OET NURSING WRITING

Referral letter: structure, example and pitfalls

Turning case notes into a letter the reader can act on.

  • Purpose first, then only what this reader needs
  • A fictional case with a model letter
  • Five pitfalls that cost marks

OET is a trademark of Cambridge Boxhill Language Assessment. examplat is an independent practice service and is not affiliated with, endorsed by or connected to the test provider. Case notes, role-plays and questions are fictional and written by examplat. AI feedback is a practice estimate, not a test result.

A four-part shape

  • Purpose: who the patient is and what you ask
  • Background: only history that affects the request
  • Current state: condition, care and medicines now
  • Request: what to do, when, and who to contact

The notes always contain more than the reader needs. Decide the request first, then keep each fact only if it helps the reader act on that request. Write complete sentences; do not copy note form.

Example case (fictional)

This case was written by examplat. Read the notes and decide what the district nurse needs before you look at the model letter.

Emergency department · Patient: Mr Harold Winterbourne, 81
To: Mr Yusuf Bello, District Nurse

Patient details
  • Mr Harold Winterbourne, 81, DOB 07/02/1945
  • Retired postman
Social background
  • Lives with wife Edna, bungalow
  • Wife has arthritis in hands, cannot manage dressings
  • Loves gardening
  • Daughter Janet lives nearby
Medical history
  • Hernia repair 1999
  • Cataracts
  • Fragile skin, bruises easily
Presentation
  • 26/05/2026: caught L shin on coffee table at home
  • 4 cm pre-tibial skin tear with flap, bleeding controlled
  • Tetanus booster 2021 (up to date)
Medications
  • Aspirin 75 mg od
  • Amlodipine 5 mg od
  • Emollient daily to legs
  • Paracetamol 1 g prn for pain
Treatment
  • Flap repositioned, silicone non-adherent dressing, tubular bandage (no tape)
  • Arrow drawn on dressing = direction of removal
  • Leg elevated; no sign of infection
  • Pain 2/10
Plan
  • Leave dressing 5 days; first change 31/05/2026
  • Peel dressing back in direction of arrow
  • Tape never on skin
  • Report: pus, spreading redness, heat, fever, flap turning dark
Task. Using the information in the case notes, write a referral letter to Mr Yusuf Bello, District Nurse, asking him to manage Mr Winterbourne's skin tear dressings at home. Address the letter to Mr Bello at the Saltmarsh Community Nursing Team. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180–200 words.

Model letter

A solid letter for this case, written by examplat. It is one good answer, not the only one.

Dear Mr Bello, Re: Mr Harold Winterbourne, DOB 07/02/1945 I am writing to ask you to visit Mr Winterbourne, aged 81, on 31/05/2026 to change the dressing on a skin tear on his left shin and to continue its care. His wife has arthritis in her hands and cannot manage dressings. On 26/05/2026 Mr Winterbourne caught his left shin on a coffee table at home and sustained a 4 cm pre-tibial skin tear with a flap. We controlled the bleeding, repositioned the flap and applied a silicone non-adherent dressing with a tubular bandage. We did not use tape because his skin is fragile. An arrow on the dressing shows the direction of removal, so please peel it back along the arrow. The dressing should stay in place for five days. Mr Winterbourne bruises easily and takes aspirin 75 mg once daily. He has mild pain, which he controls with paracetamol 1 g when needed. His leg was elevated and showed no sign of infection when he left the department. His tetanus booster in 2021 is up to date. Please contact the department if you notice pus, spreading redness, heat, fever or a flap turning dark. Thank you for your help. Yours sincerely, Emergency Department Nurse Saltmarsh Hospital

The request is clear at the start. The letter then explains the injury, the dressing method and why tape is avoided, with the warning signs at the end, and leaves out unrelated history.

What this letter leaves out

  • Hernia repair 1999: Old surgery not connected to the skin tear.
  • Retired postman: Past work is not relevant to the wound care.
  • Loves gardening: A hobby that does not help the dressing plan.
  • History of cataracts: An eye condition unrelated to the leg wound.
  • Bleeding controlled: A detail of the acute treatment that is no longer relevant for community follow-up.

Five common pitfalls

  • Starting with social history and stating the request only at the end.
  • Copying every observation and test result line by line.
  • Using abbreviations such as qds or c/o in a letter, or medical terms in a letter to a relative.
  • Copying a dose, date or name wrongly from the notes.
  • Leaving out a current risk, such as a recent fall or a new medicine, that the reader must know.

Feedback on your own letter

  • Missed, unnecessary and wrongly copied information, listed
  • Notes on purpose, conciseness, tone, layout and language
  • An improved version and the model letter

The AI checks your letter against the case's own list of information to include and leave out, so the content check does not depend on a guess. Feedback takes about a minute and is a practice estimate, not a test result.

Try the 3-minute Writing CheckGet feedback on a letter

FAQ

How long should the letter be?

Aim for a body of about 180 to 200 words. A letter that is much longer usually contains information the reader does not need.

Do I need to include every medicine?

Include the medicines that matter for the request and any changes. A complete list copied from the notes often makes the letter harder to use.

Heading to the US instead? NCLEX-RN practice

OET is a trademark of Cambridge Boxhill Language Assessment. examplat is an independent practice service and is not affiliated with, endorsed by or connected to the test provider. Case notes, role-plays and questions are fictional and written by examplat. AI feedback is a practice estimate, not a test result. Written by examplat and checked against public guidance (NHS, NICE, BNF).