A second day of strike action has begun by over 35,000 members of the Irish Nurses and Midwives Organisation (INMO).

Pickets are being held at 240 health service locations nationwide, a big increase on the 82 pickets held on the first day of strike action last week.

The number of medical appointments cancelled has also jumped. Last week's strike action on January 30 saw around 25,000 appointments cancelled. However, some 50,000 appointments have been cancelled as a result of today's strike, including all inpatient, outpatient and day surgery appointments.

While Emergency Departments (EDs) are open, nursing cover is reduced and the HSE is urging people not to attend unless absolutely necessary.

According to the Irish Association for Emergency Medicine, this action, which will run until 8am tomorrow (February 6), ‘will have a very significant impact on EDs'.

"Very few nurses are earmarked to be available to EDs during the action and many of the usual nurse-delivered processes will not be available. One particular issue is that the usual process of triage (prioritisation of patients based on clinical need) will not occur as a result of this action," the association noted.

The dispute centres on poor pay and understaffing. According to the INMO, nurses are ‘seeking to secure safe staffing levels in the health service through increases in pay to make the profession more attractive'.

Further strike days are planned for February 7, 12, 13, 14, 19 and 21, if the issue is not resolved.

The INMO said that it has identified ‘excessive costs and wastage in the HSE, which could be used to address the pay issues at the heart of the recruitment and retention crisis, but the Government simply will not listen'.

Costs identified by the INMO which would be cut if more nurses and midwives could be attracted to work in the public health service include:

-Over €100 million spent in 2018 on agency nurses, used to fill gaps left by vacant posts
-€10,000 - €20,000 spent per nurse or midwife recruited by overseas agencies
-Reduced durations of stay for patients associated with safer staffing levels.

Meanwhile, the Psychiatric Nurses Association (PNA) has confirmed an escalation in its industrial action. While members were already planning a daytime ban on overtime from February 5-7, the association has announced these overtime bans will run for 24 hours on February 6 and 7.

Strike action is also planned for February 12, 13 and 14.