Striking health workers have urged the government to treat them with respect as they call for an improved pay deal and safe staffing levels.
Thousands of health and social care workers took to picket lines across Northern Ireland on Thursday in the latest bout of industrial action.
Paramedics, some nurses and hospital support workers who belong to the unions Nipsa, Unison and Unite took part.
They are calling for safe staffing, better pay and improved mileage allowances.
The Royal College of Nursing also took part in strike action over pay and safe staffing levels in December.
At the Royal Victoria Hospital in Belfast, paramedic Gabriel McComish said there is a need for change within the health service and in the attitude towards public services.
He described working conditions as “horrendous”.
“We have an increase in population, increased numbers and a reduced workforce, we have people leaving on an annual basis for new opportunities within health organisations around the UK and private health,” he told the PA news agency.
“We need to hold on to staff and the only way you can hold on to staff is to respect us, don’t disrespect us because once you start to disrespect us, people will leave and the community will suffer.
“Year after year we have seen cuts in funding and we have seen our colleagues leave early, retiring early, becoming sick or leaving for other industries.
Mr McComish said with the ongoing crisis in hospitals, paramedics are spending hours after their shift ends waiting outside emergency departments.
“We’re struggling to get finished on time on a daily basis, day after day after day our crews are being held up three to four hours after their finishing time, they can’t get home to their families, they can’t get their annual leave. They’re tired and depressed about the whole situation,” he said.
He said workers are determined to stand tall and fight back.
“Morale at the minute is quite high because when you’re in a situation where you’re up against a wall, you have to fight back so people are standing firm and tall, we have a fight on our hands and we’re going to fight until this is resolved,” he said.
“We need this government to come in and start talking to us properly.”
Eddie Richmond, a duty control manager with the ambulance service, said workers were still there to help those most in need during the strike.
“We have gone to great lengths working with our management team to ensure that cover is maintained at all times,” he said.
“But it is important that the message goes out that the health service is broken, and there is no use saying it is on its knees, or got run down, it is broken and it needs to be fixed.
“We have tried, we have gone to the Government, we have gone to the department (of health), we’ve argued, we’ve presented the case, it’s not just about money. This is about the service and the fact it is now completely broken.
“We would like to see a turnaround, a proper investment, jobs, there are 100,000-plus vacancies in the NHS across the country, we would like to see those positions filled.
“This is not just about pay, this is about the service and the service we provide to the public.”
Anne Speed of Unison said that in the absence of talks workers are “stepping out and stepping up”.
“It is an appalling situation when trade unions willing to negotiate have all doors closed to them. It is, therefore, inevitable that this action today is happening,” she said.
“Health workers cannot stand idly by or stay silent. And why should they?”
Ms Speed also lambasted Secretary of State Chris Heaton-Harris, who is currently on a trip to the United States aimed at encouraging trade opportunities.
The Stormont Assembly remains in flux with no ministers in post.
“It is time he included in his priorities addressing the crisis in our health service. Staff recruitment and retention and pay justice are every bit as important as trade,” she said.
“Our members also expect a joint effort from all political parties to break this logjam.”