Eye-level contact matters in health history interviews and practical tips for nurses

The health history interview is one of the most human moments in a nursing encounter. It’s not just about a checklist of symptoms—it’s about listening, building trust, and making the patient feel seen and respected. When you’re guiding a person through their health story, the way you interact matters just as much as what you ask. Let’s unpack what matters most when a nurse conducts a health history interview, inspired by a common nursing scenario from ATI-style content.

What this question is really getting at

In many nursing questions, you’ll see a mix of practical steps and interpersonal skills. The options often boil down to two big themes: how you prepare and how you relate to the patient. The point isn’t that one single action covers everything, but that both preparation and relationship-building drive a better interview.

• Note-taking supplies matter. Having what you need at hand helps the interview flow without constant interruptions for pens or forms.

• Privacy matters. A private space protects confidentiality and makes sensitive topics easier to share.

• Personal space has its place. A respectful distance reduces awkwardness but doesn’t replace the need for connection.

• Eye-level contact matters. Meeting the patient’s gaze communicates equality, respect, and genuine interest, which in turn encourages openness.

In practice, all of these matter. But if you had to pick the single action that most strongly influences the interview’s trust and rapport, eye-level contact is a compelling candidate. Why? Nonverbal cues—especially eye contact at an even level—signal attention, empathy, and partnership. It says, “I’m with you, not towering over you.” That feeling of equality often makes patients more willing to share sensitive or personal information.

Eye level: why it’s so powerful

Picture two nurses talking with a patient. One nurse stands a step or two taller, notes in hand, occasionally glancing down to read a form. The other nurse sits or stands at eye level, keeps their shoulders relaxed, and uses soft nods and open questions. Odds are you’ll feel more at ease with the latter. Eye-level contact helps with several dynamics:

• Trust and rapport: People tend to open up when they feel understood and respected.

• Clarity: When you’re on eye level, you can catch nonverbal cues—fidgeting, facial expressions, signs of confusion—that you might miss otherwise.

• Engagement: The patient is more likely to stay engaged, ask questions, and participate in the conversation.

That said, eye level alone isn’t a magic wand. It works best when paired with other good practices, like asking open-ended questions, listening actively, and maintaining privacy.

Notes on the other aspects of the scenario

Let’s balance the other three options typically found in exam-style questions:

• Gather supplies to take notes: Being prepared is essential. A nurse should have a notebook or digital device ready to capture key information, timelines, medications, allergies, and concerns. This helps you document accurately and reduces the risk of forgetting important details. It also keeps the patient from waiting while you scramble for a pen. In other words, good note-taking logistics support the interview but don’t replace the need for a trusting connection.

• Conduct the interview in an open area: Privacy is a cornerstone of honest reporting. A reception area or other open space can make patients hesitant to disclose sensitive information. A private room or a quiet, confidential corner is far more conducive to a candid health history.

• Position and distance: There’s a line between comfortable personal space and cold distance. A distance of roughly 0.6 to 0.9 meters (about 2 to 3 feet) is a typical comfort zone in many clinician-patient encounters. It’s important, but it’s not as pivotal as the effect of eye-level interaction on rapport.

Putting it all together in a real-world approach

So, how does this look when you’re sitting with a patient, ready to gather their health history?

1. Create a private, comfortable space

• Ensure privacy, minimize interruptions, and set up the chair arrangement so you can face the patient. Privacy isn’t just about laws and policies—it’s about signaling respect for their story.

2. Start with warm, open-ended questions

• Instead of “Do you have any allergies?” try “Can you tell me about any medications you’re taking regularly, and any allergies you’ve had?” Open-ended questions invite detail and nuance.

3. Sit at eye level and maintain relaxed body language

• Sit or stand so your eyes are aligned with the patient’s. Keep shoulders relaxed, lean in slightly to show interest, and nod to acknowledge what they’re sharing.

4. Balance note-taking with eye contact

• It’s okay to glance at your notes, but do so briefly and return to the patient’s eyes. You can say, “Let me just check this quickly to make sure I’m capturing it right.” That small pause reinforces accuracy without breaking connection.

5. Watch nonverbal cues, and clarify when needed

• If the patient looks distressed or hesitant, acknowledge it: “I notice this topic is tough. Would you like me to slow down or skip ahead?” Validating emotions builds safety.

6. Close with collaboration

• Reiterate what you’ve heard, confirm you captured key points, and ask if there’s anything they’d like to add. A collaborative close reinforces trust and shared decision-making.

A quick checklist you can use

• Private space arranged

• Supplies ready: notebook or device for notes

• Eye-level positioning established

• Open-ended questions used

• Active listening with minimal interruptions

• Nonverbal cues monitored (head nods, eye contact, posture)

• Patient given time to contribute and ask questions

• Summary of key points and next steps provided

Why these habits matter beyond the exam page

The health history interview isn’t a sterile exercise; it’s a doorway to understanding the patient’s life, fears, hopes, and daily routines. A nurse who sits at eye level and communicates with warmth signals, “I’m here with you, not above you.” That perception can influence how accurately someone recalls events, medications, and symptoms. It also impacts adherence—people are more likely to follow through when they feel heard and respected.

A small digression that lands back on the main point

You might be tempted to treat the interview like a form-filling sprint, especially in busy settings. But the most memorable conversations are often the ones where the patient feels seen. Consider the difference between a hurried, impersonal exchange and a relaxed chat where you acknowledge concerns, allow pauses, and invite the patient to share details in their own words. The latter can reveal subtleties—like a home environment, daily routines, or cultural factors—that can dramatically affect care plans. Eye-level contact isn’t a flashy gadget; it’s a simple, human cue that can unlock honesty and collaboration.

Practical takeaways for everyday practice

• Start every interview by setting the scene: “I want to hear your story. I’ll be asking questions, and I’ll write down what you tell me so I get this right.”

• Prioritize privacy first, then build rapport with eye-level positioning and open questions.

• Use a natural rhythm: short sentences to invite confirmation, longer explanations when necessary, and a few well-timed pauses.

• Balance your attention: avoid staring at the chart or screen the entire time; let eye contact guide the conversation, with occasional glances to jot notes.

• Embrace gentle repetition: repeating back a concern or medication name helps ensure accuracy without sounding robotic.

Common pitfalls to avoid

• Reading from a script without looking up: patients feel rushed and unheard.

• Standing too far away or towering over the patient: it creates distance and unease.

• Failing to privacy-proof the space: sensitive topics become guarded.

• Overloading with medical jargon: keep language clear, relatable, and patient-centered.

• Letting the patient finish a thought and then moving on too quickly: give space for stories and side notes that can matter later.

Final thoughts

The health history interview is a dance between preparation and connection. Yes, you should have the right supplies and the right space, and yes, you should respect personal space. But the heart of the interaction—the moment you meet the patient at eye level and invite them into the conversation with warmth and curiosity—that moment often makes the difference between a good interview and a truly illuminating one. It’s about pairing practical readiness with human connection, so the patient feels heard, safe, and actively involved in their care.

If you’re reflecting on your own interviewing style, try this quick self-check: in your next patient encounter, did you sit at eye level, make eye contact, and invite the person to tell their story? If the answer is yes, you’re likely building the kind of rapport that makes health history meaningful—not just for exams, but for real-life care. And isn’t that what good nursing is all about?