Illawarra nurses are being treated like "the poor cousins" of their big city counterparts, caring for five patients each, compared to Sydney hospitals where nurses have four in their care, their union claims.
"Our patients are just as sick so why does this happen?" Shellharbour nurse Karin Tilden said.
"We are fighting for the same ratios as the city hospitals, the campaign is just starting and we are urging the region's nurses to get involved."
Mrs Tilden, branch president of the NSW Nurses and Midwives Association, plans to meet Shellharbour Mayor Marianne Saliba next week to lobby for her support.
"We need the government to come to the table and determine safe nurse-to-patient ratios. [Shellharbour] hospital has at least 80 per cent membership of nursing staff, so we want to use our voice and get community support," Mrs Tilden said.
Union general secretary Brett Holmes said the NSW government must ensure every public patient in NSW, including in regional areas such as the Illawarra and South Coast, had "access to the same level of safer care".
"There is no doubt mandated minimum staffing arrangements to protect safe staffing levels," Mr Holmes said.
"Staffing levels can be assessed against a mandated minimum requirement, which means we can act decisively when governments and hospital managers try to undermine safe staffing just to save a bit of money," he said.
"That is why we must get mandated minimum staffing arrangements extended to seriously ill children, emergency departments, high dependency units, rural hospitals, multi-purpose services and community health services."
A record 214 union branches, representing more than 30,000 public sector nurses and midwives throughout NSW, have endorsed the ratios and wages claim.