Maintaining eye contact during a health history interview strengthens nurse–patient communication.

Let’s talk about a skill that often flies under the radar but carries a lot of weight: how a nurse communicates during a health history interview. This is the moment when stories start to form—the patient’s past health, daily habits, worries, and goals. It’s not just about collecting facts; it’s about building a connection that makes the patient feel seen, heard, and trusted. And yes, the way you use your eyes matters as much as the words you choose. In fact, maintaining eye contact is widely recognized as a cornerstone of effective communication in clinical settings.

The power of the gaze: why eye contact matters

Think about the last time someone really listened to you. What did they do with their eyes? They didn’t stare you down; they held a steady, respectful gaze that said, “I’m with you.” In a health history interview, that same gaze signals engagement. It tells the patient you’re present, you’re focused, and you’re not just collecting data but validating their experience.

Eye contact also helps you read nonverbal cues. A patient’s facial expressions, micro-movements, or hesitation can reveal more than words alone. Maybe a patient glosses over a symptom because it feels embarrassing. A brief pause, a calm glance from you, and the patient might lean in and share a crucial detail that changes the care plan. In short, eye contact is a real-time feedback loop: it invites information, signals respect, and guides you toward a fuller picture of the patient’s health.

Cultural awareness and balance

Eye contact isn’t a one-size-fits-all gesture. Cultural norms shape how much gaze feels comfortable or respectful. Some patients may find direct eye contact intense, while others expect it as a sign of attentiveness. The key is to stay attuned. If a patient avoids eye contact, you can soften your approach—keep your head at the same level, use open body language, and invite conversation with gentle prompts. If you’re in a setting where masks are worn, eye contact becomes even more central. Your eyes, your tone, and your facial expressions carry more weight when the mouth is partially covered. You don’t have to narrate your thoughts; you simply stay present and observable in a calm, respectful way.

Eye contact in different settings: in person and online

• In person: Sit at a comfortable distance, with the patient’s chair angled slightly toward you. Use a natural, relaxed gaze. Nods and brief smiles can reinforce engagement without interrupting the flow of questions.

• Telehealth: Eye contact becomes a bit more complex because cameras act like windows into your attention. Look at the camera when you’re speaking to simulate eye contact, but also glance at the patient’s face on the screen to pick up cues. Verbalize what you’re doing: “I’m looking at your charts while you share this with me.” It may feel odd at first, but it builds trust and keeps the conversation smooth.

What to avoid to keep communication clean

• Don’t bombard with several questions at once. That’s overwhelming and makes it hard for the patient to respond thoughtfully.

• Don’t lean on heavy medical jargon. Plain language invites accuracy; it also reduces anxiety and misinterpretation.

• Don’t speak in a low tone that murkifies the message. A soft voice can be misread as disengagement, especially in busy clinics or noisy environments.

• Don’t forget to check in with the patient’s comfort level as you proceed. A quick, “Is this okay to keep going?” goes a long way.

A few practical keys to a smoother health history interview

1. Start with the setting and intentionality

• Create privacy and minimize interruptions.

• Explain the purpose of the interview in simple terms: “I’d like to understand your health history so I can care for you more effectively.”

• Position yourself and the patient so eye contact is natural—sit at eye level if possible, and let silence be your ally. It gives space for the patient to reflect and respond.

2. Use eye contact as your anchor, not a spotlight

• Maintain steady but natural eye contact. You don’t need to stare; you’re aiming for engaged, not intimidating.

• Pair eye contact with listening cues: nod, lean slightly forward, and use brief verbal confirmations like “I see,” or “Go on.”

• When a patient hesitates, maintain contact and give them time. A moment of quiet often holds a critical piece of information.

3. Frame questions with clarity and warmth

• Open-ended questions invite richer stories: “Can you tell me more about how this started?” or “What does a typical day look like for you with this condition?”

• Follow with focused questions to fill gaps: “When did the symptom begin exactly?” or “Have you tried anything at home to manage it?”

