Problem: tense errors in nursing letters are patient-safety errors on paper — “wound infected” vs “wound was infected” changes whether the GP acts today. Answer in brief: choose tenses from the actual timeline (history-past, today-present/perfect, plan-future), and use passive voice only where the agent truly does not matter. This guide teaches timeline tense choice with a worked post-surgical discharge, and OET Writing for Nurses — Course 3 trains tenses, passive and discharge writing across 21 topic sections.
Tenses from the timeline, not from habit
Three zones, three tenses. History (past simple): “She underwent a right hemicolectomy on 12 May.” Finished events stay past. Today (present simple / present perfect): “She is afebrile” for current state; “Her appetite has improved” for change reaching into now. Plan (future / modal): “She will attend clinic in two weeks”; “Please monitor…”. Most tense errors come from writing the whole letter in one favourite tense — usually past — which buries today’s findings and tomorrow’s actions in yesterday.
Passive voice without losing meaning
Passive suits processes (“The wound was closed with clips”) and unknowns (“She was found confused”). It harms when it hides responsibility: “Mistakes were made” has no place in handover; “The drain was removed on day three” is fine only with a date. Rule: passive for how-things-were-done, active for who-must-do-what (“Please review…”, “I have arranged…”). If a passive sentence cannot name its agent on demand, rewrite it active.
Master this on supervised letters? The full OET Writing for Nurses — Course 3 teaches tense choice from real timelines, safe passive use and discharge-after-surgery writing across 21 topic sections with 93 lessons and mock tests. Explore the course →
Worked example: discharge after surgery
Fictional case, newly written: Mr Silva, 61, laparoscopic right hemicolectomy for localised tumour, day 4, fit for discharge; afebrile 48 hours; bowels opened yesterday; wound clean and dry; histology awaited; lives with wife; district nurse to check wound Friday.
Tenses in action: past for the operation and course (“He mobilised on day one; bowels opened yesterday”); present perfect for change-to-now (“His appetite has returned”); present for status (“He is afebrile; the wound is clean and dry”); future/modal for plan (“Histology is awaited and will be forwarded”; “Please review the wound on Friday”). Passive twice, both safe (“was performed”, “was closed”) — agents evident, dates attached. Roughly 180 words; the timeline reads itself.
Five tense and voice mistakes
- Past-tense findings. “She was afebrile” suggests she no longer is. Fix: present for today’s status.
- Agentless passives for actions. “The referral was sent” — by whom, when? Fix: active with date, or add the agent.
- Future history. “She will have undergone surgery” tangles. Fix: past for finished events, always.
- Perfect-for-everything. Present perfect throughout blurs history and today. Fix: reserve it for change reaching now.
- Plan in past tense. “She attended clinic” when she has not. Fix: future/modal for anything not yet done.
FAQs
How much passive is too much?
If over half your verbs are passive, agency is vanishing. Aim for mostly active letters with passive reserved for processes and unknowns — roughly one passive per paragraph at most.
Do I need dates with every past event?
With every clinically load-bearing one: operation dates, symptom onsets, result dates. “Recently” and “a while ago” are not dates.
What is in the course?
Twenty-one topic sections on timeline tense choice, safe passive voice and discharge-after-surgery writing, with 93 lessons and 5 complete mock tests.
The matching course
OET Writing for Nurses — Course 3 makes grammar a safety skill: tenses chosen from real patient timelines, passive voice that never hides responsibility, and discharge-after-surgery letters — 21 topic sections, 93 lessons, 5 mock tests. If tense slips cost your marks, train here.
Sources and note
- OET Writing format per the official OET site: oet.com — Writing. Check current format guidance before the exam.
- Course details verified from its public staging page (read-only): 21 topic sections, 93 lessons, 5 mock tests.
- Case and letter lines are newly written and fictional; other valid structures exist.
Put this into practice
Compare these course outlines and choose the practice that matches your next goal.
