By Nick Triggle
BBC News, health reporter
Nurse leaders have threatened to take industrial action unless ministers make a U-turn on their "miserly" pay offer.
The RCN's rules means nurses will not strike
The government has offered nurses in England, Wales and Northern Ireland a 1.5% pay rise this month with another 1% to come in November.
But nurses at the Royal College of Nursing annual conference said the government should agree a full 2.5% immediately - as in Scotland.
Ministers said the offer was fair for nurses and affordable for the economy.
If industrial action was taken it would be the first on a national scale by nurses.
The RCN said the move was the equivalent of a below inflation 1.9% pay rise and was saving the government £60m.
An emergency motion passed unanimously at the conference in Harrogate called on the government to implement a full 2.5% pay rise as recommended by the independent pay review body.
Nurses said the staged offer was insulting and they would be prepared to take industrial action - such as sticking to contracted working hours - if necessary.
Linda Henderson, from London, said: "I personally think we should strike and get patients on board."
Helen McDermott, a psychiatric nurse from Birmingham, said: "I don't know how long I can carry on doing nursing. Most of the time I am working extra to pay bills."
And David Harding-Price, from Nottingham, added: "No more rhetoric. Action, action, action."
Ann Taylor-Griffiths, of the RCN's Welsh Board, said: "We are one nursing body, we one NHS and deserve one nationally implemented pay award."
And Irene Lavey, from Edinburgh, where nurses have got the full 2.5%, said in reference to the large pay rises other health professionals have got: "If they can invest in GPs and consultants, they can invest in nurses."
Some even suggested the 2.5% was not enough. Douglas Lockhart, from Glasgow, said it was "absolutely rubbish".
"Lets take some sort of industrial action. This is totally unacceptable."
Nurses also voted to ask the RCN to investigate what form of industrial action they could actually take.
Historically, nurses have not been allowed to take industrial action, but a rule change in the mid 1990s permitted measures which do not harm patient care.
This effectively rules out an all-out strike, but does allow nurses to refuse to work overtime and do paperwork NHS trusts use to demonstrate that they have met targets.
To date, the RCN has agreed to ballot its members on four occasions - all local issues - but the disagreements have been resolved before the ballots were sent out.
Meeting with ministers
RCN leaders said they would seek to meet with ministers over the issue before taking a decision on whether to ballot members in May.
RCN general secretary Peter Carter said the staged-offer was totally "unacceptable and miserly", but he did not want to proceed in a "ramshackle way".
He said: "There is a real sense of injustice."
He said industrial action was the last option for nurses, and pledged it would not damage patient care.
Health Minister Lord Hunt said: "What we have suggested is a sensible increase, that's fair for NHS staff and affordable for the economy.
"In 1997, a basic grade nurse earned just over £12,000, today that figure is nearly £20,000."
Nurses have also expressed anger at the shake-up of hospital services being planned.
Ministers are encouraging NHS managers to draw up proposals to close key services such as A&E and maternity in some hospitals as part of the drive to push more care into the community.
But nurses warned it was being drive by money. Sheila Dunbar, a nurse from Bolton, said: "The community services are just not there. It means there will be poorer care for our patients."
Health workers, including ambulance workers, porters, and cleaners, have told their union, the GMB, they are also prepared to take industrial action over a similarly stage pay rise.
In a consultative ballot virtually all those who took part rejected the decision to stage the rise, and 90% backed industrial action, with 75% in favour of a strike.