They stuck together and prevailed, never faltering from their mantra: “It’s not about the money. It’s about keeping patients safe.”

After nearly a year of negotiations, registered nurses at HealthAlliance Hospital - Leominster Campus are celebrating what they consider a victory after reaching a tentative agreement for a three-year contract Monday evening that they say improves nurse-to-patient staffing and overall patient safety.

Included in the agreement is a stipulation that the 257 nurses in the union at HealthAlliance, who are organized with the Massachusetts Nurses Association and UMass Memorial HealthAlliance, will not carry more than five patients each shift, according to Jennifer Johnson, spokeswoman for the union.

The settlement came at the end of the parties’ 18th negotiation session — the first of which was held in September 2014 — and less than a week after the nurses held a vote authorizing a one-day strike. A date to ratify the agreement has yet to be determined, but the contract will expire two years from the date the contract is officially ratified.

HealthAlliance Hospital is affiliated with UMass Memorial Health Care in Worcester.

Natalie M. Pereira, a registered nurse from Fitchburg and chairwoman of the MNA bargaining unit, said no nurse ever wants to strike and she is relieved hospital management and union leaders were able to come to an agreement.

“I’m relieved and I’m glad it is over,” said the medical surgical nurse, who has worked at the hospital 29 years. “I’m happy they heard what we’ve been trying to say for the last year - that patients need to be safe. Patients are complex, and the higher the number goes, the chances of mistakes increases. It’s not a factory. Patients are human beings. I’m thankful they listened and I’m hoping it’s the start of mending relationships.”

A press release from HealthAlliance Hospital says the tentative contractual agreement balances the needs of patients and the community.

“We maintain that addressing issues collaboratively and partnering with each other in the symbiotic relationship of hospital and nurse is the best path forward,” the release said. “At HealthAlliance Hospital, our number one goal is to continue to provide the safest, highest quality care to our patients and our community.”

Last June, HealthAlliance Hospital President and Chief Executive Officer Deborah Weymouth announced cuts to 20 full-time equivalent nursing positions at the Leominster campus in addition to cuts to support staff at both the Leominster and Fitchburg campuses that would occur until the end of the hospital's fiscal year Sept. 30, 2014. The announcement came just two months after HealthAlliance cut seven full-time nursing positions from the Fitchburg campus.

The nurses’ union contended the cuts would jeopardize patient safety. Shortly after the announcement, their contract expired and they have been in negotiations since.

Diane Lane-Cormier, is a RN from Ashburnham who has worked in the cardiac and medical surgical units for 14 years and at UMass Memorial Medical Center—University Campus, in Worcester for 13 years before that.

She said staffing levels decreased gradually in Leominster the past several years as nurses left and their positions remained unfilled. Some nurses were assigned six patients on their shift, she said. Ms. Lane-Cormier works the 3 p.m. to 11 p.m. shift, the busiest shift, she said, because of discharges, new admissions and transfers from ICU. At times, she had up to nine patients for part of her shifts, she said.

Several items in the new contract will help with patient care and safety, she said, including that nurses will not be assigned more than five patients and the creation of a joint staffing committee compiled of administrators and nurses who will meet routinely about staffing issues.

“We’ve never had that kind of connection or input,” she said. “They’ll be sitting right with us.”

The contract also includes the creation of a STAT nurse position, she said, who will not be assigned patients and will go to areas where they are needed. Additionally, several units including ICU, will have a charge nurse that does not have patient assignments.

“They will help with the flow of the floor,” Ms. Lane-Cormier said. “It is another set of eyes if a patient’s condition is deteriorating. To have a pair of hands and eyes free to do what a charge nurse does, unencumbered by their own assignments, is quite a victory. I’m excited and impressed we got to this point. In the end, I think administrators put the patient first.”

Nurses will also receive 1 percent pay increases the second and third year of the contract, she said.

“But, it was never about that,” she said. “It was about staffing and our ability to give safe patient care. That was the fight. I’m still pumping my fist in the air today. It was a long uphill battle with many people involved getting us to that agreement.”

Theresa M. Love, a RN from Orange at the hospital for 15 years working in the pediatrics unit, said the agreement was a win-win situation for nurses, patients, the community and the hospital.

“I don’t think anyone loses in this at all,” Ms. Love said. “We came with an agenda to provide safe staffing and patient care and we stuck to that,” she said. “We didn’t make much progress the first 15 sessions, but once they saw we were firm in our goals and had the membership behind us with the authorization of the vote to strike, we made a tremendous amount of progress. I think it was them seeing the metal of the whole membership and seeing us standing firm in our determination to reach our goal of providing safe, good, quality care to patients.

“I’m happy it is done and I’m looking forward to being able to go to work and take care of patients in the way I was taught to practice nursing,” she added.