- The strike is scheduled to start at 11am and finish at 7pm
- All elective surgery cases and nearly all outpatient clinics are being deferred for the day
- Small number of nursing staff are on call to allow for emergency surgery to proceed.
- Those with urgent medical needs will still be able to attend hospital or dial 111.
Rotorua nurses have downed tools joining hundreds around the country to highlight their anger with pay and working conditions.
More than 100 strikers and supporters are at the protest site between Kuirau Park and Rotorua Hospital, most wearing purple.
Toots are coming thick and fast from motorists in support of nurses who are in good spirits, waving banners that include: "We care for you", "Let's do this" and "Safe staffing now".
A police car drove by and sounded its siren briefly in support. Nurses downed tools at 11am sharp.
Rotorua Hospital charge nurse manager Clivena Ngatai said she wants the Government to keep nursing safe and "pay us properly".
"We are practising unsafe."
She said the impact on patients was the main reason nurses were striking and she didn't feel the Government was listening to nurses.
"They just keep on making the hospitals busier with sicker patients. We're not given the opportunity to care for our patients properly because we're too busy.
"No one wants to strike. We feel like we've been made to."
She said staff were being lost to Australia because the pay and conditions were better there.
"They need to step up."
Sally Gray has been a medical unit nurse for five years. She has a high-vis vest on at the strike with "integrity" written on the back. She said integrity was "about doing the right thing even when no one's watching".
"We're missing breaks, there's not enough staff on the floor. When we have more staff, we have better outcomes for patients.
"We're all just tired, we're burned out. We're short staffed at the best of times. It's an even worse situation now [with staff in MIQ].
"It's about safer staffing and it's about paying us what we're worth. We've been underpaid for years and years as a predominantly female workforce," Gray said.
She said nurses were often going above and beyond and staff were haemorrhaging as they sought better opportunities overseas.
"I want the Government to hear how under pressure we (healthcare workers) are. Look around. We're all old. They're going to retire in next 10 to 12 years, where's our new lot coming forward?"
She said nurses were going home exhausted after a shift.
"We never finish on time. We stay because we care about our patients. You get home and worry about could have, should have would have."
"[The Government] see us as a cost, nursing is an investment not a cost.
Simon Grant works in healthcare overseas. He's not a nurse but his mother is undergoing care at Rotorua Hospital.
"[Nurses] do a great job, " he said.
"They were telling me about staffing situation. I thought I'd come out and support, it's the least I can do."
He hoped the government would give nurses a "fair hearing".
"The thing they're concerned about is the staffing. It creates challenges for them. it's not sustainable.
The strike is affecting all public hospitals and DHB facilities in New Zealand and involves nurses, midwives and hospital assistants.
The strike action will involve a complete withdrawal of labour by members of the New Zealand Nurses Organisation. About 730 nurses are currently employed by Lakes DHB, with many of them members of the union.
Offer "overwhelmingly" rejected
The New Zealand Nurses Union "overwhelmingly" rejected a second district health board offer in the multi-employer collective agreement (MECA) negotiations.
New Zealand Nursing Organisation lead advocate David Wait said there was a high voter turnout from the 30,000 members who worked at district health boards.
"Members are facing serious nursing workforce issues, with pay rates that do not attract people into the profession or retain the people we have, and staffing levels which stretch them to breaking point, putting them and their patients at risk."
A Lakes District Health Board spokesperson said the strike would cause disruptions to services, but the DHB was doing "everything possible" to ensure patient safety.
More than 220 outpatient appointments had been deferred due to the strike, along with 27 surgical procedures.
Contingency planning meetings have been held regularly at Rotorua Hospital since the health board received notice, said the spokesperson.
"We will be providing essential services including emergency surgery, emergency department care, intensive care, and maternity care.
"Only urgent cases will be able to be dealt with at the Emergency Department at Rotorua and Taupō hospitals during the industrial action," said the spokesperson.
People with minor health issues were being asked to visit their family doctor or Lakes PrimeCare.