Nursing staff are under severe pressure, unlike anything they experienced during the first wave of the pandemic, the head of the largest nurses' union has said.

Pat Cullen, Director of the Royal College of Nursing in Northern Ireland, said nurses are "currently under immense pressure in all areas".

"As we enter a second wave, we are facing a severe shortage of staff which is compounded by the number of nurses isolating or affected by Covid-19", she said.

“This is a very worrying situation and has created pressure we did not have the first time around.

"We know that intensive care units are having serious problems in relation to getting enough nursing staff to fill shifts and nurses are having to work longer hours as a result.

"Pressures are also being experienced in district and community nursing, and our emergency departments. Staff are exhausted and there is no doubt this will have a toll on their mental and physical health.

"Our members are very concerned about the impact this is having on services and would ask the public to be patient. Nursing staff are doing the very best they can under very strained circumstances," she added.

Across Northern Ireland's hospitals, there are currently 360 inpatients who have tested positive for Covid-19, the highest number since then pandemic began. The previous peak of 322 hospital patients was recorded on April 8.

Dr Tom Black, chairman of the British Medical Association's Northern Ireland Council, said it had been the worst week "in living memory" saying the second wave of the virus appeared worse than the first.

Dr Black said hospitals were being hit with a "triple whammy" of rising numbers of Covid-19 cases, with lack of available staff and seasonal pressures adding to the crisis.

The senior medic warned of a "very, very difficult month" ahead.

"To be frank, it's the worst I have seen it in my 35-plus year career and that would be the same for all doctors in Northern Ireland, we have never seen anything like this", he said.

"This is the worst week in the NHS probably in living memory and the concern is that next week will be worse."

Mid Ulster, Belfast and Derry and Strabane remain peak areas for Covid-19 infections where hospitals "will get it hard for the next few weeks".

"We are hitting a triple whammy - we have a pandemic, huge numbers of staff off sick and winter pressures, all three at the same time, we have never had to deal with this before with a system that works at near capacity usually," he said.

Dr Black said more support for hospitals was needed along with further restrictions to stem the spread of the virus.

"We need to make it very clear to the public that we have a very, very difficult month ahead of us," he added.

The Northern Health Trust issued an urgent message urging patients at Antrim Hospital who were fit to be discharged but required a community bed to accept the first they were offered.

Patients have also been asked by the Northern Trust not to attend the hospital's emergency department unless they require urgent medical care.

As of yesterday afternoon there were 27 seriously ill people waiting for a bed at Antrim.

Medical Director of the trust Seamus O'Reilly said: "during last surge we had empty beds in the system, which allowed us to keep the flow going through the emergency department ... we don't have that this time."

Other Trusts soon followed, urging the public not to attend A&E unless it was urgent.

The Southern Health Trust released a statement saying: "Please only attend if you need emergency treatment, non urgent cases will have a long wait time."

Altnagelvin Hospital in Derry trigged its emergency contingency plan. The Western Trust said: "As numbers increase, we increase capacity as per our critical care surge plan up to 18 beds."