Twin Cities nurses voted overwhelmingly Tuesday in favor of a new proposal that preserved their pension, health benefits and salaries, bringing to a close one of the most contentious and public contract negotiations in state history.

"It's been a long three-plus months, but the nurses I'm talking to tonight have a healthy mixture of relief and resolve," said Cindy Olson, a nurse at St. John's Hospital in Maplewood and a member of the Minnesota Nurses Association (MNA) bargaining team.

In a statement released moments after the nurses union announced the results just before midnight, the 14 Twin Cities hospitals said they welcomed the ratification of the contract. "We are eager to re-focus on the collaborative approach with our nurses that has made our hospitals some of the most innovative in the country," hospital officials said.

Even before the vote, nurses were reflecting on the months-long battle and the way it will affect the mood inside hospitals in coming months.

"Their rhetoric and posturing were very successful in angering the nurses," Kevin Campbell, a nurse at the Riverside campus of the University of Minnesota Medical Center, Fairview, said of the hospitals. "The trust from the nursing staff is below the level of the Mississippi River right now."

Lori Flesland, a nurse at St. John's Hospital in Maplewood, said she was happy that she could vote yes, and was deeply relieved that the nurses did not have to strike. When the settlement between the MNA and the hospitals was announced Thursday, she ran to hug her boss.

"We were both crying," she said.

As for the issue of nurse staffing, where the union compromised, she said, "Sometimes it takes more than one contract negotiation to get what you want. We can continue to work on it."

Many nurses who cast their votes Tuesday said they were relieved and pleased that they were able to preserve their health care, pensions and salaries. But some said they could not in good conscience vote for a deal that failed to provide the staffing ratios they claimed on lawn signs and at rallies were critical to patient safety.

"It's embarrassing for me," said one nurse who said she voted no, but declined to give her name. "That's what I was picketing for."

Others said the months of public bashing might have inflicted lasting damage on the relationship between nurses and their employers. Vicky Michaels, an operating room nurse at United Hospital in St. Paul, said she voted for the contract, but directed her frustration at hospital administrators, who she said "make millions and get huge pay raises." The only bonus she's received was for saving the life of a patient by doing CPR. It was a cookie, she said, laughing, for saving a life.

Hospital officials said they know they have fences to mend. "We understand this has been a divisive and difficult time," said David Kanihan, a spokesman for Allina Hospitals and Clinics, which owns five of the 14 hospitals involved.

Hospital executives say they will take the nurses' concerns about patient safety and staffing to heart, even it they won't put it in the contract.

"The voices of our nurses were clear and resolute -- they believe that patient care can be improved and that our work is far from over," Allina Chief Executive Ken Paulus wrote in a staff e-mail Friday.

Campbell, the union negotiator, expressed doubt that the hospitals will address the staffing issue as the nurses hoped. He said the union gave up on the question last Wednesday when, in exchange, the hospitals agreed to withdraw their demands for concessions on health insurance and pensions. Campbell said he realized at that point that the hospitals were not prepared to discuss staffing the way the union hoped. In that case, he said, "it is not in the best interest of nurses or patients to pursue it."

He said the union would turn to the Legislature for help, as nurses successfully did in California. "They could end up like California, where the Legislature crammed it down their throats," he said.

Others said the compromise reached at the bargaining table -- addressing staffing issues through existing hospital committees -- is a positive step.

Alice Swan, associate dean of nursing at St. Catherine University, called it "a win for both sides."

"There has been a fair amount of intense debate around this," she said. "I hope the public will feel assured."

A similar, if smaller, fight is brewing in Duluth. Nurses at St. Mary's Medical Center, SMDC Medical Center and St. Luke's Hospital there are in the midst of contract negotiations, with staffing also emerging as a key issue. Duluth nurses plan to do informational picketing on Monday, and Twin Cities nurses have been invited to join them.

Staff writer Chen May Yee contributed to this report. marcotty@startribune.com