Nurses have warned health chiefs they have until the end of the month to come up with substantial ideas to end staff shortages or face a strike.
The Irish Nurses and Midwives Organisation (INMO) deferred its decisions on industrial action, including walk outs and work-to-rule, but said they wanted to offer management a last chance to resolve the crisis.
The immediate strike threat was lifted as the union's latest trolley watch report revealed the overcrowding crisis in the country's hospitals had soared again to 527 patients waiting for a bed.
The numbers included 372 people on trolleys or chairs in A&E units and another 155 people held on wards waiting access to a proper bed.
The worst overcrowding was in Letterkenny General Hospital, with 38 people waiting for a bed, followed by Our Lady of Lourdes Hospital in Drogheda, which had 32 patients waiting.
The INMO has given health chiefs two weeks to develop plans to tackle staffing issues.
Union president Martina Harkin-Kelly said it was the last chance for management to prove they want to tackle the issues of recruitment and staff shortages and retention.
"Management must clearly understand that the decision of my executive council provides them with two weeks within which to demonstrate, after years of neglect and disrespect, that they are now committed to recognising that patient care is being compromised, nurses/midwives are completely overworked and their health and safety is being neglected," she said.
INMO general secretary Liam Doran said: "The INMO, while affording management the opportunity to engage and bring forward all initiatives necessary to address the crisis, will continue, at workplace level, to prepare for industrial action to protect the health and safety of our members."
Nurses are also being told to submit statement of concern forms to management in their hospitals which sets out professional judgment and issues about conditions where they work.
"They will be presented to management, as part of this campaign, with a demand for concrete measures, including the closure of beds if necessary, to ensure nurses/midwives can practice safely," Mr Doran said.
INMO will hold talks with the HSE over the coming days and meet on January 30 to review the final proposals.
The union said a timeframe for industrial action will be finalised at the end of the month if substantial ideas are not produced.