Hunter nurses and midwives strike for 24 hours, rally in Newcastle Civic Park for pay rise and ratios

Hunter nurses walked off the job for the fourth time this year, taking their fight for ratios, adequate staffing, and a fairer wage to Newcastle's Civic Park on Wednesday as part of state-wide industrial action.

Peggy Smith - the Muswellbrook Hospital branch delegate for the NSW Nurses and Midwives Association (NSWNMA) - told the crowd services were so diminished in their area, that the hospital had lost its maternity unit.

"We have midwives who are fighting, fighting, fighting for their unit and for these mothers and babies who are now birthing in our emergency department," she said.

"That is if they're not trying to get to another area and not birthing on the side of the road. We are being told this is an incredible standard of healthcare. We are being told we're better than Queensland, better than Victoria. I can tell you now, we are not. We don't have ratios, we don't have fair pay. How can we sustain this?"

Intensive care nurse Daniel Mackay, of the NSWNMA's John Hunter Hospital branch, said burn out was high, with nurses working more overtime and double shifts to ensure patient safety while forgoing time with their own families.

"Just the other night, I did 18 hours," he said. "I was about to walk out and we had a patient who was a bit aggressive and at the last minute I had to call my wife up and say I'll have to stay to help. That's just how it is. We feel obligated to stay. The government has failed us. To be called heroes... It's all words. They are not giving us anything. They're not giving us the ratios we need to keep ourselves and our community safe, they're not giving us fair pay. It is just really hurtful."

Charlotte Ismay, president of the Hunter's NSWNMA drug and alcohol branch, said in some of their clinics, the ratio of nurses to clients could be "one to 100" on many days, placing "unreasonable stress" on nurses supporting vulnerable and stigmatised people with substance use disorders.

A NSW Health spokesperson said the industrial action by the NSWNMA was in defiance of orders from the NSW Industrial Relations Commission (IRC).

"The current 'nursing hours per patient day' ratio system was introduced in 2011 following an industrial settlement with the NSWNMA. This flexible ratio system considers the numbers of patients, their complexity, acuity and care needs and allows for the professional judgement of nurses and managers to adjust staffing levels to reflect the changing care needs of patients."