"I don't think unless they [the hospital managers] are a nurse they are going to have full insight into how nurses are running things. It's the same as someone who's not a doctor trying to tell a doctor how to do their job," Ms Coffey said.
She said the changes were just the start of major cost cutting between the two DHBs.
"Basically what they're trying to do is cut $5.3 million - it's all about cost cutting.
"The patient suffers at the end of the day when it becomes about money," she said.
Nearly 750 staff from the two DHBs gave feedback on the new structure. Ms Coffey said the feedback from the nurses' organisation was not listened to.
Ms Coffey said professional development training for nurses had also been cut until June.
"Professional development for nurses and doctors is really important. They need to be able to go on these courses to enhance their patient care and gain new skills.
"The outcome will be affecting the patients at the end of the day," Ms Coffey said.
Mr Dyer said he was aware of the concerns raised but decided to go ahead with the proposed changes to the nursing structure.
"I want to make it clear that the change to the reporting lines of nursing directors is not to be seen as a demotion.
"It is simply a result of the changes I have decided to make in order to introduce hospital managers," Mr Dyer said.
In 2010 senior clinicians from three lower North Island DHBs began looking at vulnerable services, and those which would most benefit from a joint approach.
In October 2012, the DHBs released a partnership programme to address sustainability, access and quality issues.
