Mrs Johnson said looking after adults is simply outside her frame of reference and she had to repeatedly call adult wards for support.

"I've worked in the kids ward for a few years now and we've had the delightful opportunity when we've been told the hospital is in crisis that we take adult patients," she said.

"We're all a specialty unit with pediatric training, and of course there were staffing issues, so we just accumulated extra.

"It's a little bit of a safety issue for our current patients and a bit of a safety issue for our adult patients."

Staffing continues to present daily challenges for nurses in other parts of the hospital.

As a result, nurses and midwives at the Tamworth hospital chose to strike for the fourth time this year, this time for a whole 24 hours, as part of state-wide action.

Mrs Johnson's husband Josh Johnson, also a nurse, took the opportunity to speak to those gathered for the strike about how hard work has been.

"I've never seen so many people so deflated. It's really, really hard," he said.

"I've never seen it so bad, and it's not COVID. We are just inundated with patients.

"I've never seen so much bed-block."

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For Mr Johnson, implementing nurse to patient ratios is essential for supporting them in their workplace otherwise people will just start leaving.

"We need ratios. It's just a no-brainer," he said.

"There are plenty of people who are looking for other jobs... for the for time in my career I've thought about not working in ED [emergency department]."

NSW Nurses and Midwives Association branch secretary for Tamworth Jill Telfer said there needed to be a nurse for every three patients in the emergency department.

"We're short every day, so I don't know how we're meant to keep this up," she said.

"We've had 5700 hours of paid overtime for nurses and midwives just in July, and even with that we didn't meet safe staffing levels.

"We have been at probably our worst state in the past few months."

She said that without ratios the situation simply is not sustainable.

"The overtime is for full-time staff or people who are doing double shifts ... and they're offering that because this place would be closed without it," she said.

Ms Telfer said nurses and midwives feel like they're not being heard by the government and the situation just won't improve without clear communication and understanding.

"The situation has actually got worse as the year has gone on," she said.

One of the things that could improve the communication with government is the new Regional Health Ministerial Advisory Panel, she said.

Ms Telfer said that for the panel to really make any difference it needs to include nurses.

"I think frontline nurses, that's the honest truth, and that's been missed," she said.

A NSW Health spokesperson said in a statement it was committed to its current system of determining ratios.

"The current 'nursing hours per patient day' system used under the Nurses Award in NSW Health is a far more flexible ratio which enables hospitals to increase staffing, where needed, to ensure safe and effective care," the spokesperson said.

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