As a major nursing union considers intensifying a pay dispute, nurses from A&E, intensive care, and cancer wards may go on strike in England.
The Royal College of Nursing (RCN) demands higher pay as living expenses rise, but ministers counter that wages are decided by a separate body.
A 48-hour strike that includes nighttime walkouts is something the union is considering.
The minimum legal standards of care would still be upheld by all employees.
Additionally, the union stated that it might not make local agreements to support NHS managers during the strike periods as it has in the past.
A joint committee of NHS and RCN staff decided on approximately 5,000 cases during the previous action where the strike was not fully implemented.
NHS administrators are "fearing this escalation," according to a source from the Royal College of Nursing, and "must apply pressure to the government to get it stopped.".
Any action by the union would require two weeks' notice.
The RCN is angry that the government won't talk about raising the current 4 percent pay offer for the 2022–2023 fiscal year.
After receiving offers of a 7% pay increase, strikes in Wales were called off, and nurses in Scotland who are members of the RCN and GMB unions are not staging walkouts while negotiations are taking place.
One of the main points of contention in the dispute is pay for the current year, and the Department for Health has stated that it has not changed its position regarding nurses in England.
In addition to requesting that strikes be called off, it stated that Health Secretary Steve Barclay would talk about pay for the upcoming year.
The department continued, saying the NHS has "tried-and-tested plans" to minimize disruption and that keeping patients safe is its top priority.
In a letter to Prime Minister Rishi Sunak earlier this month, RCN general secretary Pat Cullen requested dialogue. The union reported not receiving a response.
The health secretary would respond to the letter as soon as possible, Downing Street stated on Saturday night. Downing Street stated that it would not add a further level of negotiation to the process.