The strength of nurses' anger was never in doubt as they gathered for the Royal College of Nursing (RCN) annual conference in Harrogate this week.
An independent pay review body said they should get a 2.5% pay increase this month. The government decided to give them only 1.5%, with another 1% to follow in November.
The postponement will cost nurses about £60m this year, but it has also lost the government the last shreds of gratitude in the profession for the extra billions ploughed into the NHS over the past five years.
The problem for a nursing union is that it is extremely difficult to convert this anger into industrial action. And today's vote will not solve that problem.
The RCN is not a militant trade union. It is a medical college, concerned as much with professional development as pay and rations. Most nurses have a fundamental professional commitment to their patients. The idea of a full-blown strike is anathema to them - because a strike would be likely to leave patients sicker and in more pain. Some might die.
So the RCN's leadership has to find a form of industrial action that will hurt the politicians without hurting the patients. Is that possible?
Peter Carter, who took over from Beverly Malone as general secretary this year, has been feeling his way in Harrogate this week towards an answer.
It might involve a work to rule, asking nurses to stop performing tasks that they are not contracted to do. They might stop providing an average of six hours a week of unpaid overtime. When there is a breakage or a spillage, they might call for an auxiliary instead of getting down to clear up the mess.
And there is the paperwork to consider. Mr Carter said yesterday that it might be possible to boycott the forms that NHS trusts complete to satisfy government targets, while still keeping rigorous notes on patients' medical condition.
"We would be saying to frontline nurses: put clinical care first; don't compromise that by filling all the cacophony of returns that are needed for trusts to be compliant with star ratings and so on."
But would industrial action that did not damage patients really put pressure on ministers to give nurses the extra money? If nurses worked to rule, would not hospitals have to reduce the throughput of patients? Would that not deny some patients the treatment they need?
Mr Carter said: "If we did take drastic action we would probably end up being successful. The trouble is nurses will never do that. The idea of an all-out strike is not something that is going to happen. That is the difficulty and I would rather be frank about it.
"But that is the dilemma the government is trading on. That really is blackmailing us. And that's why some of our members are saying: if we don't break out of this the problem is going to go on in perpetuity."
Public sector pay
· Current starting salary for a newly-qualified nurse £20,026
· Current starting salary for a newly-qualified teacher £19,641 (but most teachers get a golden hello of £4,000 - £5,000)
· Mid-career average salary for a nurse £26,110
· Mid career average salary for firefighter £27,876
· Mid career average salary for police officer £35,578
· Mid career average salary for a teacher £33,361
* all figures are gross salaries without London supplement
