“I want to be independent” can mean several things after a hip fracture. One person is frightened of falling again. Another dislikes calling a busy nurse. A third is thinking about the only toilet being upstairs at home. The condition is the same, but the useful conversation changes. This OET nursing hip-fracture role-play teaches you to notice that difference and respond to the concern the patient actually gives you.
The lesson draws on the instructions and hip-fracture cases C05, I05 and M02 in Jobins Training’s OET Speaking Nursing Role-Play Cards, linked to OET Speaking for Nurses — Course 37. The course includes reassurance without guarantees, asking for assistance and home stairs. The source provides nurse cards. The paired cards, patient details, condition explanation and extended nurse model below are original teaching material developed for this article, not an official examination script.
1. Your hip-fracture role-play cards
Nurse role card
Setting: An orthopaedic rehabilitation ward.
Situation: Jamie Collins, 73, is recovering after surgery for a hip fracture. The team has documented an individual mobility plan with the physiotherapist. It currently requires assistance before getting up. Jamie has a call bell and is reluctant to take part in the planned mobility session. The operation type, weight-bearing instructions, medicine chart and discharge date are not supplied. Explore Jamie’s concern, check pain or new symptoms, and work within the documented plan.
Your five tasks:
- Introduce the purpose of the conversation, check current comfort and invite Jamie to explain the reluctance about the session.
- Explore the particular concern, previous experience and what being independent means to Jamie; summarise without labelling the person uncooperative.
- Explain the purpose of individually assessed rehabilitation and assistance, using the supplied plan without inventing movement restrictions or guaranteeing recovery.
- Agree a practical next step with Jamie and the physiotherapist, checking any clinical concern or unclear instruction with the team before activity.
- Check how Jamie will request help before getting up, explain when to report new symptoms, and invite any remaining question about recovery or home arrangements.
Patient role card
You are: Jamie Collins, 73. You had hip-fracture surgery and are on the rehabilitation ward. Before the injury, managing your morning wash and breakfast yourself mattered to you. You understand that the current plan says to ask for assistance. You are not trying to reject all rehabilitation.
Your five tasks:
- Begin with “I do not think I am ready for the session.” If asked about pain, say the hip aches when you move, but it has not suddenly become worse. Report no new dizziness, breathlessness or other new symptom in this attempt.
- Explain that you are afraid your leg will give way. The fall happened unexpectedly, and remembering it makes you hesitate. You have not fallen again on the ward.
- When asked about independence, explain that washing and getting breakfast without having to ask someone for every small thing are your priorities. Ask, “Will I definitely get back to doing all that?”
- Ask whether accepting help now means you will always depend on someone. Be willing to discuss the first assessed step with the physiotherapist, but do not immediately agree to an unspecified walking distance.
- Say that you can reach and use the call bell. Explain that you will ask for assistance before getting up and report a new or worsening problem. Ask what will happen if the planned activity feels too difficult.
Practice method: Allow three minutes to prepare and aim for an approximately five-minute conversation. The patient should reveal the personal concern when invited, rather than read out every cue at the start. Practise the words while seated; no standing, stair climbing or physical assistance is needed for this exercise. Study the extended model afterwards and select the language that fits your partner’s responses.
2. Understand hip-fracture recovery before reassuring the patient
What does “hip fracture” mean?
A hip fracture is a break near the top of the thigh bone. It is a serious injury, commonly following a fall in an older person. Treatment usually involves an operation, but the procedure depends on the injury and the person. Repair with metalwork and replacement of part or all of the hip joint are different possibilities. “Hip-fracture surgery” does not tell you which operation Jamie had.
This matters when you speak. Do not say “your new hip” if replacement is not stated. Do not borrow precautions from a different hip-operation leaflet and present them as Jamie’s instructions. A sound explanation starts with the known fact: surgery has taken place and there is an individual rehabilitation plan.
What is rehabilitation trying to achieve?
Rehabilitation supports recovery of movement and everyday function. The team considers what the person can do now and which activities matter to them. Getting between a bed and chair, walking with appropriate support, dressing and preparing a drink can involve different skills. Progress is assessed rather than measured only by how far someone walks.
