Dublin's five largest acute hospitals have warned they may not be able to cope with any surge in demand for their services if the nurses' strike continues.
In a joint statement issued last night, St Vincent's, St James's, Beaumont, the Mater and Tallaght said they expected "substantially increased pressures on the system in the coming days" as patients who had deferred attendance began to return.
"There is considerable concern regarding the capacity of the hospitals to meet any resultant surge in demand," the statement said, adding that "it is considered vital that every effort be made to secure a resolution [to the dispute] before the forthcoming weekend."
The warning comes as attention begins to focus on the State's 2,500 non-consultant hospital doctors who have been forced to perform the bulk of normal nursing duties.
The president of the Irish Medical Organisation, Dr Fenton Howell, said such doctors were working in horrendously difficult circumstances. "There needs to be a recognition that these young, recently qualified doctors are under particular strain."
Some hospitals are faring better than others, with Cork University Hospital and Our Lady's Hospital for Sick Children in Crumlin, Dublin, among those reported to have suffered difficulties.
At Cork University Hospital, Dr Stephen Harris said that already over-worked non-consultant doctors took it as a "hard blow" to be requested by consultants in the medical division to work additional four-hour shifts this bank holiday weekend. "We support the nurses' overall cause, but we have been pushed around for years and we wonder how much we can take care of patients when we are under additional strain," said Dr Harris.
At Beaumont Hospital in Dublin, doctors said the low level of cover in wards was delaying the movement of seriously ill patients out of intensive care where a backlog was in danger of forming.
"The average length of stay in intensive care is being prolonged by a day or so. People coming out of theatre are being delayed until they are stabilised," said one doctor, who did not wish to be named.
In contrast, doctors at Tallaght hospital said the skeleton staff was coping reasonably well, although it was taking longer for patients to have their bed sheets changed and medication administered.
Dr Peter O'Connor, the Mater's accident and emergency consultant, said the department was "a little busier" yesterday than on the first day of the strike when many people went to their family doctors instead of casualty departments. "The fear is that there is a bow wave of work building up in front of us," he said.
Among the "extended duties" nurses are refusing to perform are administering intravenous antibiotics and drips, doing blood tests and taking blood pressures and temperatures.
There was also growing concern yesterday for the parents of mentally handicapped children who have been discharged from care. It was expected many care centres would not send patients home until after the holiday weekend.
However, St Ita's in Portrane, Co Dublin, and St Anne's in Roscrea, Co Tipperary, returned a number of people to their parents yesterday. Some 33 were discharged from St Anne's, bringing to 60 the total number discharged so far with 63 patients remaining.
Mr Brian O'Donnell, chief executive of the Federation for Voluntary Bodies, said the level of nursing cover was "very inconsistent around the country". Some strike committees were "very accommodating. Others are very demanding about what they will allow and what they won't."
Ms Deirdre Carroll of the National Association for the Mentally Handicapped of Ireland said many parents were unable to cope, adding "the hardship is going to get much worse as we move into the second week".
Hundreds of beds have been closed across the State with nearly half the beds in Midland Health Board acute hospitals now vacant.
In Rome, the Archbishop of Armagh, Dr Sean Brady, yesterday asked for prayers to break the deadlock. Ms Elizabeth Person Evans, co-ordinator of the CHILD group for children with leukaemia at the National Children's Hospital at Tallaght, expressed her backing for the nurses despite the fact that it was leading to delays in chemotherapy treatment for children such as her daughter, Isobel.
"Mr Cowen should be fired. Minister for Health and Children is an anomaly. He is an accountant. He has no empathy for kids or the area he is responsible for," she said.