OET Nursing Writing: Select Case Notes for a Clear Discharge Letter

A patient lives alone. Her son lives 45 minutes away. She now needs help with dressing, showering and stairs. You have three facts, but the receiving nurse needs to understand the connection between them: who will provide the help this patient needs after discharge?

If you write only “She has family support”, your sentence sounds reassuring while losing the most useful information. If you write “Home care has been arranged”, you turn a request into a completed action. Both sentences are grammatically possible. Neither accurately represents this case.

This OET Nursing Writing lesson follows an older patient preparing to leave hospital after a fall. You will select information for the receiving nurse, organise it around the patient's ongoing needs and check every claim against the notes. By the end, you will have written a complete letter and revised it when the available support changes.

Start with the person who will read your letter

Before selecting a medical fact, read the writing task. Identify your role, the recipient and the reason for contacting them. For this exercise, you are a ward nurse writing to a senior aged care nurse to request support after discharge. That reader needs enough information to understand and coordinate the requested care.

The task gives you a practical question: What does this nurse need to know to respond to this request? Use that question each time you decide whether a note belongs in the letter. It helps you explain why the patient needs assistance, how much help is already available and which arrangements remain outstanding.

For example, “left wrist fracture” helps explain difficulty with personal care. “Family cannot provide regular care” explains why the request cannot simply be left to relatives. The year osteoporosis was diagnosed is less central to this particular handover than the fact that the patient has osteoporosis and has experienced repeated falls.

Selection is also about the recipient's knowledge. The task does not establish that the receiving nurse already knows the patient. Introduce her clearly. Equally, there is no need to explain the general meaning of osteoporosis to a senior aged care nurse. Use that space to describe this patient's situation.

Know what a good OET Writing response needs to do

OET Writing has six assessment criteria: Purpose, Content, Conciseness & Clarity, Genre & Style, Organisation & Layout, and Language. The questions below are a practical way to review this exercise; they are not an official scoring sheet. [1]

The test allows five minutes of reading time followed by 40 minutes for writing. The suggested length of 180-200 words is a guide; OET does not apply an automatic penalty simply for being above or below that range. Relevant, accurate communication remains essential. [2] [3]

For this lesson, work through the reasoning first. Then attempt a timed letter. Learning to identify the recipient's needs will make your practice more useful than repeatedly counting words while copying the notes.

Case Notes

The following teaching notes are based on Case Note 4 in OET Nurse: High-Level Writing Drills. The date is set to the planned discharge day. Read the full case and writing task before looking at the model. The letter, explanations and later change of circumstances are newly written for this lesson. This is a fictional language-learning exercise, not an official OET test paper.

Pause here. In one sentence, identify the purpose. Then choose the three facts you would least want the receiving nurse to miss. Keep your answers beside you when you review the model.

Select information by explaining why it matters

Highlighting nearly every line gives you little help when drafting. Instead, attach a reason to each selected fact. “I included this because it changes the help the patient needs” is a stronger explanation than “I included this because it was in the notes”.

Omission is a decision about this task, not a declaration that a fact is medically unimportant. A letter requesting an assessment after a prolonged time on the floor might prioritise the four-hour interval differently. Here, the focus is continuing support after the documented inpatient care.

A concise summary can also preserve background without listing every medication. The model identifies hypertension but focuses its medication-related request on adherence monitoring. If a task requires a medication handover or reports a recent change, the drug, dose, frequency and change may become essential. Never invent a missing frequency to make a list look complete.

Notice the strongest social detail: “Her family cannot provide regular care.” This does not mean her family has abandoned her, refuses to help or will never visit. Those are different claims. Preserve the stated limitation and avoid judging the people involved.

Organise the letter around the next stage of care

A useful plan for this case has four parts. The opening identifies the patient, discharge context and request. The second paragraph summarises the injuries, current function and relevant history. The third explains the home situation and outstanding adaptations. The final paragraph specifies the support and follow-up being requested.

This order lets the reader understand the problem before considering the actions. It also brings related information together. The fact that Mrs Fielding lives alone belongs close to the fact that regular family care is unavailable. Home hazards belong close to the recommended adaptations. You do not need to preserve the order in which the notes happen to appear.

Write a short purpose statement during practice: “Request home support for a patient who needs help with personal care and stairs after a fall.” Use it to test each paragraph. A paragraph containing only unrelated background may need to be shortened, moved or removed.

Keep the discharge status precise. The notes say discharge is scheduled and support is required. “Is due to be discharged” preserves that status. “Was discharged” would assert that the event has already happened. The letter should not create certainty that the notes do not provide.

Understand the decisions inside the model

The opening states a request the reader can act on

“I am writing to request home support” establishes the purpose immediately. The next sentence makes the support concrete and identifies the family-care limitation. Compare this with “I am writing regarding Mrs Fielding”. That phrase identifies a topic, but the reader must continue searching to learn what you want.

The model does not use “urgent” automatically. The timing of discharge matters, and the closing asks for confirmation of arrangements. However, the supplied task does not label this an emergency. Choose urgency from the notes and task rather than adding it as a persuasive word.

