Nurses warn conflicting approaches to dealing with COVID-19 between district health boards (DHBs) and even within hospitals are putting health workers' safety at risk.
Sandra Richardson from the College of Emergency Nurses at the Nurses Organisation said the Health Ministry's guidelines were interpreted differently by each DHB.
Some staff were receiving three sets of policies in one day, and different professions were taking different stances to using personal protective equipment and spacing patients, she said.
"Even within the same profession, it might be nurses working in one ward or one area within one institution might have a different understanding of what's appropriate to nurses working in the next ward."
This was causing huge stress for staff, who were worried they were not taking the appropriate clinical approach, she said.
The Health Ministry needed to take a more "hands on" approach and enforce standardised national protocols.
"As long as they are happy to sit back then there will continue to be that variation.
"And while they may not want to be interventionist perhaps, it may be that someone needs to take that overall responsibility."
One example of how a framework could help was around things like the need for separate physical placement of patients to minimise infection, Dr Richardson said.
"This requires more staff, dedicated areas within each workplace, and increased time spent carrying out isolation procedures."
She said DHBs had been "extremely innovative in some cases" in creating separate spaces and redeploying staff.
However, with the move to level 3 and more "business as usual", nursing staff were apprehensive that some of these measures would be stepped down.
"Of course we want people to seek treatment if they need it - we worry that some people are afraid to come into hospitals, and are not getting the care they need.
"But, as things go back to normal and we get more patients coming in, staff may get overwhelmed without sufficient guidance.
"What will ensure we can look after those who need care, during COVID-19 and going into winter, is the DHBs and the Government taking accountability and showing leadership by ensuring secure and consistent processes.
"That way, our staff will have the security and confidence they need to practise to the best of their ability, without being unfairly held responsible for circumstances beyond their control."
The Health Ministry said the COVID-19 Health and Disability System Response Plan establishes a framework to prepare for and manage the national response to the outbreak of COVID-19 and is available online.