MLHD Chief Executive Jill Ludford said that as of May 21 this year, there were 179 vacancies in various positions across the district. She was responding to questions on-notice that were asked during the ongoing inquiry into rural and regional healthcare outcomes in NSW.

The average length of job vacancies for RNs and midwives, as well as enrolled nurses, is around 59 days in the MLHD. However, the longest time it has taken to fill these positions has been 216 days and 245 days respectively.

"Longer than average vacancy periods occur for hard to fill geographical locations and highly specialised roles," Ms Ludford said.

"Vacant positions are readvertised when there are no suitable candidate applications during the recruitment round."

Ms Ludford said that staffing levels across the MLHD's 33 hospitals are reviewed annually. Each site is benchmarked with similar facilities and assigned minimum staffing requirements, however local managers can staff above this level if required, she said.

The NSW Rural Doctors Network (RDN) conducts an annual needs assessment for the health workforce, which has identified both a nursing workforce shortage in rural NSW and an increased demand for nurses in health and aged care settings.

Since 2012, there has been an increase in nursing job ads by more than 50 per cent, as well as a 34 per cent increase in aged and disability care ads in regional areas.

"It is estimated that one third of all current job vacancies occur in rural areas despite the recent cessation of job keeper subsidies," RDN CEO Richard Colbran said.

"The disproportionately high general vacancy rate in rural areas is likely to impact the workforce available to support aged residents in rural NSW."

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The NSW Nurses and Midwives' Association said that "standard pay and conditions for nurses and midwives in NSW have fallen behind those in other states," arguing that workers may "earn more working in other states" and seek employment there instead.

The association also said that safe workloads and work environments are needed to attract staff and prevent burn-out and rising attrition rates.

"Nurses and midwives are not attracted to services that do not provide safe care and they describe a growing unwillingness to subject themselves to the risk of being involved in an adverse incident by working in an understaffed service," the association said.

"They know that adequate staffing and skill mix delivers better patient care and limits adverse incidents."

Ms Ludford said that eight of the MLHD's 33 hospital sites have security staff, who are engaged on an assessment of risk.

Over the last two years, six staff members have sustained an injury from the aggressive or violent behaviours of patients - four at Wagga Base Hospital, one at Deniliquin and one at Holbrook. Wagga and Deniliquin have security staff on-site, but Holbrook does not.

"All staff receive the appropriate violence prevention and management training to ensure they can provide assistance to their colleagues in the event of an incident," Ms Ludford said.

"All staff working in EDs carry personal duress alarms to call for assistance from both colleagues and the local police when necessary."

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