The candidate card
Setting
Aged care facility
Candidate
You are the registered nurse in charge at an aged care facility. Mr Ramil Reyes, aged 55, is the son and nominated family representative of an 86-year-old resident with moderate Alzheimer's dementia. At about 2 am she became very distressed, tried to leave the building and struck a carer. For over an hour the night staff tried a quiet room, calm reassurance, walking with her, offering a drink and a snack, and taking her to the toilet. At about 3.15 am the night nurse gave one dose of an as-needed (PRN) antipsychotic medicine charted by her GP, then recorded her observations through the night, but did not contact the family. When you assessed her an hour ago, she woke when spoken to and answered simply, her breathing was normal and her observations were within her usual range, but she was drowsier and more confused than usual. You have asked the GP to see her today and have started regular observations, a food and fluid chart and supervision whenever she walks. Her records contain an admission consent form signed by Mr Reyes, but you cannot yet tell whether it covers this medicine, whether her own ability to make this decision was assessed, or who is legally authorised to consent for her. Mr Reyes has just found her drowsy and has asked to speak to you.
Task (interlocutor: relative)
- Acknowledge Mr Reyes's concerns and apologise that the family was not informed
- Explain what happened overnight and how his mother is this morning (strategies tried, the medicine given, your assessment, monitoring and GP review)
- Find out about any recent changes in his mother's health and what usually settles her
- Address his concerns about the medicine (its risks and intended benefit, how consent will be checked, the medication review)
- Agree how the family will be involved in future decisions and explain his options for making a formal complaint
In the test you get 3 minutes to read the card and plan, then about 5 minutes to talk. This card is original, written for this site; the interlocutor's card is not shown.
How to approach this card
- Open with an apology for not telling the family, then acknowledge what he found: she is drowsy. Do not defend the omission or blame the night nurse. Find out what is behind his anger rather than assuming it.
- Tell it in sequence: her distress, over an hour of non-drug strategies, one as-needed dose, then your assessment. Say plainly that her observations are within her usual range but she is drowsier and more confused than usual. Do not call her fine.
- Cover the medicine: it is intended to ease severe distress when other approaches have not worked, but it can cause drowsiness and has other risks in dementia. Say the GP is assessing whether it explains her state, and the review will weigh benefit against risk.
- Be honest about consent: you are checking whether the admission form covers this medicine, whether her decision-making ability was assessed and who is legally authorised to consent. Do not call consent valid or invalid yet. Ask about recent health changes and what settles her.
- Close by agreeing how and when he will be contacted, then explain complaint options without defensiveness: the facility's process and the Aged Care Quality and Safety Commission. If time is short, prioritise the apology, her current state, the medicine's risks and the contact plan.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- I am sorry the family was not told overnight. I understand why that is upsetting.
- I will take you through the night in order, then you can ask me anything.
- Have you noticed any changes in her health recently, and what usually helps her settle?
- Tell me what worries you most about this medicine, and I will answer as honestly as I can.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| PRN | A medicine ordered to be given only when needed, not every day. |
| antipsychotic | A type of medicine sometimes used to calm severe distress; it can cause drowsiness. |
| observations | Regular checks such as breathing, pulse, blood pressure, temperature and how alert she is. |
How this card is marked
Two assessors mark the recording on nine criteria: intelligibility, fluency, appropriateness of language and resources of grammar and expression (each 0–6), then relationship building, understanding and incorporating the patient's perspective, providing structure, information gathering and information giving (each 0–3). Grade B usually means 5 on each language criterion and 2 on each clinical one. See the AI Speaking practice guide for what each criterion looks for.
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All sets: nurses, doctors, other professions. Your profession's guide: OET Nursing.
Questions about this role-play
He asks whether the medicine caused her drowsiness. What can I say?
Say it is being considered, because the medicine can cause drowsiness, but the cause is not yet confirmed. The GP is seeing her today and monitoring has started. Avoid both blaming the medicine outright and ruling it out.
He says he signed the consent form. How do I respond without being defensive?
Acknowledge the signed admission form, then say honestly that you are still checking whether it covers this medicine, whether her own ability to decide was assessed and who is legally authorised to consent. Offer to update him, and say when.
What should I say about her safety while she is drowsy?
Describe what is already in place: regular observations, a food and fluid chart, supervision whenever she walks, and GP review today. Do not say she is safe or out of danger; say you are watching her closely and will tell him of any change.
Sources
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