For more than a year, the NSW Nurses and Midwives' Association (NSWNMA) has been calling for more staff at the town's hospital amid concerns of fatigue, lack of security and burn out among staff.

The emergency department is currently covered by two RNs for eight hours a day and the lack of an on call doctor is not only increasing their work load, but adding to the pressures they already face.

The union said this is leaving the nurses in the ED in isolation for the remaining 16 hours of the day when there isn't an on call doctor available.

NSWNMA general secretary Brett Holmes says so far the calls for extra staff at the Leeton hospital are going unanswered by the state government.

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He said despite raising the issues repeatedly being raised with Murrumbidgee Local Health District, they had persisted.

"Our members have been calling on MLHD for more than a year to address widespread concerns in Leeton hospital's emergency department," Mr Holmes said.

"At a minimum, we need two registered nurses to be on duty in the emergency department at all times.

"Expecting one registered nurse to manage patients in the emergency department when there are no doctors available in Leeton is simply not good enough."

Following a work health and safety inspection in May last year, several issues were bought to MLHD's attention, including nursing staff "repeatedly being forced to work in isolation".

"The physical layout of the hospital is a contributing factor with the emergency department located on the ground floor, separate to the rest of the hospital," Mr Holmes said.

"As a declared mental health facility, the emergency department is also required to assist in the assessment of patients who present with a suspected mental health condition, using a video conference with the mental health team at Wagga.

"We're aware there's been a number of violence and aggression incidences in the emergency department recently, prompting calls for improved protocols and system upgrades to better protect staff."

A lack of security officers at the hospital is also of concern for the union, with only one full-time health and security assistant employed.

The Leeton police station is also not staffed 24 hours a day.

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