Members of the NSW Nurses and Members Association (NSWNMA) plan to "walk out" in their own time between shifts Thursday morning after hearing the local health district has plans to open "unfunded" wards to accommodate emergency department (ED) overflow.

"It's the straw that broke the camel's back," Ashley Dobozy, the Hunter New England organiser for NSWNMA, told the Newcastle Herald. "The nurses and midwives are saying that it's just not good enough because they can't even staff their own wards, and now they're opening a new one."

They are calling for the state government to mandate staff to patient ratios and fund the opening of the fifth level of the hospital.

Ms Dobozy said the hospital was having "major, major issues" that started at the front doors.

"The new hospital location in Metford has meant that the catchment area has changed," she said. "They are now picking up areas which the previous hospital site didn't, which is putting a lot of pressure on the ED.

"On top of that you also have what we call bed block in the rest of the hospital. People are coming into ED and needing medical attention to the point where they do need to stay in the hospital, however the number of people coming through those ED doors is far higher than the amount of people they are able to discharge everyday."

Double shifts - such as working from 1.30pm and not going home until 8am the next day - had always existed. But now the "entire service" was relying on overtime, with staff experiencing "unsafe" levels of fatigue.

"All of those horrible experiences patients are experiencing due to not having much access to the nurses and midwives is because we have a much bigger problem than just people calling in sick," she said.

A Hunter New England Health spokesperson said Maitland Hospital has had an increase in the number of people attending the emergency department, and "many staff" had been furloughed due to winter illnesses.

"There has also been a rise in complex NDIS and aged care patients spending longer in hospital as they await discharge to aged care facilities or disability services," she said.

"To address some of the challenges Maitland Hospital is facing, we've recruited over 20 nurses to staff additional beds, transferred hundreds of elective surgeries to our private partners, and increased virtual medical coverage to support other local hospitals.

"We constantly review our operations, taking into consideration workforce requirements and the availability of additional beds that can be surged when required."

The spokesperson said they worked "very hard" to avoid asking staff to do overtime, using casuals and agency staff to fill deficits, and redeploying staff around the hospital to areas with the highest need.

"The unprecedented demand this winter has meant that in some cases we have had to request overtime from staff to ensure we can continue to provide high quality care to our patients," she said.

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