prepared since L&D is very unpredictable and I might be assisting a patient and might not have time to order lunch.  It is always nice knowing I have lunch waiting for me when I can take a break.

Rashida Mungin, Labor & Delivery - RN, NYU January 31, 2012 7:14 PM
New York NY

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