Hospital and community services in the HSE West area are currently coping with the work to rule industrial action initiated by the Irish Nurses Organisation and the Psychiatric Nurses Association on Tuesday. Contingency measures have been put in place to deal with the situation. According to a statement from HSE West, some procedures have been cancelled at hospitals, due to the industrial action and there have been delays and a slowing down of processes due to the nurses’ action. This is already having an impact on patient flow and discharge management, and on the transport of patients to other locations. Day ward and in-patient activity is carrying on as normal and there have been no significant cancellations of out-patient services to date. In some HSE centres difficulties are being experienced with communications. Local management are addressing these issues on a case by case basis, and continue to work locally with the local coordinating committee of the unions involved. The HSE believes that the continuation of this industrial action will cause significant disruption to hospital and community-based services, which may result in hardship and distress to patients. The HSE is asking members of the public not to ring hospitals unless absolutely necessary. The HSE suggests it may be helpful if families nominate a relative who, when visiting, can inform other wider family of a patient’s status/condition, rather than family members phoning the hospital.