Registered nurses at Henry Ford Genesys Hospital in Grand Blanc, Michigan, voted to ratify the hospital's final three-year contract offer, officially ending a strike that began on Labor Day 2025 and lasted 411 days.

Teamsters Local 332 members voted 230 to 165 in favor of the deal, and hospital officials said Friday they are preparing to discuss terms for the nurses' return to work.

According to WJRT ABC12, the agreement includes a 13% wage increase, new weekend and critical off-shift pay rates, continued nurse-to-patient staffing ratios, and seniority rights for every striking nurse.

A strike of more than 13 months is extraordinary anywhere, but especially in community health care.

According to The Detroit News, this was only the second strike in the hospital's 110-year history, and administrators and union representatives met more than 90 times trying to hammer out an agreement.

The ratification also came with unusual tension: just days before the vote, about 264 nurses — roughly 70% of the 385 nurses currently working at the hospital — signed a petition to the National Labor Relations Board seeking an election to remove Teamsters Local 332 as their bargaining representative, a wrinkle that made a clean ending look unlikely.

The approved contract implements a 13% pay increase, new premium pay rates for weekend and off-shift nurses, and maintains staffing ratio requirements from previous Teamsters contracts, per The Detroit News.

The hospital said it has already begun a revamped staffing model giving frontline nurses greater say in patient care, nursing practices and safety.

Meanwhile, the Teamsters alleged that Henry Ford Health encouraged nurses to support the decertification petition and pressured nurses to resign from the union to return to work — actions the union called labor-law violations. Genesys denied the allegations.

The hospital pointed to financial challenges — including average annual losses of $50 million, according to The Detroit News — to justify its proposed contract terms and efforts to control labor costs.

Nurses argued that fair wages, adequate staffing levels and patient safety needed attention despite the hospital's financial difficulties.

Teamsters Local 332 President Dan Glass acknowledged that the parties would not reach a mutual agreement on some core issues, but said nurses felt it was time to return to advocating for patients at the bedside while keeping Teamsters protection throughout the agreement.

With ratification complete, the hospital and Teamsters Local 332 will now negotiate the terms of the nurses' return to work, while the hospital says it is thrilled to welcome its 'valued team members back.'

Hospital interim president Gwen Sandefur said the institution looks forward to working side by side with returning nurses to provide care the communities count on.

Per WJRT ABC12, the union says it will continue to back the nurses and advocate for their rights, and the return-to-work negotiation will be the next test of a relationship scarred by more than a year on the picket line.