The Irish Nursing and Midwives' Organisation has said industrial action by its members is "inevitable" unless extra staff are taken on and public beds are re-opened to improve conditions in hospitals.
Speaking on RTÉ's News at One, General Secretary Liam Doran said the record numbers of patients on trolleys in hospitals today - 563 - is as a direct result of a contracting health service.
He said extra beds and extra staff are needed immediately to improve the situation and that only additional resources will solve the problem.
He said there are 2,000 public beds closed.
Mr Doran claimed that the emergency department at the Midland Regional Hospital Mullingar was in "meltdown" last night with patients turned away, due to what he called "bureaucracy".
He described the situation as "unforgivable".
In a statement, the HSE said steps are being taken at the Midland Regional Hospital Mullingar to cope with the additional demand for services.
It said the hospital has a policy for dealing with surges in activity, as have been experienced in recent days.
He said nurses would likely ballot for industrial action in the coming weeks.
"Until beds are reopened, until units are properly staffed, extra wards are brought on stream, then our members will continue to put patients first and if that means they have to highlight it by banning administrative duties and so on they will".
He said: "We have had ten years of counting trolleys, today is the worst ever figure - who says in management that's progress, that's abject failure by them and they have got to pull their socks up and solve this problem now."
Mr Doran said he was shocked at the record figures for what is regarded as the first working day back of the New Year.
Tony Fitzpatrick, INMO industrial relations officer, has described the situation as a crisis which Minister for Health Leo Varadkar needs to look at and identify all that is needed to address it.
There are 67 patients waiting for admission at Our Lady of Lourdes Hospital in Drogheda, 41 at St Vincent's University Hospital in Dublin, 39 at St Lukes in Kilkenny and 30 at Naas General.
There are currently 20 patients on trolleys at Letterkenny General Hospital awaiting admission, according to a statement issued by the Saolta University Health Care Group.
The Group said the ED at the hospital is very busy in common with a number of other hospitals throughout the country, and asked members of the public to keep the ED for emergencies only and to contact their GP in the first instance.
Mr Doran said that unless the Department of Health and the Health Service Executive act to deal with the issue immediately, there could be over 600 patients waiting by next week.
The HSE has advised people not to attend the emergency department of the Midland Regional Hospital Mullingar unless it is an absolute emergency.
The INMO claim conditions at the hospital are now unsafe and all elective surgery for the month of January should be deferred.
Derek Reilly of the INMO said there have been incidents in the last few days where patients have fallen from trolleys and have remained unwashed for days because of an acute shortage of staff.
Mr Reilly said the situation was now urgent and the INMO will be balloting its members for strike action if critical decisions are not made to alleviate the overcrowding.
Meanwhile, a ballot of nurses at four hospitals in the midwest region over an ongoing problem of persistent and chronic overcrowding gets under way today.
Around 1,000 nurses at University hospital Limerick, at Ennis and Nenagh hospitals and at Croom Orthopaedic Hospital are to be balloted.
Staff are also concerned at HSE plans to place additional beds in Ennis and Nenagh hospitals without enough staff to manage these extra patients.
INMO Officer Mary Fogarty said staff are extremely frustrated that they are facing into another year with chronic overcrowding, where staff cannot deliver a safe service to patients.
She said there is a major problem with staff vacancies - there are currently 50 nurse vacancies in University Hospital Limerick - and these are not being filled because graduates are emigrating.
She said a HIQA report on the emergency department in Limerick found there are clinical risks as it is not fit for purpose but management is not addressing the problem.
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