Cheers arose as the tally of ballots cast by about 1,900 members of Service Employees International Union Local 1199NW in the past week was announced Sunday night outside Swedish Hospital on First Hill. Union leaders would not say how many members also signed a petition that essentially would authorize a strike vote.

Union leaders had recommended rejection of the proposed contract, which would phase out a traditional defined-benefit pension plan with a 401(k)-type retirement investment system and for the first time require workers to pay part of their health insurance premiums, 7 percent starting in 2007.

The union represents 2,000 nurses, 1,800 service workers and more than 500 technical employees at Swedish, which bills itself as the largest hospital system in the Pacific Northwest with three hospitals, an emergency room and specialty center in suburban Issaquah, 12 primary care clinics, a number of specialty clinics and home care service.

"We're really very disappointed in the outcome of the vote," Swedish chief financial officer Ronald K. Sperling said.

Swedish needs the proposed changes to remain competitive, and the offer was "more than competitive in comparison to other (hospital) benefit programs," Sperling said before the vote.

A federal mediator had been assisting in the negotiations, but a quick return to negotiations is and Swedish might instead impose the terms of the last offer, Sperling said.

"We've made concessions along the way," he said. "We really don't think there's anything more to bargain."

"We realize we have to make some compromises, and we're willing to do that," countered Celeste McAloon, a registered nurse and union bargaining team member, "but we need to keep talking."

In the event of a strike, hospital officials have said, service will be reduced and patients may be transferred.

"If we have to, we'll reduce significantly the patients in our hospital to correspond with the number of nurses," Sperling has said. "Our position is we're not going to bring in temporary nurses."