Nursing leaders are warning the government in England must boost the pay of nurses or face possible strike action.
A survey of Royal College of Nursing members showed 91% did not think the 3.6% pay increase this year was enough.
But, instead of seeking a bigger pay rise, the union wants ministers to reform the way the NHS contract works, warning too many nurses get stuck on the lowest pay bands which do not reflect their skills.
If the government does not act over the summer, the RCN is threatening to run an industrial action ballot in the autumn.
The government said it was disappointed nurses were not happy with the pay award, but it was willing to discuss wider reform of the contract.
