Paramedics have refused a push from the NSW government to stop industrial action after the emergency workers said they need more staff brought into their sector and a substantial pay increase.
The government took the Australian Paramedics Association NSW to the Industrial Relations Commission on Monday in what the union said was as an attempt to halt the action.
The APA NSW is pushing for a 10 per cent pay rise, 1500 additional paramedics and an expansion of the specialist paramedic program to turn around the deteriorating conditions in their sector.
The IRC recommended the industrial action, which included paramedics refusing to leave their usual posts to fill staffing gaps at other ambulance stations should stop - but the union said it would continue through to Tuesday morning.
"Our members have little confidence that NSW Ambulance is ready to address our concerns," APA (NSW) president Chris Kastelan said.
"We're disappointed and frustrated that the government would rather try to block out our voices than act on our demands.
"Paramedics are taking action because we want real change from this government."
Mr Kastelan said he respected the role of the IRC but said it was the role of APA NSW to "advocate for our safety and the safety of our communities".
"We can't let this crisis continue," he said.
The union said it has not ruled out taking action beyond Tuesday if the government does not engage with it "properly".
In February, paramedics took similar 24-hour action amid claims of worsening working conditions, including staff doing 16-hour shifts without breaks.
Health Services Union NSW secretary Gerard Hayes says paramedics need a pay rise significantly higher than the 2.5 per cent on offer.
"It could well be higher than 10 per cent," he told reporters.
Mr Hayes said more than 84 intensive care paramedics should be rostered on in Sydney every 24-hour period, but NSW Ambulance no longer replaces sick and injured specialised staff leading to gaps in the health system.
According to the union, Western Sydney hospitals were without specialist paramedic coverage on at least 23 occasions between January 24 and February 24.
"There is no escaping the fact that NSW needs more paramedics and they need proper professional recognition," Mr Hayes said.
"Over the last 10-15 years paramedics have been getting 2.5 per cent - now that doesn't barely keep up with CPI."
NSW Opposition Leader Chris Minns said the best way to avoid industrial disputes was for the "government to sit down with the HSU, paramedics, with nurses and understand what their grievances are, and come up with common sense solutions".
Nurses are also threatening more industrial action later this month after calling for a 4.75 per cent wage increase, better nurse to patient ratios and more maternity staffing during a rally outside NSW parliament last month.
