Thousands of Minnesota nurses at 15 Minnesota hospitals have ratified a new three-year contract. It comes after months of bargaining and a three-day strike this September.

The contract includes wage increases — 18 percent in the Twin Cities, 17 percent in the Twin Ports — as well as more input on staffing levels, union officials said Wednesday.

“Because of our tenacity, we won unprecedented language to address staffing levels,” said Mary C. Turner, president of the Minnesota Nurses Association and a nurse at North Memorial, at a press conference Wednesday.

“Thanks to the changes nurses insisted on, our staffing levels will never get worse than they are today. And nurses have new protections and opportunities to advocate for safer staffing when our units are short-staffed,” Turner said.

The nurses have been in negotiations since March and working without a contract since early summer. After a three-day strike in September, nurses were prepared to walk out again this month.

“We were ready to go out in December here for a three-week strike over the holidays,” Turner said. “Finally they heard us at many of our bargaining tables. It wasn’t until that second strike vote that they started to seriously discuss staffing.”

The ratification vote comes as Minnesota hospitals are navigating a sharp uptick in severe cases of influenza and RSV, which have led to staffing and capacity issues.

ICU nurse Kelley Anaas, a union chair at Abbott Northwestern in Minneapolis, said conditions have gotten significantly worse in the past few years, including long wait times, high staffing turnover, and patients being treated in emergency department waiting rooms.

“Minnesota, everyone should care about this,” Anaas said. “These are our working conditions, yes, but they are the places you go to for help, to heal, to give birth, to die with dignity.”

She called the contract “a step in the right direction” and said that nurses will continue to advocate for more, including from the incoming state Legislature.

“For months, we have been hoping for this day, the day we could say we have a contract,” said Victoria Zeehandelaar, an RN in the post-anesthesia care unit at Methodist Hospital.

While the contracts at each hospital vary, other provisions secured include those around safety, short-term disability benefits and, at some hospitals, paid family leave — though some hospitals are waiting for the Minnesota Legislature to make a decision on that.

“Now the work starts over again,” said Andrea Rubesch, an oncology hospice nurse at St. Luke’s in Duluth. “The work to implement this new language and make sure what we worked so hard for to obtain gets followed. We know change doesn’t happen overnight, and we are ready to work to make those changes happen in the weeks ahead.”

In a statement, Essentia Health said it is grateful for the agreement, which “ensures our nurses will continue to provide the expert, compassionate care that our patients expect and deserve.”

Allina Health said it is “pleased” with the deal. The Twin Cities Hospitals Group, which represents several hospitals involved, said in a statement that the contracts are fair and “meet the needs of our nurses, hospitals and patients.”

“We are grateful to have successfully reached an agreement with MNA, so we can solely focus on continuing to serve the health care needs of our community during this time of increased need,” Allina’s statement said.

Nurses at one remaining facility in Two Harbors, St. Luke’s Lake View, are still negotiating, but withdrew their strike notice last week. St. Luke’s did not immediately respond to a request for comment.