WORCESTER, Mass. (AP) — The longest nurses strike in Massachusetts history came to an end Monday when unionized nurses at St. Vincent Hospital in Worcester voted to ratify a new four-year deal with management.

The agreement was overwhelmingly approved 487 to 9 in favor of ratification, according to the Massachusetts Nurses Association union. The 301-day strike was the longest in the nation in the past 15 years, the union said.

“We go back in that building with our heads held high focused on healing, not only our patients, but to work with all in our hospital community to rebuild and restore a sense of stability,” said Marlena Pellegrino, a longtime St. Vincent nurse and co-chair of the union’s bargaining unit.

“This is an enormous victory for our patients and our members, and it is a testament to the grit and determination of every nurse who walked that line, day in and day out,” Pellegrino said in a statement from the union.

St. Vincent Hospital said in a statement it would “work diligently to heal the wounds of the past year as we integrate striking nurses.”

“We are ready to welcome back every nurse who chooses to return to St. Vincent, and we have plans in place to make that process as smooth as possible,” the hospital said.

The tentative agreement between about 700 St. Vincent nurses and management had been announced on Dec. 17 after an all-day bargaining session mediated by U.S. Labor Secretary and former Boston Mayor Marty Walsh.

The nurses went on strike March 8, demanding that management at St. Vincent, owned by Dallas-based Tenet Healthcare, increase staffing ratios to improve patient care during the coronavirus pandemic and beyond.

The hospital countered that it was irresponsible to strike during a public health crisis and that staffing levels met industry standards. In July, the hospital announced it was scaling back some services and reducing capacity in response to the strike.

But while the sometimes-contentious work stoppage was originally over staffing levels, it later became about whether nurses who had been walking the picket line for months would be able to return to their old jobs after the hospital started hiring replacements.

The agreement includes staffing improvements and allows all nurses who went on strike the right to return to work in the same position, hours, and shifts that they held prior to the work stoppage.

It also includes language intended to better protect nurses from violent patients, pay increases through 2025, and enhanced health insurance benefits for some union members.

“They wanted nothing more than to return to work for months, and they risked their livelihoods on the picket line each day to achieve that goal,” U.S. Rep. Lori Trahan said in a statement Monday evening, praising the nurses for remaining on strike “until they secured the protections and staffing conditions their patients deserve.”

The hospital now has 30 days to issue recall letters to the striking nurses, but both sides expect them to start returning to work well before that deadline. St. Vincent said Monday it expects nurses to be back on the job by Jan. 22.

The benefits of the deal have already been seen. St. Vincent announced last week it has reopened 12 inpatient behavioral health beds that were closed in August due to staffing challenges presented by the strike.

There were a number of high-profile strikes across the country last year as labor unions feel emboldened to hold out for moreamid ongoing worker shortages.

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