Nurses had previously voted to strike if a final offer from their employees was unacceptable.
The clock starts ticking tomorrow on two strikes of 24-hours, scheduled for July 5 and 12, when the New Zealand Nurses Organisation gives formal notice of industrial action.
DHBs and nurses have been making contingency plans for a possible strike since April.
DHBs are finalising a nationwide management plan, likely to be ready later this week, to ensure patient safety and maintain key services during any industrial action.
Individual regions, such as the Southern District Health Board, will then meet nurses closer to the July 5 action day to finalise how life-preserving services will be managed during strike action.
Thousands of nurses, midwives and other health professionals covered by the pay agreement are considered an essential service, meaning each side is obliged to attend mediation talks to try to avert strike action.
New Zealand Nurses Organisation industrial services manager Cee Payne hoped those talks could be held this week, which would allow time for an online ballot of members if a new pay offer was forthcoming.
However, DHBs said the pay offer to nurses had been doubled from their starting offer, and there would be no more money on the table.
DHBs are operating collectively during the pay dispute, and the SDHB referred the Otago Daily Times to a national spokeswoman for comment.
DHB spokeswoman Helen Mason said emergency and life preserving services would be available if industrial action went ahead.
``DHBs will reduce demand be rescheduling all non-urgent hospital services and are working with the NZNO to ensure that emergency and life preserving services are available if industrial action goes ahead,'' she said.
``There is a prescribed process we're working through with the NZNO to ensure staff for essential services will still be available.''
Nurses rejected an offer of pay rises of between 9% and 15% over a three-year period, depending on seniority, position and experience, along with a one-off payment and assurances of additional money to be spent on recruiting new staff.
The last regional strike was held in 2001, in Christchurch, and industrial action in 1989 is believed to be the only time nurses have gone on strike nationwide.
``Nurses and midwives do not trust that their work environment or patient care will improve in the short term,'' Ms Payne said.
``While the revised offer included new funding to address short staffing, concern remains that this may not be enough to make a real difference.''
Health Minister David Clark said he was disappointed nurses had rejected the pay offer, and called on both sides to work towards a settlement.
``The Government has to balance pay demands across the public sector,'' he said.
``We have gone as far as we can in terms of extra Government money but hopefully the offer can be reconfigured in a way nurses are happy with.
``I know that everyone wants to find a settlement. I hope cool heads will prevail and industrial action can be avoided.''
National health spokesman Michael Woodhouse called on the Government to intervene and prevent the strike going ahead.
``David Clark appears to blame nurses for the situation by expressing his disappointment that they didn't accept the offer,'' Mr Woodhouse said.
``Clark is clearly out of touch with the mood of nurses and this is not good enough.''
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To all the Nurses, firstly thank you for the invaluable service you provide us all. Secondly good on you all and don't back down, stand your ground and demand the income you ladies and gents are worth. Thank you to your families as well. you all deserve better.