About a thousand nurses from across the Hunter and Central Coast came together to march through Newcastle to Foreshore Park as part of the state-wide strike action.

They told the Newcastle Herald that Hunter hospitals had been surviving on a lot of goodwill - nurses working double shifts, missing their breaks, and working overtime to ensure patients received appropriate care.

They were tired. They were angry. And some were considering leaving the profession altogether.

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A nurse from the Maitland branch of the NSWNMA said she was supposed to be on her honeymoon, but her leave was denied because of "significant" staff shortages.

"I requested the week off before my wedding, which was thankfully granted, and I'd requested the two weeks afterwards for my honeymoon," she said.

"I had to come back to work the Monday morning after my wedding because I was needed... It has been devastating."

"If I had to choose the one thing I'm most angry about, it is the continual insistence by this government that this health system is coping," Laurel Kibble, the NSW Nurses and Midwives Association branch secretary of the Maitland Mental Health Unit, told the crowd.

"This system is not coping. We are not coping. I don't blame the pandemic ... This is the inevitable result of a system that has been neglected for years. We were always going to come to the boil, the pandemic just turned the heat up high."

Nurses are asking for a nurse-to-patient ratio of one-to-four on hospital wards, and a midwife-to-patient ratio of one-to-three - as well as a 4.75 per cent pay rise to correct a previous "freeze".

They warned that mistakes were more likely to happen, and patients could receive sub-optimal care, without mandates to ensure appropriate staffing levels.

Rachel Hughes, secretary of the John Hunter Hospital and Children's Hospital NSWNMA branch, said safe staffing ratios were their priority - but the government had been unwilling to negotiate.

"We have people sitting in the emergency department in the waiting room for eight hours," she said.

"We have ambulances who can't offload for eight hours. On Monday night there were nine ambulances banked up out the front of John Hunter Hospital because there was nowhere for them to go. They were short nurses, they were short doctors, and we don't have enough beds. We have gotten to the point where we have nothing left to give."

Newcastle's Woman of the Year, midwife Oceane Campbell, said they deserved respect and recognition via safer ratios and a wage that increases with inflation.

"We all bust our guts to provide an adequate standard of care, but it's exhausting - it means overtime, often you stay back or worry whether you did good enough or could have done more," she said.

Greg Luxton, Dungog Hospital's NSWNMA branch president, said hospitals big and small were impacted.

A NSW Health spokesperson said NSW Nurses and Midwives' Association members took 24-hour strike action in defiance of Industrial Relations Commission's orders.

But all local health districts had plans in place to ensure people in need of emergency and urgent care received it as quickly as possible.

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This story originally appeared in the Newcastle Herald