Australian Paramedics Association NSW assistant secretary Alan O'Riordan says conditions are dangerous and unsustainable.
"If the government fails to meaningfully invest in a safer, fairer workplace, they'll be staring down the barrel of a mass exodus of highly skilled and qualified workers," he said on Thursday.
A new survey of members revealed 87 per cent had missed more than half their scheduled breaks in the past month and 80 per cent had felt too tired to drive home safely after a shift.
The government needs to prioritise frontline health services in the June 21 budget, Mr O'Riordan said.
"We're fighting for a better service, for ourselves and our communities," he said.
"Our demands aren't going to go away."
Patient care was being compromised by a crisis in resourcing, he added.
Until May 18, paramedics across NSW will refuse to undertake "staff movements", where staff are re-assigned from their station once on shift.
The union will also refuse to undertake non-urgent patient transfers from hospitals after routine or post-treatment discharges on Mondays.
The escalation of industrial action comes after the government failed to act on the union's core demands of a wage increase and 1500 additional paramedics.
The heightened risk to staff coupled with an excessive workload and exhaustion had contributed to paramedics having "the worst morale in living memory", Mr O'Riordan said.
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