Health staff at Wairarapa Hospital say pressure on the system is no longer just a crisis but a catastrophe.
The emergency department and the general ward have been down to just two staff on shift several times in the past week.
Trudy Pearce has been a nurse in Wairarapa Hospital's general ward for four years.
On Friday evening, it was just her and a junior nurse responsible for 23 patients.
Pearce said she was "hoping to God" there would be no emergencies "because we would have been screwed".
On Sunday, the emergency department was also staffed by just two people.
Department head Dr Norman Gray said the situation was dire.
"I heard the minister say it's not a crisis, well I think he's right, it's more than a crisis, really becoming a catastrophe now," Gray said.
Having just one nurse staff the emergency department was almost unheard of, he said.
It was ironic the hospital had fewer staff than its industrial action levels, which was set to the safest minimum standards, he said.
The department has hit an all-time nursing staff low, with some working more than 10 days in a row.
There has been a combination of staff leaving the hospital for overseas or entirely, and remaining staff getting sick.
Gray said he felt they were not being believed by the government when they call for help.
"Even if you were heard, you never felt you were believed, and I think that's still the case now when the minister feels that people are not quite telling the truth, even when they're using the ministry statistics."
Inequitable response from Health NZ
Gray said he was aware of other hospitals around the country, and within the Wellington Region, that had been incentivising nurses for the extra work, for example, offering up to triple overtime.
But there has been no sign of that available at Wairarapa Hospital.
Health NZ was not being equitable, Gray said.
"There's a lack of tangible thank you from the system to our doctors, nurses and other staff here in the Wairarapa, I'm not quite sure why that is.
"When people elsewhere doing the same job are getting some sort of tangible reward or appreciation, it builds resentment."
The hospital simply needed more staff, he said, but extra money would help alleviate some stress on the remaining nurses and make them feel valued for their tireless work.
Health NZ said it recognised the pressure staff and services were under.
Interim district manager Dale Oliff said it was working to find solutions, and it was already reducing or deferring some planned care to alleviate stress.
Te Whatu Ora Wairarapa was waiting for a national agreement on the incentive payments question, Oliff said.
Health NZ said it was considering all options to recruit staff and it acknowledged the consecutive days some of staff were working and issues around staff safety.
The organisation's modelling shows that winter illness in Wairarapa will continue for a further six to eight weeks.
Nurse warns people away from career
Nurse Trudy Pearce is worried that burnout is looming for her and her colleagues.
She said there were times she felt disillusioned about her career choices - something she retrained passionately to do.
"If anybody, any teenager or school leaver came and said 'I want to be a nurse', I would just totally put them off becoming a nurse," Pearce said.
"There's just nothing nice about being a nurse at the moment, and as far as we can see it's only going to get worse."
Masterton mayor Lyn Patterson said the state of the hospital was concerning, and the community needed to step up and help alleviate pressure.
She said like many places, there had been a decline in mask use in indoor spaces, and businesses should toughen their stance.
"I really ask that our businesses in the Wairarapa work together and collectively start pushing back at people who are not wearing masks," Patterson said.