The Australian Nursing Federation has implemented a ban on WA nurses working double shifts on the first day of their industrial action campaign.
The union said an online poll of its members indicated overwhelming support for the action, despite a last-minute attempt to reach an agreement on pay and conditions.
State secretary Janet Reah said nurses were not compelled to work double shifts and should refuse to do so if asked.
"We know ANF members are responsible, and they will use their discretion to avoid dangerous situations," she said.
"However, that does not mean we continue to fill the gaps on the rosters created by a government that won't take reasonable steps to match the demand on the health services with the supply of nurses and midwives."
'No such thing as a safe double shift'
Ms Reah said the ban will cause delays to patient care, but said it was up to the government to step up and look at ways to mitigate that.
"We will still aid and abet critical care patients and make sure that they're safe and [nurses] will use their judgement, they're not just going to walk out," she said.
"But for the longest time, we've had a double shift culture and the question has to be asked, when did we normalise double shifts?
"There's no such thing as a safe double shift.
"I don't think anyone would particularly choose to have a nurse or midwife looking after them that's worked 18 or 20 hours."
Industrial action to ramp up
Nurses and midwives plan to ramp up industrial action, including gradually escalating to bed closures and an indefinite strike in seven weeks' time.
Ms Reah said she hopes the union and the government can come to an agreement before then.
"We're waiting for them to come back after our discussion yesterday and present something that's more palatable," she said.
"We'll present it to the members again, and then they'll vote on whether they think that's okay or if there's other concerns that we need to raise with the government."
The action comes despite a last-ditch meeting between Ms Reah and Health Minister Amber-Jade Sanderson.
Ms Sanderson met with Australian Nursing Federation (ANF) officials late yesterday to promise amendments to conditions after making an offer the union had described as "disgraceful".
That included shortening the time frame for implementing nurse-to-patient ratios below three years, as well as implementing ratios in metropolitan hospitals earlier than in the regions.
There was no movement on the government's pay offer of a three-per-cent a year increase plus a $3,000 cost of living payment.
McGowan urges nurses to accept 'big win'
Responding to the looming threat this morning, Premier Mark McGowan said any revised offers had largely been made yesterday morning when he said he was hopeful ratios could be introduced in less than three years.
"I sort of said that yesterday morning, that if that could be done then we would do that … so that's already on the table," he said.
Mr McGowan continued to call for nurses to back down from industrial action.
"We've acceded to what was asked for, and nurses have had a big win in Western Australia with this announcement," Mr McGowan said.
"I just urge the nurses to look at the offer, it's in accordance with what was asked for.
"It's a big win that hasn't occurred for nurses before and we want to work through the detail."
The Premier said if nurses did start a ban on double shifts today, the impact would be watched closely by the Health Department.
He said there were no plans to take the union to the Industrial Relations Commission to force an end to the industrial action at this stage.
Government's 'tight-fisted approach' putting lives in danger
Opposition health spokeswoman Libby Mettam said the government's "tight-fisted approach" was putting the lives of WA patients at risk.
Ms Mettam said while she doesn't support the ANF's campaign of industrial action, it was up to the government to "step up and negotiate in good faith".
"It is extraordinary that the McGowan government is illustrating no urgency to address this issue," she said.
"We have a health system which is on its knees and the McGowan government needs to do more to ensure that we are retaining health workers but also attracting new health workers into our hospital system."
Ms Mettam also claimed the health minister was putting politics ahead of patients.
"There is a lack of confidence amongst our health workers about the McGowan government's political approach to this issue," she said.
"If [they] were doing more to incentivise health workers and ensure that they were not leaving the health workforce, then we would not be looking at these issues."
Police also planning action pending offer
The WA Police Union has also flagged potentially beginning low-level industrial action from Monday as it said the government dragged its feet on providing an acceptable offer on pay and conditions.
Union president Mick Kelly said officers would not compromise community safety but said there was a lot of extra unpaid work officers were doing that could be halted.
"We served our log of claims in April this year, our agreement finished on the 30th of June, we're now four months down the track and we still don't have an offer from the state government," he told ABC Radio Perth.
"What's loud and clear from our membership is that they're annoyed, they're disappointed, they're frustrated, and they're becoming extremely angry.
"The government really needs to take us seriously and increase the wages policy, it's not suitable.
"I think the Labor government is standing firm under the stewardship of the Premier, I don't believe we're being listened to, and I don't believe the state government really respects the effort that our members have certainly done over the last few years."
The union's demands have included a five per cent annual pay rise, a longer rostering pattern, and a "right to disconnect", limiting texts and calls officers are expected to answer after hours.
Commissioner backs higher penalty rates
WA's Police Commissioner, Col Blanch, took the rare step of lending his support to calls for higher pay when it came to the penalty rates officers receive for shift work, weekends and public holidays.
"Policing is a tough gig, it's a 24/7 job, it is not family-friendly when you have to work Friday night, Saturday night, Sunday nights," he told ABC Radio Perth.
"So I absolutely agree with the union ... I think we should pay our police, our nurses, those that have to work late evenings, nights, and difficult times when they are not with their families.
"When people are tucked up at home, even me as commissioner, I expect that our police get paid well to come out of their houses and work late at night."
Commissioner Blanch pointed to a recent incident in Pingelly, where an officer attending an incident after hours was forced to shoot a man armed with a knife, as a demonstration of why officers should be paid more at certain times.
He said police should at least be given the same level of penalty rates as other public servants who work unusual hours.
"Now, police get a good wage, a base wage, this is about working evening shifts and night shifts."
Police to get pay rise: Minister
Commissioner Blanch said he had raised his concerns with Police Minister Paul Papalia and the union.
"I'm always going to advocate for my officers, to make sure that we can get them in the door to deal with the difficult shifts," he said.
"And I think that's the important message from me, it's such a tough job that I've got to support my officers, in breaking up what is a normal family life."
"As Mick Kelly said, you can go to other organisations, work Monday-Friday, and spend all weekend with your family, I can't give that same commitment to my officers."
Commissioner Blanch said he would not provide details about his discussions with the government about pay but said they were ongoing.
Mr Papalia said a wage increase was coming for WA police, but said he would have no part in the negotiations.
"Our police work hard, they deserve a pay rise and they will get a pay rise, as all industrial disputes come to an end eventually," he said
"What that will look like is currently being negotiated and I have no part or say in those negotiations."
