Some patients are missing out on medication, showers and meals due to widespread understaffing in hospitals across New South Wales, according to the state's Nurses and Midwives Association.
The union this week lodged a court case against the state government for breaching patient care awards.
According to the union, Gosford Hospital on the state's Central Coast is the worst for staffing breaches, with 777 award contraventions between 2018 and 2022.
Ward nurse and Gosford's union branch president Meg Pendrick says staff cannot do their job properly under the current circumstances and many are at "breaking point".
"You can't be feeding people, giving medication to people, toileting people, talking to people's families and answering phones and chasing the doctors and then supporting your colleagues," she said.
"The care we give is not satisfactory to us and it should never be accepted as satisfactory."
In the statement of claim for the Supreme Court, the union has alleged that patients at numerous major hospitals in NSW have recently missed out on 120,000 hours of nursing care due to "systemic understaffing".
The court case could lead to financial penalties for the state if it is found to have contravened public health awards.
Staff rallied outside of Gosford Hospital and other hospitals across the state today to once again call for better pay and conditions.
Since the COVID-19 pandemic began, many healthcare workers have walked off the job four times, calling on the state government to do more to address their concerns.
Ms Pendrick claims the healthcare system at Gosford is "almost already broken" and she fears that unless it is improved the next cohort of nurses will be scared off.
"It is just so demoralising and heartbreaking and there's no job satisfaction in it," she said.
"You certainly wouldn't recommend it to anyone. Who would want to work in an area like that?"
Another local nurse and Wyong union delegate, Kelly Falconer, said the breaches have made it "really hard" for the hospital to attract and hire new staff.
The union has long pushed for a one-nurse-to-four-patients ratio, which it says is necessary to deliver safe health care.
But the NSW Ministry of Health has argued that its current "nursing hours per patient day" (NHPPD) system is working.
In a statement, a spokesperson said the system is "flexible" and allows hospitals to increase staffing where needed, "to ensure safe and effective care."
"NHPPD considers the numbers of patients, their complexity, acuity and care needs while allowing for the professional judgement of nurses and managers to adjust staffing levels to reflect the changing care needs of patients," a spokesperson said.
However, Ms Falconer said there were clear deficiencies that are felt by staff every day on the ground.
"We're not talking little shortfalls. We're talking tens of thousands of hours that are missing," she said.
"That's hours that you're missing care for your loved one, it's pain relief that's not been given or antibiotics that are not been given; it's complications after falls whether they have broken bones or bleeds in their brain."
The NSW Liberals and Nationals have not budged on their stance around nurse-to-patient ratios ahead of the March 25 election.
NSW Labor will also not take the nurse-to-patient ratio to the election but has promised enforceable staffing levels.
Meanwhile, the Greens NSW have backed the calls for ratios and have used the election campaign to call for them to be implemented.
