Delegates at the Irish Nurses Organisation (INO) annual conference have voted to ballot the union's 40,000 members on a fresh campaign of industrial action.
The campaign could include what the union's deputy general secretary, David Hughes, labelled "the most dramatic action ever contemplated."
However, following a lengthy debate, it was decided that a forthcoming Labour Court recommendation must first be rejected by the union's members before the ballot on industrial action takes place.
Similarly, the 380 delegates stopped short of backing a full national walkout, for the time being at least, after an original motion calling for members to be immediately balloted on a full withdrawal of labour once the Labour court recommendation is known did not achieve the support of those present.
Instead, an amended motion resolved that, in the event that the Labour Court recommendation does not grant the union's demand for parity of pay with "our therapeutic grade colleagues", this decision should be put to a national ballot of members for acceptance or rejection.
If it is rejected, the amendment stated that the union will "immediately ballot for industrial action."
The amendment did not, however, specify what nature such a ballot should take, although senior union sources said yesterday that this is likely to include the option of a full national walkout.