A 4% rise in nursing and midwifery vacancies in Scotland is unsustainable, according to union bosses.
The Royal College of Nursing (RCN) Scotland says more funding is needed to ensure patient care does not suffer.
In Fife, there are 129 nursing vacancies, up from just 57 this time last year.
Across NHS Fife, staffing levels have risen by 0.6% on this time last year, but dropped by 0.2% since June 2015. There are 25 less administrative service staff and 11 less support service staff than during the last quarter.
RCN Scotland Associate Director, Ellen Hudson, said: "This situation is not sustainable and puts even more pressure on existing staff who are working flat out on our wards and out in the community, without enough staff and feeling unable to provide the care they would like to.
"The last NHS staff survey showed that only a quarter of nursing and midwifery staff feel that there are enough staff to do their job properly. We need to take a long, hard look now at how our health services are delivered, if they are to be sustainable into the future.
"We have an ageing nursing workforce, too, with many nurses, particularly those working out in the community such as health visitors and district nurses, due to retire over the next 5-10 years.
"We cannot ‘magic’ nurses out of nowhere to fill these vacancies, but what the Government can do is make sure that health boards have the resources to invest in their nursing staff, while at the same time implementing changes to the way services are delivered for the future."
Record staffing
Health Secretary Shona Robison said: "Under this government, NHS staff numbers have risen significantly, with more consultants, nurses and midwives now delivering care for the people of Scotland.
"To give people the high quality health care they deserve, we are investing in and supporting a highly skilled NHS Scotland workforce. Over the past year, this includes an additional 600 WTE nurses and midwives.
"In addition to having record staffing levels, Scotland is leading the UK in the development of mandatory nursing and midwifery workload and workforce planning tools that help health boards to plan for the number of staff they require. By using these tools, health boards can make sure they have the right number of staff required to provide the best possible care for patients in a variety of specialities."