Nurses struggling to cope in the South Eastern Health Trust are "bearing the brunt" of the problems of a failing health system, staff have warned.
The Royal College of Nursing (RCN) has said that in order to address the current crisis facing the health service in Northern Ireland a major change in policy is needed with a shift focused on the needs of patients and "not on financial considerations".
The union's concerns are centred on lack of staff, patient welfare and underfunding.
The trust, however, insists it is "satisfied" there is sufficient staffing in place in each ward.
The RCN has also voiced frustration at the lack of progress with the Transforming Your Care (TYC) plan to revolutionise the current health care system.
The comments come after the South Eastern Trust had to put in "escalation measures" after the number of patients who attended the Ulster Hospital emergency department peaked on March 4, with 306 patients at its A&E against a daily average of 226.
"Clinical and managerial staff worked extremely well together to respond to increased pressures and the trust would wish to pay tribute to the staff for their wonderful commitment and dedication," a spokeswoman for the trust said.
Janice Smyth, director of the RCN in Northern Ireland, said staff were facing increasing pressure.
"Feedback from RCN members within the South Eastern Trust confirms the pressures they are working under as they bear the brunt of a system that is not working."
Ms Smyth said the RCN had "consistently" pointed out that pressures on A&E departments and acute hospital services generally were a symptom of wider problems in health and social care.
"The recent use of escalation measures in the emergency departments at the Royal Victoria (Belfast), South West (Enniskillen) and Ulster (Dundonald) hospitals illustrates the point that these pressures are widespread across the system and not confined to one particular location," Ms Smyth added.
The RCN added staff were not only stressed but "disillusioned" with the lack of progress on TYC – the Department of Health's plan to shift the focus of healthcare from hospitals to the community.
This week Health Minister Edwin Poots (left) said a number of projects were on target.
In a statement to the Assembly he said: "We are making significant progress in transforming health and social care services to deliver the right care, at the right time, in the right place."
Ms Smyth said the transition to TYC was causing more problems for patients and staff.
"This is supposed to relieve pressures on emergency departments by providing alternative 24/7 points of access to health care, particularly for older people with long-term conditions, in order to avoid unnecessary hospital attendance," she said.
"However, these alternative services are either just not there or, as in the case of the minor injuries unit at Bangor Hospital, are actually being reduced.
"Until the system is fixed so that it is focused on the needs of patients and not on financial considerations, the problems that we have been seeing in emergency departments across Northern Ireland will continue to grow".
A trust spokeswoman said: "There will be some occasions when wards will be under extra pressure and where this is the case the trust will arrange for additional staff to ensure there is adequate cover.
"Overall the trust is satisfied that there is sufficient staffing in place in each of the wards."
Last month Mr Poots attended an RCN summit on emergency care in Belfast where he listened to concerns voiced by nurses who work in front line care.
A spokeswoman for the department said: "As a result of the summit and in the spirit of collaboration, the RCN emergency nurses network will be a key stakeholder in the College of Emergency Medicine summit, planned for early April."