The nurses at Straub Medical Center have voted to accept a new three-year contract after working without one since November.

On Friday, 91% of about 400 union nurses voted to ratify the contract with parent company Hawaii Pacific Health, which includes a 9% increase in wages across the board over three years, in addition to a retention bonus of $4,000, among other terms.

The ratification comes after nurses in late 2022 held two informational pickets and a march from the state Capitol to the headquarters of Hawaii Pacific Health at Harbor Court in downtown Honolulu.

“Our efforts paid off,” said Daniel Ross, president of the Hawaii Nurses Association, in a statement. “We were heard. The hospital’s management made some improvements in their last best and final offer, but their proposed agreement still fell short of addressing our concerns. Rather than escalate this battle to the point where it disrupts patient care with a work stoppage, the nurses have decided to take the high road for now, but are not giving up. The correlation between staffing and patient safety is still a major issue at Straub and we will relentlessly strive to keep hospital management accountable for doing what’s right for patients and the nursing staff.”

Ross told the Honolulu Star-Advertiser that the union was pushing in large part for competitive pay commensurate with the high cost of living in Hawaii, along with benefits to help with the retention of experienced nurses, among other concerns

“We believe the nurses deserved more,” he said, “but this is a good start.”

The contract includes a 3% increase per year over three years, in addition to a $2,000 retention bonus in the first year followed by another $2,000 in the second year, plus on-call pay increases each year.

It also includes “longevity” incentives, including an extra $2.25 per hour for nurses who have worked at least five years, an extra $3.25 per hour for those who have worked at least 10 years and an extra $4.25 per hour for those who have worked at least 15 years.

Ross said these incentives should help with the recruitment and retention of experienced nurses.

Although the state has made commitments — $1.75 million by former Gov. David Ige to hire nursing school instructors at the University of Hawaii and $4.4 million by current Gov. Josh Green in his proposed budget for nursing and medical-­related programs across UH — the union said it is important to recruit and retain experienced nurses.

It takes time to gain experience, and newly minted nurse graduates need experienced nurses to mentor and guide them.

“You don’t want any particular shift or unit to have too may unseasoned new graduate nurses,” said Ross. “Multiple, inexperienced nurses is a recipe for error and disaster.”

Ross said management also acknowledged nurses should have the opportunity to take breaks, and will create a committee — made up of six management and six union members — to look at solutions and recommendations.

In the meantime, managers and supervisors have agreed to pitch in and provide break relief for nurses.

Many nurses double up and take care of a colleague’s charges while they are on their break, he said, which can be unsafe, depending on patients’ conditions. Some nurses will skip their breaks because of this, which happens at all facilities and not just Straub.

The union agreed to these terms since previous committees have been able to successfully address other issues in the past, he said.

“This new contract means a lot to everyone involved — from our staff to our community,” said Travis Clegg, chief operating officer at Straub Medical Center, in a statement. “It demonstrates how much we appreciate our Straub Medical Center nurses for always putting our patients first. Nurses are the backbone of our medical center and we are happy to start the new year by moving forward together.”

Hawaii continues to face a severe health care worker shortage as hospitals grapple with even more patients than during the height of the COVID-19 pandemic.

The state is short nearly 1,000 registered specialty nurses, according to a recent report by the Healthcare Association of Hawaii, and more than 700 certified nursing assistants and nurse aides.