Scotland's largest nursing union has voted to go on strike for the first time ever in a dispute over pay.
Members of the Royal College of Nursing (RCN) have rejected the Scottish Government's revised pay offer.
The union called on ministers to return to the negotiating table.
The government said there was no more money for public sector pay rises and that a strike would be "catastrophic".
Action is expected to start by the end of the year after RCN members across the UK voted to strike.
The most recent Scottish Government pay offer was for a flat rate of £2,205 per person, backdated to April.
Pay cut
The union has described the deal as a real-terms pay cut and accused the government of not listening to staff concerns. It asked for at least 5% above inflation, which rose to 10.1% in September.
The RCN's Scotland director, Colin Poolman, told the BBC the turnout had reached 70% in some of the organisations which had been balloted, and that more than 90% of members had voting in favour of strike action in most areas.
He said "life-preserving services" would still be in place despite the industrial action.
Mr Poolman said he hoped the Scottish Government would return to negotiations with an improved offer.
"If we don't do something now, the nursing crisis is only going to get worse and have a direct impact on patient care," he said.
"This is not just about nursing pay, this is about supporting patients and ensuring that we have a sustainable workforce going forward."
Protest
Last month, members staged a protest outside the Scottish Parliament after the union confirmed it was balloting all 300,000 UK members for the first time in its 106-year history.
Last week about 2,500 workers in the Unite union voted for industrial action.
Members of the GMB union and the Chartered Society of Physiotherapy have also backed strike action.
But Unison, Scotland's largest health union, has suspended its strike ballot of NHS staff and is consulting its members on a revised pay offer until November 14.