NSW Nurses and Midwives Association SERH branch delegate Diane Lang said it's clear nursing staff are fed up over the government's attempts to quiet nurses on their fight for improved working conditions.

"For 10 years we have been asking for better ratios and governments have given us nothing but a pay rise of 2.5%. Now they are offering a raise of only 1.04% and haven't offered us mandated safer ratios," Ms Lang said.

A majority of the nursing staff at SERH and across the state have voted against the offer.

They continue to call for one nurse to three patients in emergency and paediatrics, and one to four in medical and surgical wards.

"We are angry that the government is refusing to listen to nurses, we are professionals and are given them our professional opinion. We are angry they continually ignore us.

"Ratios are the most important thing, we want to improve working conditions above all else.

"The pay is important and economically down the track people need to have a decent pay because it impacts your superannuation, but right now nurses would say, 'I would give up my pay rise this year and maybe one more year if I got ratios'."

The association will hand over their response of refusal to the Ministry of Health on Tuesday, June 1. Their next steps depend on the government's subsequent move.

"They may just force us to take the pay increase, we may then go to the industrial relations commission for them to do something," Ms Lang said.

"We will decide further on down the track what we may do. We will be doing a public campaign about how dire the hospitals are in this state and we will follow with the majority of what the rest of the state decides to do."

Ms Lang said on a local level nurses are frustrated and continue to remain short-staffed.