Taoiseach Bertie Ahern and the Health Minister Mary Harney ruled out any pay increase for 40,000 nurses on the first day of their industrial action over improved pay and conditions yesterday.
A joint strategy committee of the Irish Nurses Organisation (INO) and the Psychiatric Nurses Association (PNA) will today consider whether the industrial action should be escalated to include rolling work stoppages, causing extra disruption.
Yesterday's action, in the form of a work-to-rule by members of the INO and the PNA did not result in any operations being cancelled but it did leave relatives of patients frustrated when they were unable to get test results over the phone.
It also led to long delays in some outpatient clinics, the Health Service Executive (HSE) said.
The HSE expects the dispute to impact on hospital A&E departments in coming days as a result of discharges being delayed and has urged the public to only attend A&E if absolutely necessary.
No figures were available last night from either the INO or the HSE on the numbers waiting in A&E for beds.
The HSE said some hospitals may have to cancel elective procedures over the next 24 hours. Some surgery will be cancelled at Cavan General Hospital today.
At present the nurses are refusing to answer telephones except in essential cases or carry out clerical, IT or administrative work in pursuit of their claim for a 10 per cent pay rise and a shorter working week.
But if they had hoped the Taoiseach would intervene quickly to resolve the dispute on the approach to a general election, their hopes were dashed. Mr Ahern said: "The nurses are looking for effectively a 10 per cent increase for 40,000 nurses and we're in a national agreement with everybody and we just can't give that."
Ms Harney said: "There can't be an exception for nurses." She said there were 40,000 nurses but 300,000 public servants and the process in place for dealing with their pay issues was benchmarking. Short of the INO and the PNA using this process "we're not going to be able to resolve these issues".
Ms Harney added: "There is no other way. There is no magic wand that I can wave or the Government can wave. There's no green button that the HSE can press to solve the issues at stake."
She claimed the only people disrupted by the action were patients. Nurses work a 39-hour week and the claim for a 35-hour week would result in 7.5 million nursing hours being lost every year, she said.
Nursing unions claim their members have been failed by benchmarking and that they are the only health staff obliged to work a 39-hour week.
There are no talks planned to resolve the dispute and Dave Hughes, deputy general secretary of the INO, said the work-to-rule would continue until there was a resolution.
He said calls to hospitals were being diverted to a central point where they were screened to assess whether the calls were of an emergency nature or not. If they were emergency calls they were being answered by nurses, he said.
Meanwhile, the Irish Medical Organisation, which represents the majority of doctors, said it expects the dispute to have "extremely serious implications for patient care". But it has advised its members not to undertake any additional duties or to take any action which could jeopardise the close professional relationship between medics and nurses.
Fintan Hourihan, director of industrial relations with the IMO, wrote to the HSE yesterday saying he hadn't been informed of what contingency plans were in place.
The INO claimed last night management had not put in place proper out-of-hours contingency plans at Cork University Hospital or Navan Hospital.