The biggest uprising of public-sector workers has confronted the NSW Labor government since it was returned to power as thousands of nurses strike for better pay and conditions.
Nurses, midwives and supporters stopped work for 24 hours from Tuesday morning as part of an escalating campaign for an immediate 15 per cent pay increase.
More than 6000 workers gathered on the steps of NSW parliament, pledging to continue fighting until they were fairly renumerated, despite the state's industrial umpire recommending an interim pay rise while negotiations continued.
"The government promised reform ... and promised to look after the essential workers, it was all hollow," NSW Nurses and Midwives' Association secretary Shaye Candish told the vocal crowd.
"We're seeing this government make nurses or midwives feel guilty or greedy for asking for pay."
Representatives from the transport union, electrical trades union and the Australian Workers Union were at the rally in support of healthcare workers.
Nurses' union assistant secretary Michael Whaites said the female-dominated industry was being taken for granted.
"The men of Macquarie St (in parliament) have a problem and you're it," he told the roaring crowd.
"This is a system that's on its knees and nurses and midwives are worked to the bone."
NSW emergency departments have been hit with record and increasing demand, but a decreasing number of patients are starting their treatment on time, according to latest quarterly figures.
The 24-hour stop-work action by nurses and midwives affected 454 elective surgeries and temporarily closed 81 beds, according to NSW Health.
As the roars of nurses rumbled into the lower-house chamber, Premier Chris Minns deflected opposition calls for him to talk to those protesting.
"For 12 years, there has been a deliberate wage suppression by the previous government," he said in reference to the coalition's long-standing cap on public-sector pay rises.
"Now the nurses association, for understandable reasons, have said to the (Labor) government, we want you to make that up in a single year. We can't do it."
Opposition health spokeswoman Kellie Sloane suggested the premier's evasion was because he couldn't hear over the voices of the nurses outside.
"Clearly he has lost control of this situation," she said.
Industrial Relations Commission president Ingmar Taylor recently recommended an interim agreement for a three per cent increase ahead of four weeks of "intensive discussions" in a bid to broker a longer-term deal.
Health Minister Ryan Park said he was disappointed with the union-led strike.
"The independent umpire has said very clearly that this action shouldn't take place," he said.
The strike is the union's second major stop-work action since Labor came to power in March 2023, with the previous 12-hour strike earlier in September involving multiple rallies across the state.
All NSW public sector workers, including nurses, have been offered a three-year, 10.5 per cent pay increase factoring in a mandatory rise in superannuation payments.
Public rallies were also planned in Tweed Heads and Albury, near the respective borders of Queensland and Victorian, two states the union says nurses are moving to because of better pay.
