Patients and nurses are being put in dangerous situations at Maitland Hospital due to management making risky staffing decisions, the nurses' union says.
Hunter New England Health has disputed this, saying the hospital is "appropriately staffed and resourced".
The Maitland branch of the NSW Nurses and Midwives' Association rallied outside the hospital at 8am on Monday on their own time, saying they were "fatigued and frustrated by understaffing issues".
Association assistant general secretary Michael Whaites said "if registered or enrolled nurses are not available, they are being replaced by less experienced assistants in nursing [AINs]".
Mr Whaites said this was leading to new graduate nurses being left at times "in charge on some of the wards, creating untenable workloads, stress and anxiety across the remaining staff".
"It's a serious concern and puts patient safety at risk," Mr Whaites said.
Mr Whaites said Maitland Hospital staff had "raised concerns with management several times this year over critical staffing shortages".
The association's Maitland Hospital branch secretary Monique Murray said the nurses wanted "like for like replacements".
Ms Murray highlighted situations in which "they leave a new grad in charge of an area with an AIN, without support from a senior staff member".
She said the assistant nurses were "being put in positions that are completely out of their scope of practice".
"It's dangerous for them, our patients and the RNs [registered nurses] left to oversee everything," she said.
The hospital's reasonable workloads committee had been "back and forth with hospital executives" for 18 months over the matter.
"We've come to the table in good faith. They've flat out told us that everything is fine," Ms Murray said.
A Hunter New England Health spokesperson said "Maitland Hospital is appropriately staffed and resourced to provide safe, high quality and compassionate care to patients".
"Hospital management ensures there is always an appropriate skill mix of registered nurses, enrolled nurses and assistants in nursing to provide safe and effective care," the spokesperson said.
"We want to assure the community that the hospital is staffed to the levels required under the Public Health System Nurses' and Midwives' (State) Award 2023, which aligns staffing requirements to the number of patients and their care complexity.
"This approach allows hospitals to increase staffing where needed."
The spokesperson added that "assistants in nursing and enrolled nurses work under the supervision of a registered nurse".
"They are not asked or expected to perform duties outside their scope of practice.
"In the event of any staffing gaps, registered nurses may be reallocated to another area in the hospital to ensure there is an even and safe skill mix across all wards."
Branch member Kathy Chapman said a lot of senior nurses had left Maitland Hospital and "half the nurses are new grads now".
"If conditions were better, that would attract back the staff that have been leaving," she said.
Ms Murray said the nurses "love new grads", but "retainment is just as important as recruitment".
"Senior staff are the ones to nurture these new grads."
Ms Chapman said the hospital had experienced an increase in rapidly deteriorating patients in the past 12 months.
In August, the Minns government signed a memorandum of understanding with the nurses' union to progress "safe staffing levels in NSW public hospitals".
This followed the government announcing the Safe Staffing Working Group in April for "major reform" in public hospitals that would "help retain experienced staff" and attract the "future healthcare workforce".
The Hunter New England Health spokesperson said "attracting and retaining nurses is a challenge across Australia".
"Maitland Hospital has several strategies in place to increase recruitment of nurses, including an overseas recruitment campaign that has so far attracted around 20 registered nurses."
The spokesperson added that the government provided $419.1 million in the 2023-24 NSW budget to recruit 1200 additional nurses and midwives by 2025-26.
The government had committed to ongoing funding for "the equivalent of 1112 full-time nursing and midwifery positions [138 in Hunter New England], which had been funded by the previous government on a temporary basis until June 30, 2024".
"This reform will help retain experienced staff while also helping to attract our future healthcare workforce."
