OCEANSIDE -- It's official: Tri-City Medical Center's governing board has two new members.

At 5 p.m. Tuesday, the San Diego County Registrar of Voters Deborah Seiler certified the results of the Nov. 4 general election. Those results show that challenger George Coulter unseated four-term incumbent Darlene Garrahy by only 56 votes. Incumbent David Tweedy also failed to retain his seat, coming in seventh in a field of eight candidates.

Longtime incumbent RoseMarie Reno led the field, easily winning her seventh consecutive four-year term on the hospital's board. Challenger Charlene Anderson, a registered nurse, came in second while voters slotted incumbent Kathleen Sterling third and Coulter fourth.

The four winners were backed by the Service Employees International Union and the California Nurses Association, two collective bargaining organizations that together represent more than 1,000 employees, including 700 registered nurses, at the public hospital that primarily serves Oceanside, Vista and Carlsbad.

The unions have aggressively opposed staffing changes at Tri-City and listed "eliminating big bonuses being paid to management staff" as one of four priorities if the four-person slate of candidates was elected. That day came to pass Tuesday, representing a changing of the four-person majority on the seven-member board.

Reached by telephone Tuesday, Garrahy said she will not seek a recount.

"I have better things to do with my time," she said.

She said that the unions' financial involvement, which included spending an estimated $44,000 on glossy mailers to 50,000 likely voters, plus an aggressive telephone operation to help sway voters to candidates they supported, probably made the difference.

"I don't think that kind of money has ever been spent before on a board seat at Tri-City," Garrahy said. "The election process will be forever changed because of it."

Garrahy said she did not seek, and would not have accepted, union support because the SEIU is in contract negotiations with the hospital.

She said she will be watching to see where the new majority takes Tri-City.

"I don't know that 56 votes necessarily gives Mr. Coulter a mandate, but I wish him well," Garrahy said.

Coulter could not be reached Tuesday evening for comment.

Anderson, the other newcomer, said Tuesday that she hopes the new majority will be able to "improve patient care" at Tri-City, but said she had no specific initiative to announce right away. She said she wants to get to the bottom of the staffing issue, which has seen different camps of hospital workers insist that patient care is suffering and also that everything is fine.

"On one hand, they say there's a staffing crisis, and on the other hand, some say their jobs are wonderful," Anderson said. "There has to be some middle ground there."

Contact staff writer Paul Sisson at (760) 901-4087 or psisson@nctimes.com.