Thousands of nurses and midwives have walked off the job in NSW to protest pay and staff levels. 

Many have travelled from across the state and city to march through Sydney’s CBD, while rallies are also taking place in regional parts of NSW. The workers say COVID-19 has pushed an already stretched system to its limit. 

The strike is on after NSW Nurses and Midwives' Association defied an order to cancel the industrial action.

The Industrial Relations Commission (IRC) had ordered the union to cease organising the strike and to refrain from taking any kind of industrial action for the next month.

The NSW Government took the matter to the IRC, claiming the strike would disrupt health services across the state.

Previous crisis talks between the nurses union and Health Minister Brad Hazzard could not resolve a stalemate in negotiations over pay and staffing levels.

The Nurses and Midwives' Association said members needed to “stand tall” to express their frustrations. 

Nurses have chosen to strike for between four and 24 hours, staggering their times to lessen disruption for patients. 

Skeleton staff remain in position to treat critically unwell patients and preserve life. 

The protesters want pay rises and legislated staff-to-patient ratios, similar to those in Queensland and Victoria.

The union says the changes are vital to prevent the ongoing loss of qualified health professionals.

NSW Health says its “flexible staff to patient ratio system” ensures “the right number of nurses in the right place at the right time”.