Hundreds of nurses and health staff in Derry are on strike and have joined picket lines outside Altnagelvin and Gransha Hospitals.
The staff, represented by a number of health care unions, are taking industrial action over pay parity and staffing levels.
Staff striking include nurses, paramedics and catering and administration staff.
Royal College of Nursing (RCN) members are taking strike action for the first time in its 103 year history.
The beginning of the strike action follows three days of action, short of strike, which took place earlier in December.
If no resolution is forthcoming, the RCN has further strike days planned in January, February and March of 2020.
Cars driving past the striking workers this morning showed their support by beeping their horns.
Many of the nurses had just finished night shift before joining the picket line.
RCN steward Andrew Doherty told the ‘Journal’ that nurses were ‘saddened and disheartened because we hoped it wouldn’t come to this.’
“This is a last resort. Our nurses don’t really want to be out here on strike so it is a sad day.
“The number one focus for all the nurses out here is the safety of patients on the ward. For far too long we have had too many vacancies. Most wards in all hospitals are short two or three nurses and that leaves a massive gap in workload and patient safety.
“Our other priority is pay and nurses here paid less than England, Scotland and Wales, significantly less.”
Mr Doherty said that the support shown by patients in Altnagelvin Hospital and by passing members of the public “is reassuring us that we are doing the right thing and it is reassuring that people know why we are doing it.
“We’re not doing it for us we are doing it for the patients in the hospital who don’t have enough nurses to look after them.”
The Western Trust said the strike action will have a ‘widespread’ impact on all health and social care services.
They have confirmed that 582 outpatients, new and review outpatient appointments, have been postponed and 53 planned inpatient and day case procedures have been cancelled across the Trust.
A number of clinics have been postponed or rescheduled, including ante-natal and routine mental health appointments, and a number of family centres have been closed.