More than 1000 Northland nurses, midwives and health care assistants will go on strike in July if pay equity and workload concerns are not addressed.
They will join about 27,000 staff from across the country who are also members of the New Zealand Nurses Organisation calling on the Government to address their concerns.
NZNO members at district health boards across New Zealand received their strike ballots in the post on Monday and they have a month to decide whether to take that course of action.
Julie Governor, NZNO organiser for Northland, said strikes would take place on July 5 and 12 and each would last 24 hours if members chose to go down that path.
But it will depend on what solution an independent panel recommended by the Prime Minister can come up with in mid-May.
Governor said the panel's recommendation may delay strike action.
"Nurses don't want to strike. They haven't done so for 30 years but there comes a point where they just can't plug the gaps anymore in terms of their workload and pay."
She said inadequate staffing is the main issue that needed urgent attention.
NZNO members employed by the Northland District Health Board took part in two rallies outside Whangarei Hospital on April 13.
Similar rallies were held nationally as NZNO called for better funding of public healthcare after contract negotiations with DHBs broke down.
NZNO wants a pay rise of more than 2 per cent in the revised collective agreement it is negotiating with the Ministry of Health.
The Government is offering a 2 per cent pay rise and a $1050 lump sum payment.
DHB spokeswoman Dr Ashley Bloomfield said hospitals have started contingency plans to ensure patient safety in case of industrial action.
She said DHBs were hopeful the independent panel could help find an agreement to the impasse.
"I think nurses and midwives would expect us to explore all options before they consider strike action."