Delays in bodies being released to families after postmortem examinations and a patient being left in pain for 1½ hours at a Dublin hospital are among the incidents which have resulted from the industrial action by nurses, the Health Service Executive has claimed.
In a seven-page report, it also claims a patient with a fast heart rate at a large Dublin hospital was not seen for six hours and that when another patient haemorrhaged after an operation at the same hospital, no direct contact could be made by telephone or bleep with theatre staff.
"The time delay involved resulted in a near miss and the fortuitous presence of senior staff, two with nursing background, meant that they understood immediately the gravity of the situation and ran to theatre and other areas to ensure as good a response as possible," it said.
Some 40,000 nurses who are members of the Irish Nurses' Organisation (INO) and the Psychiatric Nurses' Association (PNA) are now in the third week of working to rule, under which they are refusing to deal with non-essential phone calls or carry out clerical or IT duties.
The HSE report also says there was "a serious infection outbreak issue in the neo-natal intensive care unit" of a maternity hospital but the infection control nurse could not be contacted as a result of the ban on use of phones.
In relation to a large regional hospital, it said: "Porters are now required to check all wards each morning for notes or instructions regarding remains, leading to delays in some instances to remains being released to families."
It also said two mothers with breastfeeding problems experienced distress when unable to contact a nurse at a maternity hospital.
The report from the HSE's national incident room for management says the work to rule is causing "increasing discomfort for patients, their families and staff, including nurses who are involved in the industrial action".
There were also significant extra costs associated with the dispute, it said, with extra staff being brought in to answer phones. These include students and agency staff.
"This unplanned drain on budgets may impact on services during the remainder of the year," it said.
Liam Doran, general secretary of the INO, said the union met management on Monday and none of these issues was raised. He added that the HSE report had been leaked to the media and he had not seen it. "It just suggests to me it's more important to get the soundbite out about the negative connotation of this dispute rather than dealing with the substantive issue, if one exists," he added.