Ambulance resources in the Hunter are so stretched that "we sometimes struggle to get enough crews to help the sickest patients", paramedic Tim Hilliar says.
"That's even for cardiac arrests and heart attacks," said Mr Hilliar, a Hunter delegate for the Australian Paramedics Association NSW.
"It's a culture of near misses, which is a worrying sign the workload is getting busier.
"The Hunter is one of the areas that's been more significantly left behind in terms of the required staffing levels."
Mr Hilliar said there were "big issues across all the inner and outer Hunter areas with having enough paramedic crews available to attend life-threatening emergencies".
"The underfunding of the entire area makes it difficult," he said.
Health data shows ambulance ramping at hospitals has massively worsened over a decade.
For example, the percentage of patients transferred from paramedics to emergency department staff at John Hunter Hospital within 30 minutes fell from 92.7 per cent in the January to March quarter in 2017 to 64.5 per cent in the same quarter this year.
"As you can tell from the data, there's not enough crews to meet the demand," Mr Hilliar said.
"There just needs to be much more funding for both us and the hospitals to improve all the wait times and make sure we hit our KPIs."
Mr Hilliar said ambulance ramping was "always pretty bad, especially towards the end of winter".
"The last couple of months have probably been one of the worst periods," he said.
He waited with an assault victim at John Hunter for eight hours a few weeks ago.
"It's horrendous. All the evidence says ramping is terrible for patient safety and health," he said.
"Morale is affected for us when we know there's people waiting for us to help them, but we're stuck with a patient waiting for a bed to become available.
"It's getting to the point where I tell my patients to pack their medication, phone and something like a book to entertain themselves because they'll be waiting so long."
Shadow Health Minister Sarah Mitchell said "despite promising the world before the last election, Chris Minns and Labor have failed to address ambulance ramping across the Hunter".
"Our sickest patients are stuck waiting in ambulances while hospitals are at capacity, and paramedics are unable to attend emergency call outs," Ms Mitchell said.
"Patients and paramedics deserve better."
The doctors' union president, Nicholas Spooner, said "doctors are being asked to do more with less".
"NSW hospitals need enough staff, beds and capacity to move patients safely through the system," said Dr Spooner, of the Australian Salaried Medical Officers Federation of NSW.
"The Minns government is failing its own benchmarks. The government must urgently invest in our public hospitals. NSW patients deserve better."
NSW Health Minister Ryan Park has been urged to boost beds at John Hunter Hospital in particular, which nurses say is short by 40 to 65 beds every day.
Additionally, waits of more than 14 hours in emergency have been highlighted at Belmont and the Calvary Mater hospitals in recent weeks.
Mr Park reiterated that aged care and NDIS patients stuck in hospitals were worsening the bed-block problem.
"We cannot underestimate the profound impact this has on patient flow, as well as the impact it has on the patients themselves," Mr Park said.
"Despite these challenges, there have been improvements in emergency department performance and the number of people accessing care."
A federal government spokesperson said the Albanese government "invested heavily" to get new aged-care beds in the system in this year's budget.
Mr Park said the NSW budget was "investing $10.3 billion to help recruit an additional 9000 health workers and deliver record pay rises for nurses and midwives".
"John Hunter, Maitland, Belmont and Cessnock hospitals have now recruited and are rostering to safe staffing levels in their EDs," he said.
