The Irish Nurses and Midwives Organisation (INMO) has set a deadline for a pay offer from Government.
It says the deadline of September 26th is for a "serious pay offer for nurses and midwives in the public health system."
The INMO executive council are to hold a Special Delegate Conference on that date.
Delegates from across the country will consider pay proposals or "discuss alternative actions if no pay offer is made", the INMO says.
The executive council is angry at what they say is the failure to address the recruitment and retention crisis facing nursing and midwifery.
It adds that the Health Service Executive (HSE) "has failed to adequately staff the service, meet its own staffing targets, or even decide a staffing target for this year."
"Time to face facts"
The INMO says: "The executive council consider the difficulties of recruiting and retaining nurses and midwives to be unresolvable without addressing the pay and conditions of employment.
"Without nurses and midwives, bed capacity and adequate services in either hospitals or community hospitals will not be maintained.
"Every possible initiative except pay has been tried and has failed to either recruit the nurses and midwives we need, or to stem the outward flow from our public health service.
"The executive council's view is that it is time for Government to deal with nurses’ and midwives’ pay now, as patience is running out."
INMO General Secretary Phil Ní Sheaghdha says: "Without the incredible work of nurses and midwives, the health service will slowly grind to a halt.
"Aside from a pay rise, the Government have tried everything to stem the tide of nurses and midwives leaving, but it just hasn't worked.
"It's time to face facts and accept that a real pay rise is the only way to recruit and retain nurses and midwives."
INMO President Martina Harkin-Kelly adds: "If the Government don't make a serious offer, our 300 delegates will face a stark choice.
"Either they stay with a failing public service agreement or consider alternatives to deliver fair pay and a safe health service."