Security staff at Milton-Ulladulla Hospital have to manage violent and aggressive patients and visitors alone.
That's according to Health Services Union spokesperson Joshua Howarth.
He says at Milton-Ulladulla Hospital, just one security person is rostered on per shift, and about 42 of those shifts are unfilled each month.
"We have been trying to negotiate a roster, but the employer maintains the shortfall is because they cannot attract staff," Mr Howarth said.
"Staff have confiscated weapons, had chairs thrown at them, and been spat at.
"Policy states there must be five people to take down an aggressive person, yet there is only one officer rostered on at a time, and they are made responsible."
The union says more than 22,000 hospital workers across NSW will strike for four hours on August 1, "in response to the NSW Government's stubborn refusal to improve hospital security".
This includes staff at Shoalhaven and Milton-Ulladulla hospitals.
"The HSU has consistently sought 250 extra security guards with extra constable powers to deal with the crisis," the union claimed in a release.
"However these pleas have fallen on deaf ears."
Further north, at Shoalhaven District Memorial Hospital there are three full-time security workers off on workers compensation, and there has been a significant increase in the number of security incidents.
"In March, a man was charged with threatening to kill staff - police took an hour to respond," he said.
"The radios that have been out are on the risk register, and no action has been taken.
"Security cameras are broken, and there is no view of the hospital entrance. That has been on the risk register for more than 12 months."
Health Services Union NSW secretary, Gerard Hayes, said the issues were state-wide.
"Our members are sick of being treated as punching bags. We do not take this strike action lightly, it really is a last resort," Mr Hayes said.
"We've seen too many people stabbed, too many people shot, too many people who have been spat upon or punched, too many people getting PTSD because they went to work.
"Enough is enough. We are sick of the reviews and talkfests."
The Illawarra-Shoalhaven Local Health District has been approached for comment.