Stressed-out nurses in Dargaville are going on strike over fears for staff and patients while there is no doctor at the beleaguered hospital.
Members of the New Zealand Nurses Organisation plan to voice their frustrations with a strike starting at 1pm on 29 August.
NZNO delegate Shayna Mariscal, a registered nurse at Dargaville Hospital, said the strike would be only an hour long, but it was still a major step for her profession.
When no doctor was available after hours, Dargaville Hospital was making use of a telehealth service and transferring the sickest patients to Whangārei.
Mariscal said the nurses had grave concerns for community and staff safety, and were "sick and tired of working in fear" when there was no doctor on site.
"We're quite stressed about having no doctors because of not knowing what walks through the door and managing that without a doctor on site is terrifying," she said.
"Even Prime Minister Christopher Luxon admitted we're under tremendous pressure, but still nothing is being done about it."
She said a telehealth service was no replacement for an on-site doctor.
"You can only do so much as a nurse, and while we're grateful to have help, it's not the same as having a hands-on doctor to actually do a physical assessment. And so, you feel really helpless and you're just waiting for someone to come and help you, which doesn't always arrive."
Mariscal acknowledged hiring permanent staff was difficult in rural areas such as Dargaville, but said the current shortage was related to management's unwillingness to pay locum doctors a worthwhile rate.
RNZ understands the pay rate for locums, or short-term doctors, has been cut by almost half in some cases.
Mariscal said Dargaville Hospital relied heavily on locums to fill gaps in the roster, especially when staff were sick or on holiday.
"But now the locums aren't getting paid that same rate … how can you think about cutting costs when lives are at risk?"
Fellow NZNO delegate and registered nurse Rachyl Randell said the hospital was also struggling with a shortage of nursing staff overnight and high workloads.
"If a patient is transferred to Whangārei, it means a nurse is taken off the floor to transfer them. The amount of sick calls since the doctor shortages has increased significantly due to the impact this is having on nurses' wellbeing, mentally, emotionally and physically," she said.
"I became a registered nurse to provide the best possible care I could for each and every one of my patients, not leave work in a state of wondering what if or what else could I have done with the current conditions we are working in."
Health New Zealand has been asked for comment.
Since after-hours staffing at Dargaville Hospital reached a tipping point last month, the crisis has also spread to Bay of Islands Hospital in Kawakawa.
Last weekend Bay of Islands Hospital was unable to find enough doctors to fill its roster, a situation that may be repeated in coming weekends.
The emergency department remained open but some patients had to be transferred to Kaitāia Hospital, two hours away by ambulance, instead of being admitted to the ward.
Patients would normally be taken to the much larger, and closer, Whangārei Hospital, but that was in "code black", meaning its emergency department was already at more than 150 percent capacity.
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