For this speaking case, connect the explanation to Jamie’s morning routine: “You have said that washing and making breakfast matter to you. Those are useful goals to discuss with the team.” That sentence uses the patient’s priority. It does not claim that either activity is already safe or that the team has agreed a particular programme.
Why does the current assistance instruction matter?
The card explicitly says that Jamie needs assistance before getting up. Preserve that instruction even when Jamie feels more confident. Motivation, confidence and physical readiness are related, but one does not prove the others. A patient saying “I feel fine now” is a reason to listen and reassess as appropriate, not permission to rewrite the plan.
Weight bearing describes how much weight a person is allowed to put through the affected leg. The treating team determines the relevant instruction. Because this card does not give it, the learner should say it needs checking. Do not fill the gap with “put all your weight through it”, “keep the foot off the floor” or a remembered percentage.
How should pain influence the conversation?
Ask about pain now, what happens with movement and whether it has changed. Pain may make a person reluctant to participate, but reluctance may also arise from fear, dizziness, embarrassment or a practical concern. A pain score alone does not explain the whole problem.
Before a session, the nurse can review the person’s comfort and the prescribed pain-management arrangements with the team. This article does not supply a medicine, dose or timing instruction. “Let us review how your pain is being managed before the session” stays within the scenario. “I will give you a stronger tablet now” adds a treatment decision that the card does not support.
What can you honestly say about recovery?
Recovery commonly takes weeks or months and varies between people. Some people continue to need walking aids or help with daily activities. The patient’s earlier abilities, health, injury and progress all contribute to planning. Avoid converting a general recovery range into Jamie’s personal deadline.
Honest reassurance can still offer direction: “I cannot promise exactly how much you will regain, but we can work towards the activities that matter to you and review your progress.” Follow it with a real next step in the case. Otherwise, the sentence may sound sympathetic while leaving the patient unsure what happens today.
Who helps with daily activities and the home environment?
Physiotherapy addresses movement and mobility. Occupational therapy can assess daily activities and how the home environment affects them. The team may consider equipment, further rehabilitation or support according to assessed needs and the services available. A possible option is different from a confirmed arrangement.
If the concern becomes stairs, useful facts include steps at the entrance, whether there is a rail, where the bedroom and toilet are, and what help is actually available. Do not assume that a relative living nearby can provide care. Ask what that person can do and whether the patient wants them involved.
Which new symptoms change the priority?
A sudden marked increase in pain, new calf pain or swelling, new numbness, wound discharge, fever or feeling unwell should be reported promptly for clinical assessment. New chest pain or sudden breathlessness needs emergency attention. On this ward, the nurse should summon the appropriate help immediately rather than continue a routine practice discussion. These symptoms do not establish a diagnosis by themselves.
The communication lesson is to respond to new information. If the patient describes feeling faint, do not continue encouraging them to stand simply to complete the role-card tasks. Attend to the immediate concern, obtain help as needed and explain why the planned activity must wait for assessment. The source’s individual plan is a boundary for the conversation, not a script to follow regardless of what happens.
3. Work through the five tasks without losing the patient’s concern
Task 1: invite the reason before supplying one
Begin with an open question: “What is making you feel unsure about the session?” Then allow enough silence for the answer. “You are worried about the pain, are you?” suggests a reason before you have heard it. Jamie may agree politely even though falling again is the stronger fear.
A brief comfort check belongs early in the conversation. You can ask, “How is your hip feeling now, and has anything changed?” Follow the response rather than running through unrelated questions. If there is an immediate clinical concern, address that before a long explanation of rehabilitation.
Task 2: make “independence” specific
Ask, “Which things would you most like to manage for yourself?” Jamie names washing and breakfast. You can then reflect the meaning: “Being able to start your morning in your own way matters to you.” That is more useful than repeating the broad word “independence” several times.
Explore the fear gently: “When you imagine getting up, what do you think might happen?” Do not tell Jamie that another fall is impossible. Acknowledge the previous experience and explain how assessment and appropriate assistance are intended to support safer movement. Avoid suggesting that all risk can be removed.
Task 3: explain the plan in small, accurate sections
Start with the purpose, then the current boundary. For example: “The team will work out the activity and support appropriate for you. Your current plan says to have assistance before getting up.” Stop and ask which part Jamie would like clarified. This gives the patient room to ask whether needing help now predicts permanent dependence.
Do not turn the condition lesson into a spoken lecture. The learner needs background knowledge to choose an explanation; the patient does not need every surgical option listed during this conversation. An accurate short explanation followed by a relevant question often does more than a long display of terminology.
Task 4: negotiate a next step the patient can recognise
“We will take it slowly” sounds kind but leaves the action unclear. Offer a specific discussion: “Would you be willing to talk through the first planned step with the physiotherapist, after we review your comfort?” Jamie can agree, ask for more information or explain a remaining concern.
Do not invent a booking time or announce that an unconfirmed referral has happened. The session is planned in this card, but its exact activity and timing are not given. A useful commitment is to share Jamie’s stated concern with the team and clarify the plan. Say what you intend to do rather than describe it as already completed.
Task 5: check understanding in the patient’s own words
Ask, “Before you next get up, what will you do?” This checks the important instruction more clearly than “You understand, right?” Also ask whether Jamie can reach and use the call bell. Knowing the rule is not sufficient if the practical means of following it is unavailable.
Invite a remaining concern at the end. If Jamie mentions stairs only then, acknowledge it and identify what needs checking. Do not squeeze a promise about discharge into the closing seconds. A concise summary can preserve both priorities: today’s assisted plan and the home-layout question for the rehabilitation team.
4. Extended nurse-viewpoint model answer
This is a study model for the first attempt, in which fear of falling is the main concern. The pauses show where the patient would respond. The nurse’s later sentences assume the information on the patient card has been disclosed. Change them when your partner gives a different answer; do not recite all the paragraphs in one uninterrupted speech.
“Hello, Jamie. I am the nurse looking after you. I understand that you are feeling unsure about the planned session with the physiotherapist. Would it be all right if we talk about what is worrying you before the session?” [Pause for permission.]
“First, how is your hip feeling at the moment? Have you noticed any new pain or anything else that feels different today?” [Pause and clarify any change.]
“So it aches when you move, but you have not noticed a sudden worsening or a new symptom. I will keep your comfort in mind as we discuss the session. What is making you feel that you are not ready?” [Listen.]
“You are worried that your leg could give way and you could fall again. After such an unexpected fall, I can understand why the thought of getting up feels frightening.” [Allow time for a response.]
“When that worry comes into your mind, is it mainly about the first moment of standing, or is there another part of moving around that concerns you most?” [Pause.]
“Thank you for explaining. You are thinking about losing your balance before you feel steady. Have you had a particular difficulty during a session here, or is the memory of the original fall the main thing on your mind?” [Listen without assuming a second fall occurred.]
“It sounds as though the memory of that fall is still very strong. I do not want to brush that aside by simply telling you to be confident. Let us make sure the physiotherapist knows exactly what is worrying you.”
“You also mentioned wanting to be independent. Which everyday things would you most like to manage for yourself?” [Pause.]
“Washing and getting your breakfast are important to you. Being able to start the day without asking for every small thing would make a real difference. Have I understood that correctly?” [Check the summary.]
“Those are useful goals for the team to know. Rehabilitation is about working on movement and the everyday activities that matter to you. We can use your priorities when discussing the plan, rather than treating the session as a distance you have to walk.”
“Your current plan says that you need assistance before getting up. Please keep asking for that help. Feeling more determined is valuable, but the team still needs to assess the support you require.”
“I would also want to confirm the instructions about putting weight through your leg and any relevant precautions in your record. I do not want to give you a general instruction that might not match your operation and current plan.” [Pause for questions.]
“You are asking whether accepting help now means you will always need it. Needing assistance at this stage does not, by itself, tell us what your abilities will be later. The team will review how you are progressing and adjust the plan when appropriate.”
