District health boards are under pressure as they prepare for nurses striking - but it's the same pressure facing nurses each and every shift, a Bay of Plenty nurse claims.
However, almost $1 billion was offered in the last round of negotiations over three years to address pay and workforce issues, a spokesman for collective DHBs said.
Negotiations between the nurses union and DHB's picked up again this week as nurses across the country prepare to strike for the second time this year.
The New Zealand Nurses Organisation (NZNO) withdrew its industrial action planned for July 29 after the DHB brought another offer to the table, but union members have since voted against it.
As a result, the strike planned for August 19 and another one in September are set to go ahead.
The DHB has now sought help from the Employment Court for fear the strike will affect its life-preserving services.
District health boards collective spokeswoman Dale Oliff, who is also Wairarapa DHB chief executive, was concerned the union was not co-operating by ensuring appropriate staff levels were kept while the strike action was taken.
"All it [the union] would do was to use its 'best endeavours'.
"DHBs are worried the NZNO approach will put the safety of patients and other staff at risk. This is too important to leave to chance," Oliff said.
Rebekah Opie, a NZNO Tauranga delegate, said the action taken by the DHB was baffling as she believed nurses constantly worked in unsafe conditions. The lack of a safe staffing agreement led them to strike in the first place, she said.
"The pressure the DHBs will be feeling leading up to strike day is the pressure that nurses are feeling shift by shift.
"We are having to work regularly in situations that are bordering on unsafe. Staff are having to ration their care."
The situation was happening on a regular basis and Opie said DHBs needed to do something about it. However, there wasn't a clear commitment to actual outcomes in the previous offer.
Opie hadn't heard of any serious harm as a result but knew delayed care meant patients weren't recovering fast enough.
"In the mind is always what could happen. We are holding our breath hoping what we are doing is enough to prevent harm but in this environment, where we are tired and aren't able to answer bells as soon as they come on - it's a terrible scenario waiting to happen.
"That rests very heavily on us. Knowing that every shift you're doing your very best to make sure that that doesn't happen."
NZNO industrial services manager Glenda Alexander said she was not aware of any DHB facility that did not have its life-preserving services needs met at the last strike.
"We wonder why the DHBs did not approach us to discuss the matter before issuing a media release about their decision to take this action, which seems just another distraction from meaningful negotiations."
Alexander said the union believed it had met all its obligations and its members had always ensured life-preserving services weren't compromised during the industrial action.
"Our members have bent over backwards to make sure patients were not harmed as a result of strike action, and the services were certainly provided."
Whakatāne delegate Cheryl Hammond said the move by the DHB was disappointing.
"We are actually working below life-preserving services virtually every shift."
Hammond had previously told NZME the nurses' "crisis", as she described it, was driving her to resign after 42 years in the industry.
Now she was planning to stay - to fight for patients and their safety and for the future of nursing.
"It's not just about us. It's about having enough nurses to provide the care that's required for our patients.
"This has made me more determined as a nurse, and for my colleagues, to actually have a better nursing working force."
Hammond said the industry needed to attract nurses and retain them to the profession.
"To do that we need safe staffing and better pay so they don't leave."
A DHBs collective spokesman said it could not comment on particular DHBs but reinforce the DHBs' commitment to addressing the workforce issues faced by the sector.
"We all want an environment where we can attract, develop and retain nurses and midwives, and this settlement offer is the basis for continuing that work.
"The latest offer was a significant increase with several initiatives to help address workforce shortages and safe staffing, substantial increases on base rates, and lump sums totalling $7200."
If the offer had been accepted, it would have meant an investment of almost $1 billion
over three years to address pay and workforce issues, the spokesman said.
New graduate registered nurses in a district health board start on a salary of $52,460 per year and can earn up to $72,944 after five years. According to the Ministry of Business, Innovation and Employment, senior registered nurses can earn anywhere between $77,000 and $126,000.
Negotiations began again on August 5.