Insufficient infrastructure, preparation, and communication are leading to unsafe work conditions and on the job burnout for many nurses fighting on the front lines of the COVID-19 pandemic, according to a report by Quartz.

“This is a national emergency and far too many hospitals are still failing to ensure that our caregivers, who are placing their own safety at grave risk, have the protections they need to stay at the bedside for their patients,” said National Nurses Union executive director Bonnie Castillo.

Poor-to-non-existent communication from hospital management is one outstanding source of contention: according to a National Nurses Union survey released in March, less than half of the surveyed nurses had received information from their employers on how to respond to COVID-19 cases.

“It starts with the support system that nurses have and that support system doesn’t really exist…Nurses have had issues with support with getting PPE and appropriate supplies from day one before coronavirus even developed. But now that it’s become an issue, we are dealing with issues from hospital administration not really listening to our concerns,” says Nicholas Olaverria, a registered nurse at Memorial Hermann Hospital in Houston.

Read more about the nurses who are struggling to work on the front lines without appropriate support here.