The Irish Nurses' Organisation (INOs) is to ballot members working with intellectually disabled patients on industrial action over pay.
In a motion passed at the second day of the INO annual conference in Killarney, the nurses' union called for the rejection of a recent Labour Court Recommendation (LRC) because it failed to restore the "long-standing pay position of registered nurses" in the sector.
The INO claims the LRC recommendation would result in registered nurses being paid less than unqualified people they are supervising.
Mr Liam Doran, INO general secretary, said the issue was a threat to the Sustaining Progress plan.
"Employers will have to accept that our members will not wait indefinitely to have this pay issue corrected." He said all other strategies will be considered.