The number of violent attacks on hospital staff in Cornwall has almost doubled in the past year.
People assaulting NHS staff could be fined £1,000
Figures released by the Royal Cornwall Hospitals Trust (RCHT) show 224 incidents of violence were reported by staff - an increase of 47%.
Some nurses claim they regularly face abuse, despite security measures.
UNISON, which represents health workers, says violence against staff is unacceptable and a zero tolerance approach must be maintained.
The RCHT said the increase could be partly explained by staff being actively encouraged to report all violent or aggressive incidents.
It said although the total number of incidents reported had gone down, 14% of those were of a violent and aggressive nature.
In the past three months, the percentage of violent incidents has risen to, almost 20%.
The government has said it is taking the issue of violence against NHS staff very seriously.
More than 60,000 NHS staff members were physically assaulted by patients or relatives nationally last year.
Health Minister Caroline Flint has said that people who abuse or threaten NHS staff could be prosecuted, fined £1,000 or removed from NHS premises.
Stuart Roden from Unison said the increase in the more serious violent attacks in Cornwall was alarming.
He said: "I suspect a lot of these are fuelled by alcohol and drugs and I think we've really got to reinforce the zero tolerance campaign and I'm pleased to hear the minister talking about fines and removing people from hospital."
Mr Roden said raising public awareness was another important step.
"There are signs and posters in hospital outpatients' departments and accident and emergency departments. I think people have got to be under no illusions and they've got to know there are police permanently based at the Royal Cornwall Hospital at Treliske.
"It is a real dilemma if you've got someone who's injured or ill. You've got to treat them, but if they're being violent or aggressive there comes a stage when you simply have to tell them they can no longer be treated."