Thousands of nurses across NSW are striking for 24 hours for the second time in 10 years to pressure the state government to accept their demands for better pay and mandated nurse-to-patient ratios.

Thursday’s industrial action came more than a month after the NSW Nurses and Midwives’ Association first voted in favour of statewide action that subsequently led to demonstrations at 150 public hospitals.

“Patients play Lotto depending which day they go to hospital,” union General Secretary Brett Holmes said.

“They (patients) could get lucky and get a properly staffed shift or they could get unlucky.

“Our members … want to see a better health system that will guarantee that there are enough nurses … to look after patients.”

Nurses are demanding a nurse-to-patient ratio of one-to-four on hospital wards and a midwife-to-patient ratio of one-to-three, as well as a 4.75 per cent pay rise versus the 2.5 per cent a year allowed by the state government.

Mr Holmes said the government had extended no offer to the union since its last meeting with Premier Dominic Perrottet, who has been on paternity leave since March 17.

Following the February strike – the first by NSW nurses in a decade – Mr Perrottet said he hoped “we can provide a resolution” but noted the issues were complex.

He also said Health Minister Brad Hazzard was in “constant dialogue” with the union.

Nurses from up to 170 hospitals were to take part in rallies on Thursday in Sydney, Albury, Bathurst, Broken Hill, Dubbo, Goulburn, Newcastle, Orange, Port Macquarie, Wagga Wagga, Wollongong and other areas.

They will also protest outside Parliament House in Sydney, where the NSW Greens will on Thursday introduce a bill to the upper house to legislate the union’s preferred nurse-to-patient ratios.

“Nurses and midwives are at breaking point,” Greens health spokeswoman Cate Faehrmann said.

“It’s time for the government to listen to their calls for safe nurse-to-patient ratios so that patients get a safe level of care.”

Ms Faehrmann noted Queensland and Victoria had already legislated nurse-to-patient ratios and South Australia was considering the issue.

The union said life-preserving services will be maintained at all public hospitals throughout the day.

The NSW government had successfully argued to the industrial relations umpire the strike should not go ahead, but the union has defied the decision.

The latest strike came after some NSW paramedics took industrial action on Tuesday. They have similar demands for improved resources and staffing.

On Monday, the paramedics union shared photos of ambulances queuing outside NSW hospitals, including Royal Prince Alfred, Wollongong, Wyong, John Hunter and Concord, waiting to offload patients at emergency departments.

-AAP