Nurses at Bulli Hospital are considering industrial action over a security staffer who has been stood down after a violent altercation with an elderly patient.
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Police investigated the November 18 incident, in which the patient is believed to have suffered injuries to his hands.
But staff have told independent investigators they support the security worker - called a health and safety assistant (HASA) - and believe he properly intervened.
A witness told the Mercury the patient "threw punches" at the HASA, who "put his hands up to try and defend himself".
The HASA intervened when the patient went to attack four nurses, the witness said.
"It just escalated from there," they said.
"[The worker] shouldn't have been stood down - he was doing his job.
"If he had stood back and not intervened, and this patient attacked one of the staff, he would still have been the bad guy because they would have said: 'Why didn't he intervene?"'
Illawarra Shoalhaven Local Health District's acting director of clinical operations Suzanne Harris would not provide details.
She said the hospital had worked "extensively" over the past 12 months on strategies, programs and staff education for dealing with aggressive or challenging patients.
"Bulli Hospital treats many patients, most of whom are elderly, and living with degenerative conditions like dementia which can result in aggression in some people," she said.
"The hospital takes very seriously any reported incidents of violence against staff and patients and all are investigated.
"[The strategies, programs and education] are aimed at striking a balance between maintaining the care, dignity and respect of our patients, regardless of their condition, and the safety and wellbeing of all staff.
"This can be a challenge, but the hospital is working extremely hard to implement strategies to best deal with caring for people with complex requirements; this includes ensuring an appropriate number of staff on both night and day."
The Health Services Union is involved in a statewide campaign against workplace violence, and is agitating for two HASAs to be permanently stationed at Bulli Hospital, where current rostering is for a single HASA on afternoon and night shifts.
The incident, and the hospital's safety-related staffing level, will be discussed at a branch meeting of the NSW Nurses and Midwives' Association on Thursday.
Illawarra Shoalhaven Health Services Union organiser Graham Conroy said he was awaiting formal notification of what allegations the staffer was facing, "if any".
"Security guards, no matter what facility they work in, are in a very vulnerable place," Mr Conroy said.
"They can be held liable for an incident simply because it might be perceived as being dealt with not according to policy."
Mr Conroy said the HASA had been stood down on full pay.
As of Tuesday, no charges had been laid over the incident.
