Nurses have rejected the latest pay offer by DHBs, meaning potential strikes are still on the table.
Lead advocate David Wait said the DHBs had made promising moves on pay but the the offer contained too many ambiguities.
He said strikes planned for 19 August (8 hours) and 9-10 September (24 hours) will go ahead unless an acceptable offer is made.
Nurses' union members were informed of the decision at 7pm today, with District Health Boards told just after.
Wait said that while the union appreciated a commitment to finalising pay equity by the end of November, their member are once again being asked to trust an uncertain outcome.
"We want the DHBs to come back with an offer that provides certainty over how safe staffing will be addressed. Members are tired of ambiguity.
"Members have been clear from the beginning that their safety at work and the safety of their patients is a priority, and that is where they most deserve certainty.
"Nurses don’t want more vague promises that the problem will be fixed in the future - which is what we have received once again."
DHB spokesperson Dale Oliff said the district health boards were surprised a package of over $400 million had been rejected.
He says they will begin considering their next steps to prevent the strikes going ahead.
“We’re willing to consider different ways of shaping the settlement, but the union needs to engage in a meaningful way.
“Negotiation involves a degree of realism and compromise, DHBs have shown we’re prepared to move and I’d urge the NZNO and its members to reconsider their position.”
Almost two weeks ago, the NZNO union called off strike notices and took an improved pay offer to members.
At the time, Health Minister Andrew Little described it as a "positive move towards settling district health board nurses’ pay claims".
"It’s encouraging that the discussions between NZNO and DHBs over the nurses’ employment agreement have resulted in a new offer that will go out to nurses, and that the union has lifted strike notices for July 29 and 30."
NZNO previously said if that offer was not accepted by members "the strikes planned for 19 August and 9 September could still go ahead".
NZNO delegate Diane McCulloch told Breakfast earlier this month nurses were "burnt out".
McCulloch said the conditions they were working under now "are not cutting it" and "we feel undervalued totally".
"We want to care for our patients in the best way that we can because that is why we've entered the nursing workforce. It's not only for our livelihoods but because we are a caring profession."
District Health Boards spokesperson Dale Oliff previously said their fourth offer to nurses, midwives and healthcare assistants was a "package of measures addressing the issues raised by the NZNO and follows a meeting with the mediator in Wellington".
"Nurses, midwives and healthcare assistants are an important part of our workforce, and key to delivering to the needs of our communities, this offer acknowledges the value of their role."