NYC nurses were understaffed and burned out before the pandemic, which contributed to overcrowding and worse patient care

• New research from the University of Pennsylvania School of Medicine finds that New York City nurses were understaffed and burned out in the months leading up to the city's COVID-19 outbreak.
• Between December 2019 and February 2020, 76% of New York City nurses said they would "not definitely recommend" the hospital they worked at, and 71.8% said their work had been frequently interrupted or delayed due to insufficient staff.
• The study suggests the coronavirus pandemic did not create, but exacerbated existing hospital staffing problems at New York City hospitals.

• The UPenn researchers surveyed 877 registered nurses holding active licenses in New York City. The researchers studied 254 hospitals throughout New York state and Illinois, including 47 hospitals in the New York City metro area.

New research from the University of Pennsylvania School of Medicine finds New York City hospitals were understaffed with nurses prior to the coronavirus pandemic that upended the city's healthcare system.

In the months leading up to the COVID-19 pandemic, 76% of New York City nurses said they would "not definitely recommend" the hospital they worked at, and 71.8% said their work had been frequently interrupted or delayed due to insufficient staff. More than half of New York City nurses reported being burned out prior to the pandemic's spread in the US.

In March and April, New York City became the epicenter for COVID-19 outbreaks, reporting 33,455 deaths between March 11 and May 11. The spike in cases overwhelmed the city's hospitals, as nurses told Business Insider, leading to a lack of basic protective gear like surgical masks and gowns. Patients experienced crowding in hospitals to the point where Gov. Andrew Cuomo asked healthcare professionals across the country to come to New York.

But the new study finds that nurses had been overwhelmed in New York City hospitals well before the pandemic. City medical-surgical nurses cared for around six to seven patients on average, higher than in Illinois and the greater state of New York. The study finds that for every patient that gets added to a nurse's care, 3% more patients give the hospital an unfavorable quality and safety rating.

The study used survey data from nurses and patients in 254 hospitals in New York and Illinois between December 2019 and February 2020, including 47 hospitals in the New York City metro area. It surveyed all registered nurses holding active licenses in New York state and Illinois. Titled "Chronic hospital nurse understaffing meets COVID-19: an observational study," it was published in BMJ Journals earlier this month.

The nursing profession had been in crisis before the COVID-19 outbreak. A study out of the University of California at San Diego found nurses are more at risk for suicide than the general population. Half of all nurses and doctors reported suffering from burnout, per a 2019 report from the National Academy of Medicine.

High nurse-to-patient ratios led 6,500 nurses to go on strike in four states last year. "The strike is first and foremost about patient care and patient advocacy," Dominique Hamilton, a registered nurse at St. Mary's Hospital in Arizona, told Business Insider at the time. "We want the hospital to invest in the nursing staff, and we want to have more input into the recruitment and retainment of experienced" registered nurses.

• Read more:
• 'We're grossly unprepared': Nurses share their frustration as the coronavirus spreads with little direction from the government or hospitals on how to mitigate it
• A week in the life of a night nurse treating coronavirus patients in New York City's top hospital, where she says space is running out for patients and nurse staffing is starting to run thin
• Half of all US nurses and doctors are burned out — and they say the healthcare system is to blame
• Thousands of nurses tired of working with too many patients will walk out of hospitals in a 4-state strike