Hundreds of striking nurses and supporters have joined the picket line outside Auckland City Hospital as part of nationwide industrial action.
Chants and supporting toots from passersby can be heard around the hospital grounds and surrounding streets.
Auckland City Hospital registered nurse Gui Restall said it was a "human rights issue".
"It has been ongoing a number years with unsafe staffing, and remuneration that does not reflect our skills, education and level of responsibility."
Over her more than 20 years in the profession, Restall said there had been increasing pressures on nurses.
"We go home crying, it is so stressful. Many nurses do hours and hours unpaid overtime.
"The population has expanded, there are more patients coming in who are more sick, we have more diverse communities, we work with more advanced technology and medications, more protocols and regulations.
"It is challenging, and it requires more nurses."
She said the pay increases should be over a shorter timeframe, and there needed to be an extra 1500 nurses nationwide, rather than the 500 promoted by the Government.
"[The increase] is a start, but it needed to happen 10 years ago. We need extra funding to recruit more nurses, and decent remuneration to attract and keep them here, and stop them going overseas for better conditions and pay."
Life preserving services put in place today would ensure there was no drop in the level of care, she said.
"There has been a lot of work done to get those in place, and in some areas the rosters today are better than they would be on a day-to-day basis.
"Nurses are carers. We don't like to do this. It has been 30 years since the last strike. We feel completely undervalued."
The timing had nothing to do with the new government, rather the timing of the negotiations, she said.
"We have reached critical mass now, something needs to be done. Come on Winston, I doubt politicians would put up with what we put up with."
Nurse assistant Vijanti Kumar has worked at Auckland City Hospital for the past 14 years.
"When I started there was always enough staff. Now we are always short staffed," she said.
"We just can't keep up with the amount of patients."
The strike was not about money, but about providing better care, Kumar said.
"It is not safe for the patients. We need more staff."
Nurses nationwide walked off the job today from 7am after rejecting the latest pay offer from the district health boards (DHBs).
In Dunedin, one senior Dunedin nurse has a simple explanation for why she is on strike today: "I want us to be able to look after our patients properly."
The nurse, one of about 30,000 healthcare workers nationwide who walked off the job for 24 hours at 7am, told the Otago Daily Times that staff shortages at Dunedin Hospital prompted her to vote for industrial action.
"For me, it's not so much about the money, it's about the number of nurses - that is the problem," the nurse said.
"When people come into hospital there are not enough nurses to look after them - there just isn't."
The nurse, who did not wish to be named in case speaking out affected her employment, said in recent months in one ward at Dunedin hospital around 40 gaps in each week's roster needed to be filled.
Sometimes, junior nurses were asked to fill in for senior colleagues, the nurse said.
Nurses were "literally running" from patient to patient, and often worked unpaid overtime for what should be routine tasks such as preparing patient notes for shift handovers.
"People are always there well over time ... an enrolled nurse on her first day on her own on an afternoon shift without being mentored, and they were heavy patients, didn't get away until quarter to one in the morning.''
Patient safety 'paramount'
NZNO industrial services manager Cee Payne has said life-preserving services and contingency plans would be in place across the 20 district health boards.
"Patient safety and public safety is paramount," Payne said.
DHB spokeswoman Helen Mason said it was very disappointing that strike action was going ahead.
"We're waiting to receive the final recommendations from the Employment Relations Authority [ERA]," Mason said late yesterday.
Mason said those recommendations would be taken "very seriously" and it was disappointing NZNO hadn't waited for those recommendations before deciding on strike action.
The ERA are assessing whether the offer addresses the NZNO's concerns.
Mason could not say what would happen if the recommendations arrived in the middle of the strike.
"We're looking at an unprecedented circumstance for the country. Not having 70 per cent of your workforce in the workplace will be a significant challenge.
"We need to understand what the recommendations are and we need to consider those recommendations and that will inform what our next actions are," Mason said.
The Government had hoped last-minute talks between district health boards and nurses would avert strike action on Thursday.
Acting Prime Minister Winston Peters said the Government was very disappointed that nurses had voted to reject the latest pay offer and walk off the job for 24 hours tomorrow.
"From this point the Government believes there is still time to avert industrial action. We encourage DHBs and NZNO to continue with urgent facilitation talks over the next two days.
"As it stands, though, we are on track for a strike action on Thursday which will cause disruption to health services nationwide," Peters told reporters.
"We need the public to be prepared. We've made all the steps possible we can to ensure there is the least amount of sacrifice, or medical difficulty, with respect to potential patients."
All NZNO members striking will walk out of the hospitals in time for the industrial action and join the picket at the hospitals.
The rallies for Auckland, Christchurch and Wellington begin at 7am outside the main hospitals.
For the full list of activities please go to the Health Needs Nursing Facebook page.
What you should do
• Nurses plan to strike for 24 hours from 7am today.
• Anyone with an urgent medical need should not hesitate to dial 111 or go to an emergency department.
• For day-to-day medical queries you can contact your GP or phone Healthline on 0800 611 116.
• If your appointment or surgery has been postponed you should have been contacted by your district health board already.
• If you have something scheduled and have not heard otherwise, you should attend as usual. If you are unsure, contact your health board.
• Patients deemed not to require "life-saving" care, who need help with tasks such as turning on bedrests, inserting intravenous pumps, and assistance going to the bathroom and bathing, will wait longer for help. Family, volunteers and doctors have been asked to help out in some cases.
• Some services like Family Planning are not affected by the strike, but others could be if the nurses are paid by the DHB so check if your appointment is still going ahead.