More than 700 Nova Scotia paramedics are prepared to walk off the job after a near-unanimous rejection of their employer's collective agreement.

Todd Mills is one more than 700 paramedics a part of the International Union of Operating Engineers (IUOE) local that voted 98 per cent in favour of rejecting an offer made by their employer, Emergency Medical Care Inc. (EMCI).

"We wouldn't be doing it unless we thought it was absolutely necessary," he said.

The company offered a 10.95 per cent wage increase over five years, as well as a shift premium for working nights and weekends, premium increases for senior paramedics and more funding for education programs. But Mills said the IOUE's rejection of the offer had nothing to do with money.

At the heart of the dispute is working conditions and pensions, said Mills.

Last year EMCI introduced a "fatigue management policy" that Mills said gives the company too much discretion over whether paramedics are too tired to work.

The IUOE was also against a decision that would give ECMI that ability to temporarily move a paramedic across the country without compensation.

Mills said paramedics also want to switch from their current defined retirement contribution plan where employee contributions are matched by the company to a more secure, defined benefit pension plan.

Defined benefit pension plans tend to be more stable and lucrative than defined retirement contribution plans.

In a statement to CBC News, ECMI said it's disappointed the union rejected the offer.

"We feel that our proposal is competitive in comparison with other health-care agreements in Nova Scotia ... We remain committed to reaching an agreement," the company stated.

Nova Scotia's last paramedic strike lasted less than one day and occurred during a Progressive Conservative administration in 1999.

Mills served as a paramedic during that strike. He said a failure to reach a deal would reduce vital services.

"Unfortunately if we go on strike it's going to mean reduced ambulances on the street. It'll affect the collaborative care centres that we operate in the province working as paramedics and the nursing homes in Halifax that are covered by the extended care paramedics," he said.

Both sides in this dispute have yet to meet with a conciliator so any potential strike wouldn't happen for at least two or three weeks.

EMCI said in a statement that they are committed to reaching an agreement with the IOUE.

This situation is likely to come to a head in the run-up to next month's sitting of the Nova Scotia legislature.

The province's current Health and Wellness Minister Dave Wilson is a former paramedic who walked off the job during the last paramedic's strike more than a decade ago.