The main aim of this study is to examine the impact of high quality relationships on proactive work behaviour. Although much research exists to suggest that job context influences proactive behaviour, less is known about the role of the social context, and in particular, the role of relationships in fostering proactivity. This study examines individual perceptions of positive relational experiences on individual proactive behaviour. Work engagement and hope were proposed as mediators of the pathway between subjective relational experiences and proactive behaviour. Using a cross level model, the role of high quality relationships within the work unit on individual proactive behaviour is also examined. Psychological safety climate was proposed as a mediator of this relationship. Finally, the impact of proactive behaviour on the job performance and quality of care delivered by individual nurses is assessed. Using a cross sectional survey design, multi-source data was collected from a representative sample of staff nurses and their respective managers drawn from four independently owned hospitals operating in Ireland. Results of multi-level regression analysis indicate that, at the individual level, subjective relational experiences are positively related to proactive behaviour. This relationship is mediated by hope but not by work engagement. At the unit level, results indicate that high quality relationships impact individual proactive behaviour indirectly via their impact on psychological safety climate. Proactive behaviour is also positively related to both job performance and quality of care. A major contribution of this study, among others, is that it provides empirical evidence of how and why high quality relationships engender a proactive approach to work. It also contributes to management practice within the independently owned hospital sector by making recommendations on how to develop a proactive workforce.