Nursing cover was reduced to as little as one-fifth of normal levels in hospitals throughout the State yesterday as the nurses' strike began.
Staffing levels varied from hospital to hospital according to local arrangements. Cork University Hospital had just 19 per cent of its normal quota of nurses on duty, whereas Mallow General Hospital, also in the Southern Health Board area, had half the usual number of nurses at work.
Community nursing cover, however, was badly affected, with only one in 10 public health nurses in some areas turning up for work. Home visits to children and the chronically ill were severely restricted.
Accident and emergency department cover remained in place in hospitals everywhere, but with fewer staff than usual. In general, the equivalent of night-time cover was provided in casualty units during the day.
In a statement last night, the Eastern Health Board said "agreed levels of cover are generally being provided. Services are coping."
Similarly, Dublin's five major hospitals - Beaumont, the Mater, St James's, St Vincent's and the Adelaide & Meath, Tallaght - said that all planned services were provided.
In a joint statement they said: "Both strike and management committees are monitoring the situation and are reviewing these provisions on a continuing basis in light of emerging requirements."
The public seemed to heed warnings not to visit hospital casualty departments with minor injuries or ailments, but to go to their GPs. There were reports of some patients being sent back and forth between GPs and casualty departments. In general, hospitals appear to have accepted admissions from GPs.
Services for cancer patients were severely restricted, with nurses in hospitals such as the Mater refusing to assist with chemotherapy or radiotherapy treatment.
In a statement, the Dublin cancer hospital, St Luke's and St Anne's in Rathgar, said it was contacting a number of patients yesterday to inform them that admissions would be deferred.
It said, however, it was "working closely with the local strike committee to try and ensure that adequate cover is provided for the continuing of care to our patients".
The 46-bed rheumatology unit at Our Lady's Hospice, Harold's Cross, Dublin, was closed and its palliative care day service was suspended. The hospice said it was still providing care for its 107 long-term patients and its 36-bed palliative care in-patient unit would continue to operate on an emergency admission basis.
Services for the elderly and people with a mental disability were also greatly reduced.
Non-emergency maternity services were also affected. At the National Maternity Hospital in Holles Street, Dublin, four of the six post-natal wards were closed and routine scans were postponed. Mothers were sent home earlier than normal as staffing in wards was dramatically reduced.
In Limerick Regional Hospital, where 36 midwives would usually be on duty, 20 were at work. The usual number of eight nurses remained on duty in the neo-natal unit where 24 babies were under observation. However, many non-urgent services were cancelled. Nurses refused to process files or answer phones, although parents of sick infants who had been discharged were given special numbers which they could call in emergencies.
At St Luke's, Kilkenny, where 130 nurses are usually on duty each day, 26 reported for work yesterday. Because of a heavy work schedule in the male medical ward, one nurse left the picket line to help. The strikers in Kilkenny say they have been encouraged by the support they have received from the public.
The Mid Western Health Board reported that only six of 43 public health nurses rostered turned up. Such nurses normally attend to an average of 300 patients a day, including the chronically ill. The health board expressed its concern at the level of cover and said it would raise the matter with the local strike committee.
Similarly, in the South Eastern Health Board area, community nurses refused to visit children and elderly patients, 470 of whom are normally covered each week.
One institution to experience problems yesterday was the Curragh Prison, Co Kildare, which had difficulty in transferring a 74-year-old inmate with pancreatic cancer to hospital. He was first taken to casualty at Naas General Hospital late on Monday night but within hours was sent back to the prison. A number of hospitals in the Eastern Health Board area said they were unable to admit him but, after further searches, a place was found yesterday afternoon at Drogheda Memorial Hospital.
The only hospitals which were not picketed yesterday were private ones, which said services were unaffected by the action. None reported an increase in their workloads due to patients transferring from public hospitals, although a spokeswoman for the Mater Private Hospital said if the strike continued for a number of months it could become an issue.