Some 600 union nurses at Kapi‘olani Medical Center today ratified a new, three-year contract that was ironed out after more than a year of negotiations with management, with the assistance of two federal mediators.

The union nurses had until 6 p.m. to vote today, with the majority voting to ratify the contract.

The new contract was agreed upon after two strikes, a lockout by management, and two rounds of negotiating efforts with federal mediators.

HNA President Rosalee Agas-Yuu said, in the end, the union was overjoyed with the new staffing matrix that both parties agreed to after year-long efforts.

“The nurses are very happy with it,” she told the Star-Advertiser. “Over the year, it’s been talked back-and-forth up to the last day or two. Even the accountability — that language was so important — and we finally got agreement.”

Nurses are expected to return back to work at Kapi‘olani on Sunday morning, and are very much looking forward to returning to their patients, she said.

Agas-Yuu called the contract the first contractually enforceable nurse-to-patient ratios in Hawaii’s history.

“We identified what we feel is important for each unit to work with,” she said. “We don’t expect it to be perfect from day one. It’s going to take time, and we’ll make sure everybody’s aware.”

She said HNA would be happy to release more details on the matrix after today’s ratification.

Kapi‘olani Chief Operating Officer Gidget Ruscetta said both parties agreed on flexible staffing levels — and not fixed ratios.

A staffing council made up of Kapi‘olani nurses and nurse leaders will meet monthly to address staffing issues, and review the staffing matrix annually.

“We are pleased our nurses voted in favor of this contract,” said Ruscetta in a news release. “Fixed ratios are not the answer. As a result of our collaborative efforts in negotiations, our nurses will now be a part of the staffing process so we can all work together to adjust to our patients’ needs. With these agreed upon flexible staffing levels, we can focus on our patients and the ever-changing needs in our medical center.”

The agreement includes across-the-board raises that average out to 3.5% annually over nearly four years, plus longevity pay increases for registered nurses who have five, 10, and 15 years of experience at Kapi‘olani.

In addition, Kapi‘olani said it would use an innovative tool to determine scheduling needs for each unit, and remain committed to ongoing nurse recruitment and retention programs.

“This has been an emotional process for all of us at Kapi‘olani, and we are ready to move forward, together,” she said in the release.

Both sides credited federal mediators for moving the negotiations forward.

Ruscetta said, “Federal mediation played an instrumental role in the final steps of reaching this agreement. We were always a proponent of having a neutral third party involved. We encouraged it early in our talks and again in the last few weeks of negotiations.”

“We were very lucky to have two federal mediators,” said Agas-Yuu. “I believe they did make a really big difference.”