The New Zealand Ambulance Association (NZAA) has issued a two-week industrial action notice after six months of pay talks reached a stalemate "with no resolution in sight".
It also comes amid conflicting claims by both Prime Minister Christopher Luxon and Hato Hone St John's leadership of how the government will fund the country's ambulance services, two days before the Budget.
The association has now outlined a total of five actions as it strives to press St John in the coming months to table an improved pay offer.
It said if its demands were not met, its members will stop doing remote triage, no longer respond to cardiac arrests on their own and cease using their personal phones for St John operational needs.
Members will also stop auditing procedures during ambulance operations and withhold from logging into a vehicle system which monitors St John's vehicles, speeds and locations.
NZAA chairperson Mark Quin told RNZ ambulance staff were at their wits' end.
"The morale is down, they are angry, they're frustrated," he said.
"[They're] even confused why St John as an employer can't pay them what they're worth.
"They've had a gutsful."
Quin said the NZAA was regularly losing paramedics overseas to the likes of Australia or the UK, or to primary healthcare.
"We always feel we're the poor cousins in terms of being a key essential service around the country.
"In many towns we're the only medical resource available to a community."
"There is no freeze on hiring frontline ambulance officers.
"We do have a very low vacancy in our Emergency Ambulance Service (approximately 4.5 percent) with tens of contracts recently signed with international paramedics and local graduates, which means we are not actively recruiting outside of hard-to-fill rural locations."
He denied there was a freeze on wage increases.
"While we are unable to discuss specific details about negotiations, Hato Hone St John continues to have regular, constructive discussions with ministers, senior officials and our purchasers about our financial situation and future funding requirements."
At the same time there have been calls by members of another union for the government to increase its funding of St John.
St John is a charitable organisation which receives more than 82 percent of its funding through the government.
The shortfall is made up from "ambulance part-charges, third-party contracts, and fundraising".
First Union's ambulance officers have also voted for a "media strike" ahead of Thursday's Budget.
Luxon was asked on TVNZ's Breakfast show on Tuesday whether there would be a bump in funding for paramedics in this week's Budget.
"You're talking to people in the middle of a bargaining round between the union and the St John organisation.
"The government's responsibility is to interface with the St John organisation, which was done in 2022 for a four-year contract."
When asked if St John had requested to be fully funded by the government, Luxon explained it was not wanted.
"In my previous conversations they actually don't want to be 100 percent funded by the government.
"They want to make sure they can still access private funding.
"I think that model is right."
First Union's national ambulance coordinator Faye McCann described the prime minister's remarks as "shocking" and "head-scratching".
"We've been sitting at the bargaining table with them since December last year and have been repeatedly told that a wage freeze is in place because government funding isn't sufficient for ambulance officers to receive any pay increase," she said.
"Someone's lying or out of the loop, and the prime minister seems to have made up his mind before Budget Day that one of the most neglected and threadbare health services in our country has no need of further funding."
