A breakthrough has been made in efforts to resolve the crisis in accident and emergency units after the Irish Nurses' Organisation (INO) threatened hospital managers with strike action.
Cancellation of elective surgery at the State's major hospitals is now one of a range of measures that has been agreed in principle in a bid to resolve the worsening overcrowding crisis.
The INO said agreement was secured shortly after midnight on a range of emergency initiatives to deal with severe overcrowding, which brought the numbers waiting on trolleys to a record 422 in the past week. Some 285 people are on trolleys today, the INO said. Tallaght hospital has the highest number of patients on trolleys, with 34 people waiting.
At the emergency meeting of the A&E Forum chaired by the Labour Relations Commission last night the INO secured a declaration that additional urgent action is needed to deal with the crisis. The meeting started at 4 p.m. yesterday and finished shortly after midnight.
Mr David Hughes, deputy general secretary of the INO, said the measures agreed last night were in addition to the 10-point plan announced by the Tánaiste and Minister for Health, Ms Harney, in December.
Mr Hughes said the INO, which sought yesterday's meeting, told health service management and the LRC that nurses could no longer accept the situation in A&E departments and that if the problem was not addressed immediately, it would have to consider industrial action.
Under the deal agreed last night, the INO will meet as a matter of urgency with the chief officers of the various Health Service Executive (HSE) areas and the chief executives of the voluntary hospitals to identify measures for each site.
It was agreed also that elective admissions should be suspended where necessary in order to deal with overcrowding. Hospitals will also have to ensure an "efficient discharge policy" to free up vital bed space.
The nurses' body also secured agreement that nursing managers can employ additional nursing staff when needed to provide patient care.
Mr Hughes told ireland.comthe deal was a "last throw of the dice" because nurses had reached a point of overcrowding that went beyond what they had ever seen or had to deal with before.
He said it had been hard to get hospital managers to realise the gravity of the situation, but he believed the union had finally succeeded in this yesterday.
Mr Hughes said the crisis was "entirely predictable" at this time of year and could have been planned for.
He said the availability of hospital beds for patients admitted through A&E was the "single biggest issue", although there were a number of local management issues that also had to be resolved.
The numbers waiting on trolleys in A&E departments throughout the State hit a high of 422 last week - which the INO described as a situation never before encountered. Yesterday, some 254 patients were waiting on trolleys for beds.
January traditionally marks an increase in the numbers attending A&E departments as the incidence of respiratory-related complaints and 'flu-like illness escalates.
Mr Hughes said people should not attend A&E departments as if they were GPs' surgeries.
Meanwhile, nurses at Ennis General Hospital will commence working under protest from 8 a.m. on Thursday morning in a dispute over staffing levels. They said the move followed the failure of senior management of the hospital to deal with issues raised last July.