The HSE has confirmed that elective procedures are already being cancelled in seven hospitals due to next Tuesday's nurses' strike.
Emergency department nurses are due to hold two-hour stoppages in the seven hospitals on Tuesday in protest at overcrowding and inadequate staffing.
The HSE National Director of Human Resources Rosarii Mannion said patients had already been notified, and appealed to other patients only to go to emergency units on Tuesday if absolutely necessary.
She said hospitals would do everything possible to minimise the impact on patients.
Earlier, the Irish Nurses and Midwives Organisation denied that the dispute was really about nurses pay, and insisted solutions could be found without breaching the Lansdowne Road Agreement.
However, Ms Mannion said that while progress had been made on 7 out of 8 issues raised by nurses, the key stumbling block was incremental credit and student pay.
She said that was not within the gift of the HSE due to the Lansdowne Road Agreement, though talks had commenced yesterday with an independent facilitator to progress this.
She rejected union claims that the HSE had come to the WRC talks empty handed or failed to make concrete proposals.
She urged the INMO to return to the table for a short sharp focused engagement in a bid to resolve the row.
As yet there is no indication of a resumption of talks over the weekend, but it has not been ruled out.
Earlier, the INMO claimed that the HSE had breached an agreement reached on 8 October on promotional structures and student pay.
Ms Mannion acknowledged that the HSE had advanced proposals, but said the INMO were aware that those arrangements were subject to funding.
She said she did not accept that funding approval had not been forthcoming from the Department of Health
Earlier, INMO General Secretary Liam Doran said that hospital authorities would probably have to start winding down over the weekend to prepare for the strikes.
Mr Doran claimed that based on a study on Tallaght Hospital, emergency departments were operating on average with only 60% of the required staff resources.
He said that four days of talks had failed to deliver any concrete proposals from the management side to alleviate the problems of nurse recruitment and retention.
He said health services abroad and private hospitals in Ireland were offering recruitment incentives of up to €6,000 - but that the HSE was failing to recruit because it was not matching these offers.
He noted that in the first 11 days of December, 3,045 people had been admitted without a bed with the vast majority being cared for in already overloaded emergency departments.
He acknowledged that was down on this time last year, but said management had accepted that a target of 236 trolleys would be an average acceptable norm in future - which would not reduce workload or pressure on patients.
The strike action, which will involve two-hour rolling stoppages between 8am and 4pm, in seven hospitals - Beaumont and Tallaght, Dublin; Mercy Hospital, Cork; MRH Tullamore; Cavan General Hospital; UH Galway; and UH Waterford - will see nurses completely withdraw from these departments for the two hours, while maintaining an emergency response team in an adjacent area.
The Dublin Midlands Hospital Group, incorporating Tallaght and Tullamore Hospitals, issued a statement saying it had contingency plans in place to minimise the effect of stoppages.
Dublin Midlands Hospital Group CEO Dr Susan O'Reilly said: "I wish to reassure patients and members of the public that we are focused on maintaining patient care in all our emergency departments, particularly in Tallaght and Tullamore, notwithstanding the planned industrial action.
"Staff at Tallaght and Tullamore Hospitals are working hard to ensure that the majority of patient services are maintained. We regret that some non-urgent elective procedures in the two hospitals will be cancelled as a result of this industrial action."
