The picket was a little smaller, the noise levels a little bit lower - but the message remained the same.
For Liverpool's striking nurses, this battle is draining and depressing. They didn't want to walk out on strike for the first time in December and they absolutely do not want to be out again today - more than six weeks later.
While that first picket line outside the Royal Liverpool Hospital at the end of the year was all about noise, colour and energy, today's more modest showing was all about defiance against an increasingly hostile government.
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Raquel Perez has been a nurse for 15 years, with nine of those years in the National Health Service. She, like her colleagues, believed, hoped this dispute would have been settled long ago and that there would be no need for another two-day action from her union, but she is back out today determined to show that she will not give up in the fight for what is right.
"We feel like the government is trying to villainize us, trying to shift the blame for what is happening in the NHS onto us and trying to turn the public against us," she explained.
"For me, the reason I am back here today is because there is a massive shortage of nurses and healthcare assistants, we just do not have enough staff to meet the needs of our patients."
She added: "I regularly work a shift without being able to take a break or only going to the toilet once because we don't have time and still I go home thinking that I haven't done enough for my patients."
While pay is at the centre of the Royal College of Nursing's dispute, every striking nurse you will speak to will tell you how it is about much more than the cash in their pocket. While many are struggling to get by, the real issue for so many is the inability to do the job they care deeply about well because so many are leaving the profession to do less stressful work for better money elsewhere.
Peter Cherry has been a nurse in Liverpool for 20 years, he has never seen things as bad as they currently are. "It's the worst I have seen it, you often see nurses crying in the corridors, everyone is so stressed out all the time", he explained.
"It is partly to do with pay - there are nurses picking up double and triple shifts to try and make ends meet - but it is also about being unable to give patients the care they deserve."
Asked about the government's approach - or lack thereof - to negotiating with the RCN, Peter added: "I think they are trying to show a sort of macho approach, they are just not talking to the unions. For the RCN to have to go out on strike at all is a disgrace but we have all been backed into a corner."
Peter, like Raquel, like the thousands of other nurses and paramedics taking action again today, this is a particularly gruelling process. These are people who have dedicated their lives to caring for others and they badly want to be doing just that, not standing outside hospitals holding placards and hoping someone in government will listen. But until they are heard, they will keep doing just that.
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