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Hundreds of elective surgeries have been cancelled as up to 10,000 nurses and midwives across NSW have walked off the job.
Nurses and midwives began the 24-hour strike at 6:30am on Wednesday, as they ramp up their fight for a one-off 15 per cent pay rise.
Registered nurse Mia Casagrande had threatened to leave her role at Lismore Base Hospital in the Northern Rivers to take up work just an hour away in Queensland, for 18 per cent more pay and better conditions.
"They obviously look after their nurses more than they do in NSW," she said.
Nurse Mia Casagrande says she would get an automatic pay rise of 18 per cent by crossing the Queensland border, and hour drive away. (ABC News: Elloise Farrow-Smith)
The third-year nurse said she had to work overtime to make ends meet.
"We're living pay cheque to pay cheque," Ms Casagrande said.
The industrial action has been condemned by the state government who warned of a "challenging day" ahead for people accessing healthcare in the public system, that is not life-preserving or emergency.
Hundreds of nurses and midwives gather in the heart of Coffs Harbour. (ABC Coffs Coast: Jasmine Kassis)
Last month NSW Nurses and Midwives Association (NSWNMA) accepted an offer to receive an initial 3 per cent pay rise, back paid until July 1, but on the provision its members would not strike while discussions were ongoing.
"We honoured our end of the bargain," Health Minister Ryan Park said.
"Of course I'm disappointed, I'm extremely concerned about hundreds of people today who are going to be missing out on very very important surgery," he said.
But the union has disputed that and said it only agreed to halt industrial action during the four week negotiation period from September 30, which has come to an end.
About 10,000 nurses and midwives went on strike today after initially promising not to while negotiations were underway. (ABC News: Elloise Farrow-Smith)
Earlier this year the union turned down an offer of a 10.5 per cent pay rise over three years.
Their frustrations were heightened when on Monday NSW Police officers were offered an historic pay increase of up to 39 per cent over the next four years, at a cost of almost $700 million.
It is being paid for in part by reform of the police association's disability and insurance scheme.
NSWNMA assistant general secretary Michael Whaites said nurses and midwives wanted to know why they were still fighting for their pay deal.
"Is it because we're such a large workforce, is it because we're a female dominated workforce?" he said.
Nurses striking for better wages march in Lismore. (ABC News: Elloise Farrow-Smith)
Mr Whaites joined about 8,000 nurses and midwives in Sydney's Hyde Park to protest the discrepancy, while other rallies were held across regional centres, including Broken Hill, Armidale and Crookwell.
He warned staff would continue to leave NSW in droves if they were not paid like their counterparts in Queensland.
"They're exhausted from working short-staffed, exhausted from working excessive amounts of overtime and this is all generated out of a rate of pay that is too low," Mr Whaites said.
As they made their way through the city to NSW's parliament house, the blue-uniformed union members held up placards of Premier Chris Minns's face and others that read "F**k this! We deserve more" and "value us".
The chants of those striking in Sydney could be heard inside state parliament. (ABC News: Timothy Ailwood)
Their yells could be heard inside parliament as they chanted on Macquarie Street, "Pay us properly, pay us fair, recognise how much we care".
The state government said it had made several offers to nurses and midwives as it tried to reverse the impacts of the former government's wage cap, but none had been accepted.
Mr Park said it would be impossible to "essentially erode the gap in wages in a single year" because it would cost the state several hundred million dollars.
Since rejecting the 10.5 per cent offer, Mr Park said, the union had also rejected another offer to increase early-career registered nurses wages by 16 per cent.
He said the union also turned down a multi-year deal for the 15 per cent rise with the caveat of slowing down the $1 billion safe staff ratios reform, which the nurse's association had labelled its number one priority last year.
"We said very clearly that this reform is often around choices and priorities," Mr Park said.
Chris Minns said his government was determined to solve this matter with the NSW Nurses and Midwives' Association. (ABC News: Timothy Ailwood)
He said the government remained "committed" and "determined" to solve the matter, but that it would move towards arbitration in the Industrial Relations Commission.
Shadow Health Minister Kellie Sloane attended the rally and said nurses told her they had been left with an "impossible choice".
"Safe staffing ratios are about patient safety, it's not about them, so they should be getting a pay increase as well," Ms Sloane said.
At a press conference, Opposition Leader Mark Speakman said NSW had become a "strike state" under Chris Minns, pointing to the number of nurses' strikes as well as Thursday's planned Rail, Tram and Bus Union industrial action.
Sydney Trains will operate a 24-hour timetable on suburban lines this Thursday, Friday, and Saturday as bargaining continues on a new Enterprise Agreement.