Antrim Area Hospital remains under extreme pressure on Monday after it was forced to close its emergency department over the weekend for safety reasons.
On Saturday night, the hospital declared a major incident and issued a statement asking people to "not attend under any circumstances" after it had reached full capacity due to the number of patients needing to be admitted.
The Northern Health & Social Care Trust said the decision to close the ED was regrettable but it was the only safe response under the circumstances.
Read more: Trust issues statement after hospital ED declared 'major incident'
Jennifer Welsh, the Chief Executive at the Northern Trust, said the decision to close A&E on Saturday night was " a last resort", adding that it has been a very difficult situation for staff to manage.
"We had been running our full capacity protocol and had already brought in additional staff," she told the BBC.
"ED is actually overstaffed, recognising that we were dealing with a high number of decisions to admit every day. We reached out for help early on Saturday morning.
"We did get help from neighbouring Trusts and the Northern Ireland Ambulance Service. We were doing everything that we could to try and deal with this. This was a last resort."
She added: "At the time we called the incident there were 131 patients and about 66 had a decision to admit (DTA) and no bed available. It's not just a numbers game but about the acuity of the patients and how sick they are.
"Our resuscitation unit was overfull. We simply couldn't cope. It was the safest thing to do to close the door and convey people to the next nearest ED to make sure they begin the urgent treatment they need.
"It was the right call to say it was unsafe - it was at the time."
A social-media post from the hospital said on Sunday the hospital was still under "extreme pressure".
Ms Welsh also gave an update on the current situation at the hospital on Monday morning.
"We currently have 45 patients in the (emergency) department for whom a decision to admit has already been made and for whom no bed is available," she said.
"That would have been unthinkable about four or five years ago - we would never have seen numbers like that and unfortunately coming into 45 DTAs in the morning is now pretty much normal business. That is not acceptable at all."
People Before Profit MLA Gerry Carroll said the closing of the ED at Antrim Area Hospital signifies the critical need to put health workers’ pay right and demonstrates why nurses have voted to take strike action.
Last week, the Royal College of Nursing confirmed nursing staff in Northern Ireland will walk out over “pay levels and patient safety concerns”.
They will join colleagues “across the UK at the majority of NHS employers” after results of the RCN’s first ever strike ballot across the UK were published.
“Nurses are set to strike to defend our very health service,” Mr Carroll said.
“Low pay is piling further pressure on existing staff and inhibiting the ability to recruit and retain health workers. Staff are leaving NHS in droves because they are being paid poverty wages. We saw the effects of this play out in Antrim Area Hospital at the weekend and this should serve as a warning of things to come.
“The NHS cannot afford to keep paying huge sums to private agencies as a stopgap for staff shortages. We need urgent investment in our NHS staff to ensure patient safety and the future of our health service.”
“Health workers and their unions are taking the necessary steps to protect their patients,” he continued.
“They have been forced to the picket line by years of wilful neglect. More Emergency Departments will close if we do not put health workers’ pay right.”
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