A slim majority of nurses have voted to accept the Minns government 4 per cent pay offer in a result unions say was driven by cost-of-living pressures.

The NSW Nurses and Midwives’ Association has confirmed 58 per cent of members voted to accept the offer in what it described as “one of the narrowest votes in quite a long time”.

The union’s assistant general secretary Michael Whaites said with more than 40 per cent of nurses voting against it, it was a clear indication they weren’t happy with the offer.

“Even those that voted for it, we got a very clear message from our members that they don’t see the 4 per cent as enough,” he said.

He said “cost of living pressures” and “fatigue” were “absolutely” the main factors in accepting the government’s offer made in June, which included a 0.5 per cent superannuation increase.

“They’ll take the 4 per cent now but more is needed,” he said.

“The close vote reflects the economic and political environment we find ourselves in.”

The one-year pay deal will buy the Minns government some time and stave off industrial unrest for now.

“We are talking to our members about what actions needs to occur but that would be right, no immediate strike action in the short term,” Mr Whaites said.

“They want to be paid a rate that respects the work and contribution that they provide.”

The NSW government welcomed the decision, describing it as “the biggest pay increase for nurses and midwives in over a decade”.

Health Minister Ryan Park said the government had “made a commitment to scrap the wages cap and deliver a pay increase to our frontline workers including our nurses and midwives”.

“We are committed to supporting our essential frontline workers and we’re working hard to recruit, retain and support our workforce,” he said.

The government said it would continue to work with other public sector unions to resolve other wage negotiations.