In the consultative ballot, which closed at midday on Monday, 82% of those who voted rejected the "best and final" offer from ministers at Holyrood.

The move could see members of RCN Scotland taking part in strikes for the first time ever.

The union said it will announce dates for strike action early in the new year and "the ball is in the Scottish government's court" if it is going to be avoided.

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After negotiations with the government, the deal offered pay rises ranging from £2,205 to £2,751.

NHS workers would have received an average increase of 7.5% - with a rise of 11.3% for the lowest paid staff.

Ministers said the offer meant NHS workers in Scotland would remain the best paid in the UK.

However, Julie Lamberth, RCN Scotland board chair, said that asking members whether to accept or reject the offer was "the right thing".

She added: "It directly affects their lives and each eligible member needed to be given the chance to have their say.

"The result could not be clearer - we have forcefully rejected what the Scottish government said is its 'best and final' offer.

"Make no mistake - we do not want to go on strike. Years of being undervalued and understaffed have left us feeling we have been left with no option because enough is enough.

"The ball is in the Scottish government's court if strike action is going to be avoided."

The Royal College of Midwives also announced that its members had rejected the offer, with nearly two thirds (65%) having voted against the deal which it claimed would see many midwives "actually worse off in real terms".

It has also been rejected by staff in the GMB union - although it has been accepted by workers in both Unite and Unison.