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The Irish Nurses and Midwives Organisation (INMO) is to ballot its members for industrial action, up to and including strike action.
The union has accused the Government of failing to establish a clear basis for negotiations on a new public sector pay agreement.
Similar ballots have also been announced by Fórsa, SIPTU and Unite.
The previous public sector pay deal expired on 30 June, and formal talks have yet to begin on a successor agreement.
The last deal provided for pay increases of up to 10.25% over the course of the two-and-a-half-year period.
INMO General Secretary Phil Ní Sheaghdha said they are balloting members to ensure they secure realistic pay increases for the work they do.
Phil Ní Sheaghdha said the Government must get real about the costs facing nurses and midwives
"With no public service pay agreement currently in place, we believe the Government must get real about the actual costs facing ordinary nurses and midwives simply to get to work, and that this must form part of any national agreement," Ms Ní Sheaghdha said.
"There is high-level unhappiness across the health service, particularly around the non-implementation of agreements and the lack of progress on local bargaining claims lodged under the expired agreement," she added.
Minister for Public Expenditure Jack Chambers has said previously that the threat of industrial action is unnecessary and that the Government wants to reach an agreement on public sector pay.
A spokesperson for the Department of Public Expenditure said the Government remains available for engagement with unions on all matters.
"It is only through engagement that agreement can be reached," the department said.