Striking nurses are coming under intense pressure to increase their emergency cover duties amid claims by consultants and hospital managements that patient welfare is suffering.
With hospital casualty departments throughout the State bracing themselves for a busy bank holiday weekend, the body representing the State's 1,200 consultants called for an urgent restoration of full emergency nursing care staff to pre-strike levels.
With signs of increasing friction over nurses' strike duties between medical staff and local strike committees in some hospitals, the Irish Medical Organisation called on management to redouble efforts to assist doctors.
The extent of the strain of nursing shortages forced St Luke's Hospital, the national cancer referral centre, to announce the closure of its day ward and the further deferral of out-patient appointments.
At the leading children's hospital in the State, Our Lady's Hospital for Sick Children in Crumlin, the chief executive, Mr Paul Kavanagh, said doctors believed the dispute had "compromised the care" of very ill children who require emergency treatment.
And a pregnant woman with medical complications was last night sent from the Coombe Women's Hospital to Belfast's Royal Maternity Hospital. A spokeswoman for the Coombe said this was done to ensure both mother and child would receive "the best ongoing medical care."
The Irish Hospital Consultants Association said emergency cover in most hospitals was "wafer thin" and patient welfare had suffered in recent days.
The Irish Nurses' Organisation last night maintained that levels of unpaid cover by its members in emergency situations was adequate and would continue over the weekend.
Patients were getting "full professional nursing care", the union's industrial relations officer, Mr John Delamere, said. "Some of the hospitals are looking for levels of cover higher than they give when people are on their payroll."
Meanwhile, talks at Government Buildings to agree an agenda between the Nursing Alliance and the Health Service Employers Agency (HSEA) to resolve the dispute adjourned at 12.15 a.m. today. They are expected to resume at 10 a.m. It is understood that the alliance has dropped the claim for long service increments for staff nurses but has presented all of its other demands to the HSEA.
The chairman of the special Process to Resolve the Nurses Dispute, Mr Kevin Duffy, is hoping to conclude his discussions with the two sides by Sunday or Monday at the latest. It is felt that, if the strike drags into next week, it could escalate significantly because of the growing tension between nurses and health managers on the issue of emergency cover.
Tomorrow and Sunday Mr Duffy will try to reduce the list of issues to a manageable core on which the Labour Court could give a quick adjudication. He is in constant contact with the court. Some issues may be set aside for referral to the Commission on Nursing or for discussion in a post-Partnership 2000 context.
It is understood that talks were still at a preliminary stage last night and little progress was made. With the exception of one brief plenary session at around 6 p.m., all discussions took place during side conferences, with Mr Duffy holding separate consultations.
In a separate intervention, the Minister for Health and Children, Mr Cowen, said sick children and cancer patients should be exempted from the effects of the nurses' strike.
But the Irish Cancer Society said it was opposed to categorising patients. Its chief executive, Mr Barry Dempsey, said that while in the short-term exempting cancer patients "might give us some comfort, I fear it would create a scaffold which would allow people to stall for longer and ultimately prolong the dispute."