Emergency responders are taking part in industrial action on Thursday, with paramedics refusing to leave their allocated stations to plug holes in the roster.
Paramedics in metropolitan areas are generally rostered on for 12 hours, with two breaks to eat and rest.
However, the Australian Paramedics Association claims conditions have deteriorated and paramedics routinely work 16 hour shifts without a break.
The union wants 1500 more paramedics on the road, a pandemic payment and a pay rise of more than 2.5 per cent.
It also is seeking a large investment in specialist paramedics and referral networks to improve services.
However, the APA said the union had yet to have any meaningful response from the NSW government to their industrial action.
"It all comes back to, 'Well there's a wages policy, which is 2.5 per cent, and you're not getting any more than that," a spokesman said.
"In the last 10 years, there's been no real increase in paramedic resources."
APA President Chris Kastelan said industrial action should not surprise NSW Premier Dominic Perrottet.
"We've been telling them for years that we're fatigued, too thinly resourced, and at risk of burning out," he said.
"We're asking for the resourcing we need to properly do our jobs, and a wage to reflect the skill and professionalism we bring to the role."
The NSW Opposition Leader Chris Minns said paramedics had been worked "to the bone" throughout the pandemic and negotiating with them was the "minimum" the government could do.
Frontline health workers had gone through "so much in the last two years particularly", Mr Minns said.
"We're calling on the NSW premier to sit down and start meaningful negotiations with the unions and their representatives."
The government announced Thursday it had welcomed 291 new paramedic interns at a graduation ceremony at Sydney Olympic Park.
Bronnie Taylor, Regional Health Minister, said the new recruits would be a welcome boost the NSW Ambulance's workforce.
"We've seen our health workers go above and beyond during the pandemic and our wonderful NSW Ambulance paramedics are among those leading the charge," Mrs Taylor said.
It comes after thousands of nurses rallied outside NSW Parliament on Tuesday, as well as 25 locations around the state.
The NSW Nurses and Midwives Association said earlier this week its members have indicated they support further strikes.
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