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NSW nurses and midwives are threatening to throw in the towel if the state government doesn't mandate patient-to-nurse ratios like those in other states.
Hundreds gathered outside Sydney's Royal Prince Alfred Hospital, one of 60 rallies throughout the state on Thursday, as nurses downed tools for 24-hours leaving a skeleton staff.
Palliative care nurse Phillip Heard said the protest was "the angriest" he's attended in his 30 years as a union member.
Nurses carried signs depicting Premier Dominic Perrottet's image which read "I will not be lectured by staffing levels by this man" and "How many more must sleep on the floor?"
The protesters chanted for mandated patient-to-staff ratios to match those of Queensland, Victoria and the ACT.
The NSW Nurses and Midwives' Association said more than 3000 nurses and midwives have moved interstate for work in the past year.
Nurse Ainsley Mansell, 49, said the current ratios don't allow enough time "to give proper care to patients".
"I'd like to remind politicians why hospitals exist and that is patients receiving care from experienced nurses like us," she told AAP.
"We're standing on the precipice of public health crisis.
"They need to listen to us or else we will resign."
Union General Secretary Shaye Candish said the strike, the third this year, was a sign the government was not listening to overworked health workers in a sector still reeling from the pandemic.
"We need the NSW government to engage in meaningful discussions on introducing safe nursing and midwifery ratios across our state," she said.
"(It) must prioritise patient care and commit to a safer staffing model with a guaranteed minimum number of nurses and midwives on every shift.
"The evidence is clear that ratios save lives and reduce costs."
Nurses and midwives are also demanding a seven per cent pay rise to keep up with the rising cost of living - more than double the government's public sector wage increase cap of three per cent.
Mr Perrottet said three per cent was the "most generous wages packages anywhere in the country".
"We are going through a very difficult time nationally and globally, and we have always ensured that our frontline workers have a fair and reasonable pay," he told ABC TV on Thursday.