Nurses in Northern Ireland are set to be balloted for industrial action, including a potential strike, over concerns around staffing levels.
The board of the Royal College of Nursing (RCN) in Northern Ireland made the decision to ballot members on Monday.
RCN represents nurses, health care assistants and nursing students throughout Northern Ireland.
Members are to be ballotted due to what RCN described as the current staffing "crisis" and pay inequalities faced by nurses in Northern Ireland compared to the rest of the UK.
A Department of Health spokesperson said that they were taking the concerns seriously and that they "highly value" the nursing workforce.
The RCN claimed that there are currently 2,600 unfilled nursing posts across Northern Ireland, with a similar level of vacancies estimated in nursing homes.
They said that staff shortages were resulting in higher spending on agency nurses, longer patient waits and increasing pressure on nurses.
RCN said that the real value of nurses' pay in Northern Ireland had fallen by 15% over the last eight years and was behind the rest of the UK.
Chair of the RCN Northern Ireland board Fiona Devlin said that the decision to ballot members was "unprecedented in the history of the RCN".
“Members of the RCN Northern Ireland Board have been left with no option but to ballot RCN members in Northern Ireland as a result of the total inaction to address the staffing crisis facing health care in Northern Ireland," she told the Nursing Times.
“This situation is compounded by nurses in Northern Ireland being the lowest paid across the UK.”
RCN Northern Ireland director Pat Cullen said the college would ballot members "in the coming weeks".
“No nurse in Northern Ireland wishes to take any form of industrial action,” she said.
“However, as a profession, we are no longer prepared to tolerate the risk to patients, nurses and the people of Northern Ireland.”
A Department of Health spokesperson said that they were committed to "doing everything it can, within the current budget constraints, to ensure a fair pay award settlement this year for nurses and indeed the entire HSC workforce".
"The Department has proactively been addressing the nursing shortages through a range of measures to rebuild the nursing workforce in Northern Ireland, significantly, increasing investment in pre-registration training from 709 places in 2015/16 to an all-time high of 1025 places in 2019/20," the spokesperson said.
"We are therefore disappointed at the RCN’s announcement, particularly as talks on the refresh of Agenda for Change pay, terms and conditions are continuing with HSC employers and trade unions, including the RCN.
"The Department remains engaged in this process and, as ever, is willing to talk with trade unions at any time."