Senior nursing official has 'little confidence' in acceptable pay offer being made from from the Scottish Government.
The Royal College of Nursing (RCN) Scotland opened a ballot of members on Thursday that could result in staff taking strike action for the first time in Scotland.
The ballot comes after a 5 per cent pay offer was resoundingly rejected in the summer, and the union has been campaigning for an offer equal to "inflation plus 5 per cent" - about a 15 per cent increase.
Health Secretary Humza Yousaf said earlier this week he will get back around the table with a "significantly improved" offer, with talks expected to start on Wednesday.
Speaking as a group of nurses gathered outside Holyrood on Thursday, RCN Scotland director Colin Poolman told the PA news agency: "Unfortunately, I don't have huge confidence currently.
"Although hearing 'significantly improved offer' has to give us some confidence, I'll wait and see once negotiations start up.
"Ultimately, it will be our nurses that decide, whatever offer comes in, whether it's acceptable or not - but the one thing that I can tell you is they feel undervalued, underpaid, understaffed and therefore they're looking for an improved offer."
The talks come against the backdrop of financial pressure in the Scottish Government, with Deputy First Minister John Swinney announcing £500 million in cuts as a result of an increased pay offer for local authority staff.
Any attempt to tell NHS staff that an improved pay offer could have a negative effect on health services was described as "emotional blackmail" by Mr Poolman.
"That's pure emotional blackmail on our nurses - it's unacceptable and quite offensive actually," he said.
"It's the politician's job to go away and find the resources, the nurse's job is to deliver care - they're doing their part of the deal, it's now (the Health Secretary's) and the Government's turn to do theirs, and that's to pay nurses properly."
While Mr Poolman pushed for an offer of inflation plus 5 per cent, he said any offer would have to, at least, not be a real terms pay cut.
Meanwhile, chair of the RCN Scotland board, Julie Lamberth, said the pandemic "broke" the nursing workforce due to the pressure put on staff.
"We got a 4 per cent pay award last year, 1 per cent more this year - we've had enough," she said.
"The cost of living has gone up - it's gone up for everybody - but actually we have a safety-critical role.
"We were praised in the media about how wonderful the nursing workforce was and I know everybody in the NHS, health and social care were under pressure, but no-one will truly know some of the pressure that our nursing staff have felt."
Ms Lamberth - who still works as a frontline nurse - said that should strike action go ahead, services would be reduced to those seen on Sundays or holidays like Christmas Day, with emergency care being prioritised.
Unison began balloting its 50,000 members for strike action on Monday - recommending they back walkouts - while the Royal College of Midwives in Scotland opened its vote last month. On Thursday, Unite also announced plans for a "targeted" balloting of 2,500 staff across Scotland, including the entirety of the Scottish Ambulance Service workforce.
Radiographers in NHS Greater Glasgow and Clyde - except those working in cancer care at the Beatson hospital and in breast screening to protect the service in the event of a strike - will be part of the ballot.
Elsewhere, staff at the Golden Jubilee Hospital, Ayrshire and Arran, Grampian, Fife, Highland, Tayside, Lothian, Borders and Lanarkshire will also be asked to respond by November 4.
Unite general secretary Sharon Graham said: "The heroes that we all applauded during the pandemic are being told to take a substantial real terms pay cut - yet another hit on NHS pay.
"When inflation is well into double-digits, 5 per cent just doesn't cut it. NHS workers need to pay their bills and protect their families. Nobody wants to go on strike but they are being left with no choice now but to take a stand."
Mr Yousaf said: "Any ballot for industrial action is disappointing. We are engaged with health unions and I hope we can come to an agreement on pay in the near future.
"This work continues in the context of our emergency budget review following the UK Government's fiscal event."
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