About a thousand nurses from across the Hunter and Central Coast came together to march through Newcastle to Foreshore Park as part of the state-wide strike action.

They told the Newcastle Herald that Hunter hospitals had been surviving on a lot of goodwill - nurses working double shifts, missing their breaks, and working overtime to ensure patients received appropriate care.

They were tired. They were angry. And some were considering leaving the profession altogether.

"If I had to choose the one thing I'm most angry about, it is the continual insistence by this government that this health system is coping," Laurel Kibble, the NSW Nurses and Midwives Association branch secretary of the Maitland Mental Health Unit, told the crowd.

"This system is not coping.

"We are not coping.

"I don't blame the pandemic... This is the inevitable result of a system that has been neglected for years.

"We were always going to come to the boil, the pandemic just turned the heat up high."

IN THE NEWS:

Nurses are asking for a nurse-to-patient ratio of one-to-four on hospital wards, and a midwife-to-patient ratio of one-to-three - as well as a 4.75 per cent pay rise to correct a previous "freeze".

They warned that mistakes were more likely to happen, and patients could receive sub-optimal care, without mandates to ensure appropriate staffing levels.

Rachel Hughes, secretary of the John Hunter Hospital and Children's Hospital NSWNMA branch, said safe staffing ratios were their priority - but the government had been unwilling to negotiate.

"We have people sitting in the emergency department in the waiting room for eight hours," she said. "We have ambulances who can't offload for eight hours. On Monday night there were nine ambulances banked up out the front of John Hunter Hospital because there was nowhere for them to go. They were short nurses, they were short doctors, and we don't have enough beds.

"We have gotten to the point where we have nothing left to give... "We need safe staffing ratios. Yes we are asking for a pay rise, and yes we are asking for COVID payments, but they are not our priority - our priority is safe staffing ratios, and safety for our patients and staff. That's what we're fighting for."

A nurse from the Maitland branch of the NSWNMA said she was supposed to be on her honeymoon, but her leave was denied because of "significant" staff shortages.

"I requested the week off before my wedding, which was thankfully granted, and I'd requested the two weeks afterwards for my honeymoon," she said. "I had to come back to work the Monday morning after my wedding because I was needed... It has been devastating."

Newcastle's Woman of the Year, midwife Oceane Campbell, said they deserved respect and recognition via safer ratios and a wage that increases with inflation.

"We all bust our guts to provide an adequate standard of care, but it's exhausting - it means overtime, often you stay back or worry whether you did good enough or could have done more," she said.

Greg Luxton, Dungog Hospital's NSWNMA branch president, said hospitals big and small were impacted.

"We are extremely short staffed," he said.

"We can't cover the shifts with our normal staff. The hospital would have to shut if we didn't work extra shifts. We also have a very poor skills mix. We are getting very inexperienced nurses being left in charge of a hospital with an emergency department, and it's totally inappropriate."

A NSW Health spokesperson said NSW Nurses and Midwives' Association members took 24-hour strike action in defiance of Industrial Relations Commission's orders. But all local health districts had plans in place to ensure people in need of emergency and urgent care received it as quickly as possible.

"The NSW Government and NSW Health have engaged in talks with the union and remain committed to reaching a resolution in the best interests of our patients and all our healthcare workers.

"There are more nurses and midwives in NSW public hospitals than at any other time in history. The NSW Government is also investing in a further 5,000 nurses and midwives from 2019-2022 under a record $2.8 billion boost to frontline staff."

Our journalists work hard to provide local, up-to-date news to the community. This is how you can continue to access our trusted content: