Contributors – Mary Jo Gamper, MSN, RN, CPNP

You are conducting a qualitative interview with a caregiver. As they begin to describe a difficult experience, emotion rises in the room. Instinctively, you feel the pull to respond…to comfort, to affirm, to guide, to help. These are the reflexes of a nurse. In that moment, you pause. You are not in a clinical encounter. You are in a qualitative research interview, and the purpose is different.

Nurses are highly skilled interviewers. In clinical practice, we are trained to ask focused questions, hold space for emotion, guide conversations toward interventions. Yet qualitative research interviewing requires a fundamentally different mindset. The goal of clinical interviewing is to inform care decisions within a therapeutic relationship. The goal of qualitative interviewing is to understand and interpret human experiences. Recognizing this distinction requires nurses to learn not how to ask questions, but how to ask different kinds of questions. Not… “What is the problem?” but instead… “What does your experience with this problem mean to you?” The discomfort many nurse researchers experience when withholding therapeutic responses during qualitative interviews reflects a tension between the relational foundation of nursing practice and the norms of qualitative inquiry.

Carper’s (1978) Fundamental Patterns of Knowing in Nursing provides a useful lense for understanding the distinctions explored in this article. Both clinical and qualitative interviews draw upon empirical, esthetical, personal, and ethical knowing, yet the purpose of encounter influences how these ways of knowing are expressed in practice. The nurse brings the same disciplinary ways of knowing to both encounters, but will approach questioning, listening, interpretation, and responses differently depending on whether the goal is direct patient care or knowledge generation.

Clinical Interviewing in Nursing Practice

Clinical interviewing is central to nursing practice. Whether conducted by a registered nurse or nurse practitioner, these conversations are purposeful, problem-focused, and oriented toward safety and care decisions. Nurses ask questions to assess symptoms, clarify timelines, identify risks, and determine next steps. The process is guided by clinical reasoning, which is gathering information, narrowing possibilities, interpreting findings, and moving toward action.

Importantly, clinical interviewing occurs within a therapeutic relationship. Patients and families share information with the expectation that the nurse will respond through validation, education, reassurance, and intervention as needed. Relational engagement is not incidental, it is integral to the work. When someone shares something painful or deeply personal, nurses are trained to respond in ways that affirm, support, and guide. Clinical interviewing rewards direction and efficiency. Silence may feel uncomfortable or unproductive, and tangents are redirected. The endpoint is clear, which is, a plan that supports the patient’s immediate needs.

Qualitative Interviewing in Nursing Research

Qualitative research interviews operate within a different set of expectations. The purpose is not to assess or intervene, but to explore and interpret lived experiences while minimizing the researcher’s assumptions and biases (Creswell, 2018). Rather than narrowing possibilities, qualitative interviewing intentionally expands them. The questions are often open-ended and participant-led. The interviewer practices intentional restraint in responses, avoiding language that affirms, leads, redirects, educates, or shapes the participant’s answers. Silence becomes meaningful space for reflection and data generation rather than something to be filled.

Qualitative interviews also require rapport and trust, but the nature of the relationship shifts. In clinical care, relational engagement supports assessment and intervention. In qualitative research, relational presence supports expression and interpretation without directing the experience. The researcher’s role is not to guide care or resolve concerns, but to create space for participants to describe and make meaning of their experiences in their own terms.

The Hardest Shift for Clinical Researchers

For nurses who become researchers, this transition can feel uncomfortable and may not be intuitive. The instinct to comfort, respond, affirm, support, explain, fix, and interpret is deeply embedded in nursing practice. Withholding those responses during a qualitative interview can feel, at times, like a departure from our professional identity. This discomfort reflects a deeper tension between the relational foundations of nursing practice and the methodological discipline of qualitative inquiry.

Nurses are taught to respond, to meet emotion with connection, to reduce uncertainty, to guide. Qualitative interviewing, in contrast, asks us to remain present without directing, to listen without resolving, and to allow meaning to emerge without shaping it (Berger, 2015). This may require what can be described as relational restraint, or the intentional decision to remain engaged and attentive while refraining from responses that could influence the participant’s narrative. The challenge for nurse researchers is not to become less relational, but to become relational in a different way.

Responding in Context

The difference between clinical and qualitative interviewing often becomes most visible in moments of response. The same participant statement may invite a supportive, problem-solving response in clinical care, and a more exploratory, meaning-making response in qualitative research (Kvale & Brinkmann, 2009). These differences are not about right or wrong responses, but about aligning the response with the purpose of the interaction.

Implications for Nursing Knowledge

This distinction highlights two complementary ways nurses generate and use knowledge. Clinical interviewing is oriented toward assessment and decision-making within a therapeutic relationship, where information is used to guide immediate care. Qualitative research interviewing, in contrast, is oriented toward exploring and interpreting human experiences to contribute to disciplinary knowledge (Carper, 1978). Although both forms of interviewing rely on trust and skilled listening, they differ in purpose and responsibility. Recognizing this distinction can help nurses who move between clinical practice and research more intentionally align their interviewing approach with the goals of the encounter. This is not a departure from nursing care, but a different expression of the same nursing ways of knowing.

References

Berger, R. (2015). Now I see it, now I don’t: researcher’s position and reflexivity in qualitative research. Qualitative Research, 15(2), 219-234. https://doi.org/10.1177/1468794112468475

Carper, B. A. (1978). Fundamental Patterns of Knowing in Nursing. Advances in Nursing Science, 1(1), 13-24. https://journals.lww.com/advancesinnursingscience/fulltext/1978/10000/fundamental_patterns_of_knowing_in_nursing.4.aspx

Creswell, J. W., & Poth, C. N. (2018). Qualitative inquity and research design: Choosing among five approaches (4th ed.). SAGE Publications.

Kvale, S., & Brinkmann, S. (2009). InterViews: Learning the craft of qualitative research interviewing, 2nd ed. Sage Publications, Inc.

About the Contributor

Mary Jo Gamper is a pediatric nurse practitioner and PhD candidate at the Johns Hopkins School of Nursing whose research focuses on improving the quality, safety, and equity of electronic communication in healthcare.

Acknowledgement: I am deeply grateful to Dr. Kathryn Ruble for her thoughtful mentorship, encouragement, and valuable feedback during the development of this blog.