Members of Quebec largest nurses' union voted just over 66 per cent in favour of adopting a mediator's recommendations after rejecting an agreement in principle earlier this year.

The Fédération interprofessionnelle de la santé du Québec (FIQ) has about 80,000 members and represents nurses, practical nurses, respiratory therapists and clinical perfusionists. The union's collective agreement expired in March 2023.

FIQ president Julie Bouchard says the mediator recommendations don't address all the nurses concerns, but that the union will ensure the new contract is rolled out as quickly as possible.

"The fight for stability for professionals in heath care continues, just like our fight against mandatory overtime, and for professional-patient ratios," she told Radio-Canada.

Issues around staff retention and the possibility of moving nurses from one health-care facility to another to address staffing have been among the major sticking points throughout the negotiations. The mediator recommended that staff can't be forced to travel more than 40 kilometres when moved from one health-care setting to another.

Recommendations also include salary increases of 17.4 per cent covering the period of April 2023 to April 2027.

Jennie Rhee, the president of the local union for nursing and cardio respiratory professionals at the McGill University Health Centre (MUHC), says that for their part, they're relived by the mobility flexibility clause. On this issue, the mediator deferred local unions to their local collective agreements. In the MUHC's case, it has a site protection clause meaning that workers cannot be moved from one site to another within the MUHC network.

"For us, it's not a gain, it's not a loss. It's statu quo," she said.

"We have a lot of people that are still quite dissatisfied with the salary increases," she said.

The agreement was passed by a thin margin at the MUHC with 56.2 per cent of the votes.

The local union's members were especially concerned about a proposal that would have forced nurses to work in other hospitals to fill holes in the schedule. At a vote in April, 90 per cent of local union members rejected that idea.

"We are very specially trained just like a doctor would be trained in their specialty. Like a gynecologist is not going to go work in an eye clinic, it's the same for nurses," said Rhee.

She added that language was also an important factor given the MUHC is an English-teaching hospital and not all its staff is completely comfortable working in French.

In a statement, Treasury Board president Sonia LeBel says the agreement will increase flexibility making nurses more available to care for Quebecers when they need them, including nights, weekends and on holidays. She also hopes the new agreement will help attract workers from the private sector to the public sector.

Bouchard says there's still a lot more work that needs to be done in order to make the public health care network more attractive.

"There are still better working conditions in the private sector, better salaries offered at the detriment of the public sector" she said.

The new collective agreement will expire in 2028.

Rhee says now that it's finally signed, we might see an exodus of nurses from the system.

"We are so fragile we cannot tolerate being pushed beyond a certain point," she said. "People were waiting for the signature of this collective agreement so that they could retire."