A nurse is raising safety concerns over the way security is being handled at a rural Waikato Hospital.

Until recently, a security guard sat at the door of Te Kuiti Hospital between 6pm and 6am.

But now, the nurse, who does not want to be named, says there's a new model where staff are employed in a combined cleaner/security/attendant role.

She says they've been fighting the change for months.

"We're worried -- we have a gang population in our small town, and we have real concerns for our safety and for our patients safety too."

She says if one of the night shift nurses gets busy in ED, the other one could be busy in a ward -- and they don't have anyone watching their back anymore.

"In our hospital, they could be cleaning anywhere, they're not on the floor with us...if we need them we have to call them, and if you get in a situation you haven't got time to call people, you want people backing you up."

Te Kuiti was among the hospitals which got an extra boost of security guards over summer as part of an announcement by the Health Minister in December.

Health New Zealand says they "operate an integrated 24/7 security, cleaning and attendant service" at all four rural hospitals in the Waikato region -- including Thames, Tokoroa and Taumaranui.

Waikato Group Director Operations Hospital and Specialist Services Michelle Sutherland says all staff employed in security roles are qualified to a minimum of NZQA Level 2, and are holders of a current Certificate of Approval issued by the Ministry of Justice.

She says over the period the security and cleaning service provider needed to ensure all their staff were qualified, the security role was sub contracted out to another provider.

Sutherland says now the contracted provider has all their staff certified, there is no longer a need for the additional service.

The nurse says while the security guard doesn't often get hands on, they're there for deterrence and that seems to stop a lot of the issues.

"The fact they're sitting there, they're watching the doors so we are secure at night."

She says if there's nobody sitting there, somebody could walk out and leave the door open, or let other people in and that can't be monitored now.

"All we really want is to have a security guard overnight, so that we know somebody is sitting there watching the doors making sure the hospital remains secure all night."

Sutherland says they take the safety of staff and patients extremely seriously - which is why as a result of the recent changes, Te Kuiti had its security coverage increased from 12/7 to 24/7 coverage.

She says they've also introduced CCTV and an intercom system and restricted access to some areas.

Sutherland says security staff are equipped with both a duty phone and RT radios to ensure they are accessible at all times, and will be attending handovers with the nursing team to ensure all security related information is communicated.