“I cannot promise that you will return to every activity exactly as before, or give you a reliable date today. What we can do is keep your goals in view, work within your assessed plan and review what is helping and what remains difficult.” [Allow Jamie to respond.]
“How does that sound to you? Is there something in what I have said that still feels uncertain or worrying?” [Listen before moving on.]
“You would feel more comfortable knowing what the first step involves, rather than being expected to start before you understand it. That is something we can discuss with the physiotherapist.”
“Before the session, let us also review how your pain is being managed. I can check the prescribed arrangements with the team and explain what is agreed. You do not need to hide discomfort in order to show that you are trying.”
“Would you be willing to talk through the first planned activity with the physiotherapist, including the assistance you will have and how you can tell them if something feels wrong?” [Pause for a genuine choice.]
“Thank you. I will share that your main worry is your leg giving way and that washing and breakfast are the goals you want to work towards. We can clarify the activity before you decide about taking part.”
“If it feels too difficult, please say so. The team can assess what is happening and review the activity or support. You do not have to keep going silently, and we should not assume that new symptoms are just anxiety.”
“For now, can you comfortably reach and use your call bell?” [Check the practical answer rather than assume.]
“That is helpful to know. Before you next get up, could you tell me what you will do, so I can check that I have explained the current instruction clearly?” [Listen to Jamie describe asking for assistance.]
“Yes, ask for assistance before getting up and wait for the appropriate help. If you cannot get the help you need, let staff know rather than deciding you must manage alone.”
“Please also tell us promptly if you develop a new or worsening problem, such as a marked increase in pain, new calf swelling or numbness, or if you feel unwell. Sudden breathlessness or chest pain needs immediate help. We would assess a new concern before continuing the activity.”
“Is there anything about going home or your daily routine that you would like the team to know as we plan with you?” [Pause; a new answer may change the next question.]
“For today, we have agreed to review your comfort, discuss the first planned step and the support with the physiotherapist, and keep asking for assistance before getting up. I will pass on the goals and concerns you have described. What would you like me to clarify before I do that?”
5. Speaking tips: recognise when the conversation has changed
Listen for the noun after the worry. “I am worried about falling”, “I am worried about bothering staff” and “I am worried about the stairs” need different follow-up questions. Do not respond only to the repeated word “worried”. Name the specific concern in your summary so the patient can correct you.
Keep certainty proportionate. Use clear language for the supplied instruction: “Please ask for assistance before getting up.” Use qualified language for outcomes: “Your progress will need review.” Making every sentence vague weakens the plan; making every sentence certain invents an outcome.
Separate agreement from politeness. A patient may say “All right” because they want the conversation to end. Ask what the agreed step will involve and whether anything still makes it difficult. Give them room to disagree without making them feel they have failed the interaction.
Use pauses after meaning, not after every word. Try: “You want to manage your morning routine again. [Pause.] Let us make that goal clear to the team.” The pause gives the patient a chance to confirm the priority. It also helps you avoid rushing from empathy into advice.
Show adaptation with an observable action. After the patient mentions stairs, ask about the home layout. After the patient mentions delayed help, ask what happened when they called. Your partner should be able to identify the sentence that changed because of their answer.
6. Useful sentences for different concerns
- Open exploration: “What is making this step feel difficult for you?”
- Fear of another fall: “Which part of getting up feels most worrying?”
- Personal priorities: “What would being more independent allow you to do?”
- Help-seeking barrier: “What happens when you need assistance on the ward?”
- Home layout: “Where are the rooms you need to use each day?”
- Accurate reassurance: “I cannot promise the outcome, but I can help make sure this concern is considered in your plan.”
- Preserving the instruction: “The current plan still requires assistance before you get up.”
- Checking a gap: “I need to confirm that instruction in your individual plan.”
- Shared next step: “Would you be comfortable discussing that option with the physiotherapist?”
- Teach-back: “What will you do before you next get up?”
Practise choosing two or three sentences for each concern. Do not learn the list as a sequence. A follow-up question earns its place because it helps you understand the answer you just heard.
7. Common mistakes and repairs
“You will definitely walk normally again.” This promises an individual outcome. Try: “Recovery varies. We can work towards your goals and review your progress with the team.”
