A nursing union says the ball's in Manx Care's court after its members voted for strike action.
Royal College of Nursing North West regional director Simon Browes says staff rejected a four per cent pay offer from Manx Care and 70 per cent of those polled favoured strike action.
He says the RCN is now in a position to proceed to a statutory ballot on industrial action, which would allow members to go on strike.
But Mr Browes says the RCN is asking Manx Care to continue negotiations with members.
Framework of new Sea Services Agreement ready, says minister
Attorney General says he's stepping down
Road closures in two towns for running event this week
Six weekend ferry crossings could face disruption
President of Tynwald announces retirement
Police close Mountain road
Fuel firm says "fingers crossed" for calmer energy costs
Ring doorbells will need data protection registration - but shouldn't cost you money