A postal strike ballot for Royal College of Nursing members across the UK has opened.
The union called for the ballot in response to the latest NHS pay award which, they say, leaves an experienced nurse over £1,000 worse off in real terms.
Instead, the RCN is calling for a fully-funded pay rise of 5% above inflation.
More than 300,000 members of the union will receive ballot papers in the post in what is the biggest strike ballot in its 106-year history.
RCN General Secretary and Chief Executive Pat Cullen said: “Though strike action is a last resort, it is a powerful tool for change.
"And we must demand that change.
"We’re campaigning for a pay rise of 5% above inflation to overcome a decade of real-terms pay cuts, support nursing staff through the cost-of-living crisis and recognise their safety critical skills.
"Only by paying nursing staff fairly will we be able to retain existing and recruit new nursing staff to the safety critical roles they do."
The ballot closes on 2 November.