“If you want independence, you need to get up by yourself.” This contradicts the assisted plan. Try: “Working towards independence can include using the assistance appropriate for you now.”
“There is nothing to be frightened of.” This dismisses the experience of falling. Try: “What happened has affected your confidence. Which part of the next step feels most worrying?”
“Your family can help you on the stairs.” This assumes willingness, ability and safety. Try: “Who, if anyone, is available to help, and what could they realistically manage? We need to discuss the stairs with the team.”
“Just ring again if nobody comes.” This may leave an access problem unresolved. Try: “Tell me what happened when you asked for help. Let us check how your needs can be met safely while the assisted plan remains in place.”
“The physiotherapist has arranged everything for your discharge.” This invents a completed plan. Try: “I can pass on this concern and check what assessment and arrangements are still needed.”
8. Second attempt: the same injury, a different concern
Keep the setting, surgery and assisted mobility instruction unchanged. This time, Jamie says: “I am happy to do the session. My worry is home. The bedroom and the only toilet are upstairs, and I live alone.” There is no new acute symptom. Do not repeat the model’s explanation of fear about the original fall.
In your next attempt, acknowledge the changed priority, ask three relevant questions and propose an assessment-based next step. Preserve the current ward instruction. Avoid promising a stairlift, a downstairs toilet, a care package or a discharge date.
Open a suggested response and explanation
“Thank you for explaining. You feel ready to discuss the session, but you are worried about managing the stairs when you go home, especially because you live alone. Could you tell me about the stairs and whether there is a handrail? Are there steps to get into the house as well? Is there anyone you would want involved in discussing support, and what help could they actually offer?” [Listen to each answer.]
“Those details are important for planning. I would like to share them with the rehabilitation team so they can assess your mobility and the practical demands at home, including whether stair practice, equipment or another arrangement needs considering. I cannot tell you today which option will be suitable or confirm a discharge date. We can clarify what assessment is needed and involve you in that discussion.”
“Here on the ward, your current plan still says to ask for assistance before getting up. Before we finish, is there another part of living alone that you are concerned about, such as washing or preparing food?”
Why this works: The nurse accepts that the session itself is no longer the main barrier. The questions gather information relevant to home access and support. The explanation identifies a team assessment without claiming it has already happened. The current assistance instruction remains accurate even though the patient’s confidence has changed.
A third variation: Jamie says, “It is not the stairs. I hate bothering people to help me to the toilet.” Ask whether this is embarrassment, concern about staff workload, an experience of delayed help or another difficulty. Do not assume. A useful opening is: “You need help, but asking feels uncomfortable. Can you tell me what makes it difficult?” Agree a practical way to request assistance with the ward team; do not authorise independent walking to solve the discomfort.
Review your recording: Identify the patient’s actual concern, your first relevant follow-up, the supplied fact you preserved and the next step you agreed. If your response would sound identical for fear of falling, embarrassment about help and an upstairs toilet, repeat the attempt with a more specific question.
Continue with OET Speaking for Nurses — Course 37 and the matched OET Speaking Nursing Role-Play Cards pack. Compare the guided, independent and mock hip-fracture concerns after you have attempted them. The aim is to keep the clinical facts accurate while allowing the patient’s answer to shape the conversation.
Clinical reading for this teaching example
The source cards provide the communication setting, not a treatment protocol. Background checks included the NHS broken-hip overview, reviewed in July 2026; Gloucestershire Hospitals’ rehabilitation information; Hull’s individual mobility and daily-activity guidance; Gateshead’s rehabilitation and warning-sign information; and the NHS explanation of DVT warning signs. Exercise doses, local service arrangements and general recovery timetables from those pages are not prescriptions for Jamie.
Your next step
OET Speaking for Nurses — Course 37
Explore the complete course outline and related practice topics.
Source: OET Speaking Nursing Role-Play Cards.pdf, Jobins Training. Examples labelled original or illustrative were written for this article. Independent exam preparation; no affiliation with or endorsement by the examining body. Practice does not predict an official score.