The clinical paragraph connects history with present function

The paragraph moves from the fall and injuries to what Mrs Fielding can currently do. It preserves “short distances”, “with a frame” and the need for assistance. These qualifiers prevent “mobilising” from becoming an inaccurate claim of independent mobility.

It also includes fear of falling because mood is part of the requested monitoring. A relevant emotional detail can support the purpose just as directly as a physical finding. There is no need to label her “depressed”: the notes do not establish that diagnosis.

The social paragraph preserves the care gap

The model keeps living arrangements and home hazards together. It does not describe the house as suitable simply because an assessment took place. An assessment can identify a problem while the work needed to address it remains outstanding.

“Their installation has not yet been confirmed” is deliberately cautious. It does not assert that installation definitely has not happened. This distinction matters whenever the available record is incomplete. If the notes explicitly said “not installed”, you could state that more directly.

The closing expands the opening purpose

The requested actions are specific: help with daily activities, weekly nursing monitoring and follow-up of outstanding care arrangements. “Please provide all necessary care” would make the reader infer those responsibilities. Naming them makes the handover more useful.

The letter asks the receiving service to help confirm arrangements. It does not claim that a visit has been booked, that the falls programme has accepted the patient or that therapy appointments are scheduled. The writer remains responsible for the factual status of each sentence, including polite closing sentences.

Edit language that changes the meaning

Some of the most important edits involve one verb or one qualifier. Before improving sentence variety, check that your wording preserves what happened, what is true now and what still needs to happen.

Useful verbs have different jobs. Recommended reports advice. Requested reports a request. Referred reports that a referral was made. Scheduled reports an arranged time. Completed reports that an action has happened. These words are not interchangeable ways of making a sentence sound more formal.

Use active voice when the responsible person matters: “Her son can assist with meals.” Use passive voice when the action matters more than the actor: “Bathroom aids have been recommended.” Neither pattern is automatically better. Choose the form that makes the relevant information clear.

Also check your connecting words. “Her son lives 45 minutes away; therefore, he cannot help” invents a causal explanation. Distance may affect availability, but the case separately states the actual limit. You can report both facts without claiming that one proves the other.

Try again when the available support changes

Close the model and write your own letter from the original case. Then use the following new fictional information for a second attempt. These changes are part of this exercise, not additional facts from the book.

Spend about ten minutes on this revision. Underline each sentence that must change. If your new version is almost identical to your first attempt, check whether you have actually used the new information.

The temporary stay changes the description of support. It does not remove the need for personal care assistance, make the stairs safe or establish that the recommended equipment is installed. The planned review before Paul leaves is a request arising from the stated time limit; it must not be described as an appointment already booked.

There is more than one acceptable way to organise this revision. Judge your version by whether the recipient can identify what Paul can do, what he cannot do and how long he will remain. Those three distinctions are more useful than copying the suggested wording.

Use a repeatable practice and review routine

For your next full timed attempt, use the five reading minutes to identify the recipient, purpose, current needs and outstanding actions. Plan mentally during the reading period and follow the test instructions about when writing may begin. Once writing starts, a practical 40-minute practice split is five minutes to organise, 30 minutes to draft and five minutes to review. This split is a study suggestion, not an official requirement. [2]

During your review, compare every statement about support or follow-up with the notes. Circle words such as “independent”, “arranged”, “confirmed”, “completed” and “urgent”. Ask whether the evidence supports each one. Then check names, dates, laterality, grammar and spelling.

Use this final check:

• My opening tells this recipient why I am writing.
• I have included the current assistance needs and the limits of available help.
• I have kept planned, requested and completed actions distinct.
• My paragraphs group information the reader needs together.
• I have checked every clinical and social claim against the case notes.
• My closing specifies the next actions without inventing arrangements.

Record one factual error and one language issue after each attempt. For example: “I changed a recommendation into a booking” and “I omitted articles before singular countable nouns.” Correct those sentences, then test the same skills on a different case. A useful review should change what you do next time.

Common questions about selecting OET Nursing case notes

Should I include every medical condition?

Decide from the recipient and purpose. Include conditions that help explain the current situation or continuing care. Summarise relevant background efficiently. Do not remove an essential condition merely to shorten the letter, and do not list a remote detail solely because it appears in the notes.

Can I use a memorised opening?

A simple phrase such as “I am writing to request” can be useful. The information that follows must be specific to this task. Check whether the opening names the correct action, patient and reason. A fluent sentence that could introduce any patient is unlikely to do enough work.

Does the model have to be exactly 200 words?

No. Treat the suggested range as a guide. First check whether the reader has the necessary information. Then remove repetition and low-value wording. Adding filler to reach a number or deleting the care gap to reduce it would weaken this particular letter. [3]

Can I add a sensible clinical recommendation?

This exercise asks you to communicate from the supplied case. Do not add a new diagnosis, treatment, medication dose or confirmed appointment. You can phrase the requested support clearly, but clinical plausibility alone does not make an invented fact part of the task.

Source: OET NUR WR 03.epub, 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.