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Cindy CookeAs a nurse practitioner (NP) who was responsible for the care of active duty and retired military members for more than a decade, the importance of relationship-centered care became exceptionally clear. NPs are educated and clinically trained to care for the whole person, to listen to our patients, and to use evidence and diagnostic tools to assess their health care needs and develop appropriate treatment plans. In the modern health care system, that often means working in concert with other members of health care teams and ensuring that each team member is empowered to utilize the full scope of clinical skills and expertise they possess.

Health and healing hinges on human relationships, including those between patients and their families, patients and providers, and members of the health care team. Thanks to their strong nursing foundation, NPs excel in building patient-provider relationships based on compassion, understanding, and trust. NPs are leaders who consult with and advocate for their patients and their communities. They take time to listen and to educate patients—components of relationship-centered care that improve compliance with treatment plans and reduce unnecessary hospitalization.

NP-provided care is evidence-based and considers the unique health care needs and wellness goals of each patient. The foundation for meaningful information exchange, diagnosis, development of treatment plans, and evaluation of outcomes is rooted in relationships. As counselors and educators, NPs are empathetic, and their servant-leadership training (for more on this click here) enables them to provide care that empowers patients to achieve their wellness goals. These features of relationship-centered care are valued by patients and contribute to genuine patient-provider relationships, evidenced by the more than 800 million visits made to NPs each year.

Both the foundation of nursing practice and relationship-centered care include the concept of health care teams, centered around the patient, that work together to ensure care is coordinated and well-communicated, information is shared, and cooperative partnerships are fostered among patients and health care professionals.1  In this dynamic system, the needs of the patient remain at the forefront and determine which member of the team should lead at any point in time. Successful teams include patient-identified and -supported goals, mutual trust among all team members, effective communication, and measurable health care processes and outcomes.

To provide the highest quality care for patients, it is imperative that all members of a health care team practice to the fullest extent of their educational preparation and clinical expertise. Currently, patients in 21 states and the District of Columbia have full and direct access to the care NPs provide. Patients in these areas benefit most from the relationship-centered care that NPs offer. Unfortunately, barriers exist in other areas that restrict NP practice, negatively affect the provision of relationship-centered care, and reduce the benefits patients might otherwise enjoy by making an NP their health care provider of choice.

Relationships between NPs and their communities continue to be built, and attempts to modernize regulations and legislation related to NP practice are ongoing. For example, earlier this year the VA proposed a rule that would enable NPs and other advanced practice registered nurses to practice at the top of their licensure in VA facilities nationwide. Similarly, several states have recently considered legislation that would modernize regulations and reduce barriers to NP practice.

In summary, relationship-centered care that places patients at the center of health care teams and empowers all members of the team to contribute at the top of their education and clinical preparation results in high-quality outcomes that maximize patient and provider satisfaction. In order for all patients to realize the full benefits associated with relationship-centered care, each member of the health care team must be able to practice at the top of their education and clinical preparation.


  1. The American Association of Nurse Practitioners. Nurse Practitioners and Team Based Care. 2013. Retrieved from: