Some patients have lain on trolleys in the corridor of Cavan General Hospital for three days.
Others who were well enough to sit in wheelchairs were wheeled from the accident and emergency (A&E) department to the waiting room and left to start the waiting game again - this time for a bed.
These crowded conditions led to a work-to-rule by nurses in the hospital two weeks ago, and while progress has been made since then, the work-to-rule was still in place last night.
Ms Patsy Doyle, industrial relations officer with the Irish Nurses Organisation, said conditions in the A&E department were "just diabolical" for staff and patients.
She visited the hospital last week and said there wasn't enough air for people to breathe in the cramped department.
"I'm a nurse for 14 years and it shocked me."
She said patients in difficult and upsetting situations had no privacy and the sick and very sick were lined up to wait together.
People going for X-rays were filing past sick patients on trolleys.
When she expressed her concerns to a nurse, she was told that the department was often more crowded than that.
The work-to-rule has already delivered results. Hospital managers have agreed to set aside six beds in the general hospital for A&E patients.
In another breakthrough, consultants and nurses are together drawing up an admissions and discharge policy and an escalation policy for the hospital.
"This is a considerable step forward," Ms Doyle said.
"But we won't be happy until we see successful implementation of the policy."
The admissions and discharge policy was the key issue in the dispute as there was no one to shout "stop" when trolleys with sick patients mounted up in the corridors.
This was while pre-booked patients continued to be admitted to the general hospital.
A spokeswoman for the North Eastern Health Board said hospital managers were making every effort to deal with the difficulties in the A&E department.
"Hospital managers are hopeful that the nurses will lift their work-to-rule and that the situation can be resolved as quickly as possible," she said.
The agreement to set aside six beds for A&E patients would be used to help ease pressure when the emergency department got crowded.
"A series of multidisciplinary meetings will take place with nurses and consultants before the end of the week in a bid to agree an admissions and discharge policy and an escalations policy for Cavan General Hospital."
This is the third dispute in the A&E department in 14 months, according to Ms Doyle.
Operating a work-to-rule system was the only viable option for patients, she said, as nurses simply did not have time to answer telephones or do clerical work.
The closure of Monaghan hospital to trauma cases has also increased patient numbers in recent months.
The Cavan hospital deals with about 22,000 A&E patients every year from a very wide catchment area across Cavan, Leitrim and Monaghan.