Nurses and midwives in Victoria have rejected the government's latest pay offer but are prepared to return to the negotiating table before taking industrial action.
The union's Victorian members voted on Wednesday to reject the pay deal.
The Australian Nursing and Midwifery Federation say they will resume negotiations.
But they will also hold a ballot in the next couple of weeks to decide if they should take protected industrial action.
Their current agreement ends on March 31 and members want a pay deal to bring them into line with their NSW counterparts, which could see pay rises between three and 20 per cent, depending on a nurse's grade.
Premier Daniel Andrews says there is no need for industrial action.
"There is no reason at all that any industrial action needs to be taken in our hospital system," Mr Andrews told reporters on Wednesday.
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