Nursing unions and health service managers are to meet this morning to discuss the £100 million Labour Court award to the State's 27,500 nurses.
There are already worrying signs that the nurses may reject the award and vote for industrial action.
It is understood that a large majority of members of the Irish Nurses' Organisation executive indicated, when they met yesterday, that they would oppose recommending the terms as they stood.
The other nursing unions also have major difficulties with the package, particularly given the dismissive attitude that was emerging yesterday among staff nurses to the £1,250 lump sum.
Many still believe they are entitled to long-service increments that will put their salary on a par with teachers.
The present offer still leaves long-service nurses between £4,000 and £8,000 a year worse off than teachers.
Staff nurses in the psychiatric service are even more alienated, as many of them will not benefit from extra allowances for qualifications and work locations that are worth £1,000 to £1,500 a year. Most general staff nurses will receive these.
Another problem group is public health nurses. Under the Labour Court proposals their differential with ward sisters will shrink from over £1,000 to just £24 a year. Nor will they benefit from the payment of extra qualifications and location allowances to some ward sisters and staff nurses. This is worth between £1,000 and £1,500 a year.
The Health Service Employers' Agency (HSEA) is also understood to be hardening its stance. Employer sources said last night that there "will be no re-negotiation of the Labour Court recommendation, especially of the public health nurse situation." The sources added that union leaders should "bite the bullet and put the recommendation out to ballot".
A more positive response to the recommendation had been expected from ward sisters and senior nurse managers.
These are the main beneficiaries of the award, receiving pay increases of 10 per cent and four days extra annual leave.
However, directors of nursing have been alienated by a proposal that they report to general managers within the health services, rather than chief executives of major hospitals and programme managers in the health boards. Many of them see this as a demotion and ward sisters may be influenced by their lead.
Yesterday the Association of Irish Nurse Managers, which is usually slow to comment on industrial relations issues, said the mood among senior nursing managers was "overall one of disappointment" at the recommendation.
The president of the AINM, Ms Mary Courtney, said the proposal that directors of nursing report at a lower level in the health service "contradicted the message being sent out by the Government and the Commission on Nursing that nurses should have parity of esteem with other professions within the health service and should participate in the decision-making process".
The Nursing Alliance yesterday postponed the press conference it had planned to give a joint response to the award.
There is now a serious prospect that, even if the HSEA gives the Nursing Alliance adequate "clarifications" on its various concerns at today's meeting, the unions themselves may not be able to agree a joint stance on the Labour Court award.
In that situation some unions might advise members to accept, while others advise rejection or simply leave nurses to make their own minds up on the issues. A more likely scenario is that the unions would advise rejection rather than split ranks.
The Minister for Health and Children, Mr Cowen, yesterday announced that the Government had decided to accept the Labour Court recommendation.