• Use transitions, so the patient feels the interview is a conversation, not a checklist.

4. Speak the patient’s language

• Swap medical terms for everyday explanations, then tailor your language to their level of understanding.

• If you must use a term, briefly define it in plain language: “arterial blood pressure, which is a measure of the pressure in your arteries.”

• Check comprehension with a gentle, nonjudgmental prompt: “Does that make sense, or would you like me to explain it another way?”

5. Read and reflect

• Mirror back what you hear to confirm accuracy: “So you’ve had headaches for three days, and they’re worse in the afternoon?”

• Summarize as you go: “To recap, you’ve had this symptom for X weeks, it’s aggravated by Y, and you’ve tried Z.”

• This not only reinforces memory but also shows the patient you’re actively listening.

6. Weave in nonverbal cues without over-reading

• Notice facial expressions, posture, and tone. A sudden tightening shoulders or a quick breath can signal discomfort or fear.

• If you sense alarm or confusion, pause and invite clarification: “I want to make sure I understand you correctly; can we go over that part again?”

7. Build rapport with a touch of humanity

• Small talk, when appropriate, can soften the emotional edge. Acknowledge the effort it takes to share personal health history.

• Use empathy statements: “That sounds challenging,” or “I’m glad you told me about this.”

• Don’t mistake familiarity for laxity. Maintain professional warmth and boundaries.

8. Document with care, then move forward

• After you gather information, reflect and write concise, accurate notes. A clean handoff to the next step—like a physical assessment—depends on a solid foundation of history.

• In many clinical settings, you’ll document with the patient present, summarizing what you’ve heard and asking for corrections. Eye contact reinforces that collaborative moment.

Anticipating barriers and tailoring the approach

• Language barriers: Use an interpreter when needed. Face the patient, not the interpreter, and maintain eye contact with the patient as you speak. Pause for interpretation and allow silent moments for accuracy.

• Cognitive challenges: Break questions into small, manageable chunks. Confirm understanding before moving on. Eye contact helps you gauge whether the patient is following.

• Sensory impairments: If hearing is an issue, speak clearly, use short sentences, and provide written summaries when possible. Visual aids can help bridge gaps.

• Anxiety and distress: A calm demeanor, steady gaze, and reassurance can ease tension and promote openness. If anxiety spikes, offer a brief pause and resume when the patient feels ready.

Why this matters beyond the moment

A health history interview isn’t just a data collection exercise. It’s the first chapter of a patient’s care story. When you establish trust through steady eye contact and thoughtful listening, patients are more likely to share context that makes a huge difference in their care plan. You learn about how symptoms affect daily life, how previous treatments were tolerated, and what outcomes matter most to the person you’re helping. That kind of insight can inform decisions, from preventative advice to follow-up schedules, and it builds a foundation for collaborative problem-solving.

A few quick reminders you can carry into any patient encounter

• Eye contact is the backbone of effective communication in this space.

• Pair eye contact with active listening, clear language, and gentle checking for understanding.

• Adapt your approach to cultural norms, environment, and patient comfort.

• Use questions that invite stories, not just yes-or-no answers.

• Attend to nonverbal cues and follow up with reflections or summaries.

If you’re navigating the broader field of ATI’s physical assessment topics, you’ll notice how central communication is to accurate data gathering. The evaluation of a patient isn’t only about what’s on the form; it’s about how the story behind the data is told. Eye contact, in particular, acts as a bridge between the patient’s experiences and the clinician’s plan. It’s not a fancy technique or a gimmick—it’s a practical, human-centered habit that elevates care.

A closing thought

The health history interview is a dialogue, not a report. When you look someone in the eye, you’re saying, “Your story matters, and I’m listening.” Combine that with clear language, patient-led pacing, and a respectful, curious stance, and you create space where people feel safe to disclose what’s really going on. In the end, eye contact doesn’t just help you gather information—it helps you connect with the person behind the symptoms. And connection? That’s where good care begins.