Thousands of NSW public hospital nurses walked off the job in protest at inadequate staff-to-patient ratios, saying they are at breaking point and stretched too thin to give people the care they deserve.

Staff at about 150 facilities, including NSW Nurses and Midwives Association (NSWNMA) members from 23 branches in the Hunter New England Local Health District (HNELHD), participated in staggered strikes across the state, with a skeleton staff working to ensure patient safety as the COVID-19 pandemic.

Nurses want one nurse to every four patients on every shift, and a pay increase above the government’s prescribed public sector offer of 2.5%.

Protesters rallied outside NSW Parliament House in Sydney on Tuesday, taking their message to state MPs returning for the first sitting day of the year.

The rally was one of about 30 around the state, which included Newcastle’s Civic Park, and comes as nurses continue to bear the brunt of the COVID-19 pandemic.

Kelly Falconer, a clinical nurse specialist in emergency at Wyong Hospital, described current staffing levels as being similar to a war zone.

“There is no limit to what we see and deal with or the numbers. And, it’s 24/7,” she said.

“We are humans, and it’s draining and soul destroying.

“Our job is much harder when we don’t have adequate staffing.”

The strike was in defiance of an 11th hour ruling by the state’s Industrial Relations Commission which on Monday ordered the union to refrain from industrial action.

NSW Health Minister Brad Hazzard met with the union on Monday in an attempt to avert the action and said he was disappointed the strike went ahead.

“It’s unfortunate … there’s been all sorts of efforts to try and work our way through their principle issues,” he told Sydney radio 2GB.

But, NSWNMA president O’Bray Smith said the union was offered nothing at the meeting.

“Those ‘crisis talks’ were merely a tick-box so they could go to the IRC and the media and say ‘oh, we tried’,” she said.

The union’s general secretary Brett Holmes said the thousands of health workers who turned out to protest demonstrated they were ready to fight and “stay fighting until we win”.

Nurse-to-patient ratios are the main point of concern.

Mr Hazzard agreed there needed to be enough nurses to ensure patients are safely cared for, but says the union’s demands would cost around $1 billion.

“I still need to be able to manage taxpayers’ dollars and make sure it works,” he said.

NSW Premier Dominic Perrottet said Mr Hazzard “will continue those discussions and where we can provide additional support we will”.

The issues are “complex” but the government hopes it “can provide a resolution to those matters as quickly as possible”, he said.

Some hospital workers, like those at Byron Central Hospital, supported the strike but won’t leave their nurses’ stations over concerns they already don’t have enough staff to provide the required care.

Opposition Leader Chris Minns said the government needs to negotiate in good faith with the union, criticising a “cynical” decision to “take them to court to try and stop industrial action” hours before the planned strike.

He did not commit to introducing nurse-patient ratios if Labor won government, saying he was “not ready to announce election policies”.

Mr Minns said Labor would negotiate and reach an agreement with the union before it does, “and that’s all we’re asking of Dominic Perrottet”.

Meanwhile, Hunter Workers will rally at Cessnock on Saturday 19 February from 11.30am, calling on the government to address the insecure work crisis.

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