The Royal College of Nursing (RCN) has voted "with great reluctance" to accept the Government's revised pay offer for nurses in England.
The decision was made at a meeting of the RCN Council in central London and follows an acceptance by Unison of the deal on Thursday.
The Government angered health unions by deciding to stage a recommended 2.5% rise, reducing the annual value of the award to 1.9%.
But ministers improved the deal last month by offering a £400 flat rate rise for tens of thousands of the lowest paid NHS workers as well as money towards registration fees.
Dr Peter Carter, general secretary of the Royal College of Nursing (RCN), said: "The RCN's ruling council has voted with great reluctance to accept the Government's revised pay offer for nurses in England.
"Although the immediate threat of industrial action has now been lifted, the Government should realise that nurses in England have accepted this offer with a very heavy heart.
"The revised offer is imperfect but it is improved. It was only after months of campaigning by the RCN that the Government, which had refused to budge, revised its original offer.
"We still believe the Government's economic arguments for giving nurses in England their pay award in instalments do not stack up.
"The Government should learn the lessons from this year's pay negotiations - it should not under-estimate the long-term implications of this year's pay round on the morale of the nursing workforce and it should remember that it is much harder to attract first-class nurses to the health service by offering them second-rate pay."
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The Government welcomed the decision. Health Secretary Alan Johnson said: "I am pleased that the RCN, on behalf of their members, have accepted the improved pay offer."
