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The key to building a trusting nurse-patient relationship is based upon communication. The patient must see the nurse as someone that he or she can open up to with their concerns, and not feel judged. If the nurse portrays an uncaring or humorless demeanor, the patient may feel put off. Frequently, the patient is under stress and by encountering a nurse who seems distant and uncaring can exacerbate their stress level. When first meeting the patient, the nurse should make sure to make eye contact and smile, while reaching out a hand to offer a warm handshake. By doing so, the patient will feel more inclined to discuss their feelings. In addition, the nurses's response to the patient's concerns should never be condescending, nor should the patient be made to feel "talked down to." Nurses should address the patient's concerns as soon as possible. For example, if in a hospital setting, and the patient calls for the nurse, the nurse should respond as quickly as possible. This will build upon the trusting relationship, as the patient will be aware of the responsiveness of the nurse. Also, the nurse should never hesitate to tell the patient that whatever they discuss, will be kept in strict confidence. By instilling trust and confidence, the nurse is able to reduce patient anxiety and create a more pleasant environment for both patient and caregiver, as this plays a significant role in the health of the patient.