Nurses in Halifax walked off the job Thursday as the Nova Scotia government prepared to push a law through the legislature to end the strike.
Nurses holding picket signs marched outside the main doors of the Halifax Infirmary. Drivers honked their car horns as they passed by the hospital near the city's downtown in support of the strikers.
The province's premier was the target of a chant by the strikers: "Stephen McNeil, you're so rude, we don't like your attitude."
Striking nurses said the walkout is about patient safety as the union tries to get a collective agreement that includes mandated nurse-to-patient ratios.
"We want to get the word across about safety for all because this affects everybody," said Jennifer Derengoski, 31, a neurosurgery nurse.
Paolo Amati, 50, an operating room nurse, said more nurses are needed to ensure patient safety.
"It's about safety," he added. "And what's important is that hopefully this government will understand that you can't go on with something you don't have. ... It's a national worry."
The strike affects services at a handful of hospitals and health centres in the city, but its impact has already been felt across the Maritimes.
The hospitals provide medical treatment to people in the three Maritime provinces and some patients have already been transferred to other health districts in the region.
The Capital District Health Authority issued a statement on its website warning patients of what to expect at its hospitals.
"This strike will significantly impact most of the services that we provide," it said.
Joan Jessome, president of the Nova Scotia Government and General Employees Union, said she expects the strike to end Friday when the legislature will likely pass essential services legislation.
She said nurses have spent their careers advocating on behalf of patients and their safety, adding that surgeries cancelled because of the strike happen even when hospitals are operating normally in the city.
"Don't look at the last 14 days and judge a nurse because they spoke out," said Jessome. "The amount of surgeries that are cancelled on a weekly basis at Capital Health goes untold, but because this is such a public fight, they're (the public) seeing these numbers over the past couple of days."
A few hundred of the 2,400 nurses represented by the union staged a wildcat walkout Tuesday that forced the cancellation of dozens of surgeries as they protested against the bill introduced by the province's Liberal government.
The union's demand for higher staffing levels has been rejected by Capital Health, which says mandated nurse-to-patient ratios won't work because they are too inflexible and there is no evidence they improve safety.
The union and the health authority have agreed to maintain full staffing levels for emergency rooms and units offering dialysis, cancer care and intensive care. But Capital Health CEO Chris Power said Wednesday many other services won't have enough nurses to provide proper emergency care.
As an example, she cited the surgery unit for people with brain tumours and brain injuries, saying there won't be enough nurses to handle an emergency. Power said the same was true of the coronary care unit, which is full of ill patients but will have 70 per cent of it regular nursing staff.
Dr. Patrick Ward, the authority's chief of critical care, warned Wednesday of safety concerns stemming from the strike.
"Is is possible that someone can be hurt?" he asked. "The answer to that would be yes."
Jessome said up to 60 per cent of the union's members in Local 97 will work during the strike.
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