The task
This is original independent practice. Assume that today's date is 5 November 2026. Dinis Benito is being discharged home this afternoon.
You are a registered nurse on a children's ward. Using the information in the case notes, write a discharge letter to Ms Jovita Agustin, Paediatric Community Nurse, requesting a home visit to review Dinis Benito and reinforce his mother's understanding of his ongoing care. Address the letter to Ms Jovita Agustin, Paediatric Community Nurse, Paediatric Community Nursing Service, 24 Orchard Road. 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.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Discharge letter.
Free · no sign-up · nursing
Which case notes belong in this letter?
Child recovering from gastroenteritis: discharge
You are a registered nurse on a children's ward. Using the information in the case notes, write a discharge letter to Ms Jovita Agustin, Paediatric Community Nurse, requesting a home visit to review Dinis Benito and reinforce his mother's understanding of his ongoing care. Address the letter to Ms Jovita Agustin, Paediatric Community Nurse, Paediatric Community Nursing Service, 24 Orchard Road. 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.
Mark every line: Include keeps the specific detail; Compress keeps the relevant gist in fewer words; Omit leaves it out. Then compare your choices with our reviewed analysis. Some choices are optional.
Download practice checklist (PDF)
One-page worksheet. Answers and reasons are on the linked webpage, so you can practise before checking.
Case notes
Patient details
- Name: Dinis Benito; boy
- DOB: 15/07/2022 (4 yrs)
- Home: 8 Willow Close
- Admitted 03/11/26; discharge home 05/11/26
Social background
- Lives with mother, Ms Jordana Pena; main carer
- Mother available throughout recovery; consents to community nursing visit
- Attends nursery on weekdays; currently absent
- Enjoys drawing buses and collecting toy cars
- Mother criticised ward meals and complained about staff parking
Medical history
- Previously well; no regular medicines
- No known drug allergies
- Otitis media 6/12 ago; resolved
Admission and progress
- 02/11: vomiting and watery diarrhoea began
- 03/11: ↓ intake and urine; admitted with dehydration
- Admission assessment: alert; dry mouth; no blood in stools
- Medical diagnosis: gastroenteritis; no antibiotics indicated by treating team
- Oral rehydration given under observation; intake improved
- Last vomit 04/11 morning; none since
- 05/11: dehydration resolved; alert, drinking freely, urine back to usual
- Two loose stools today; no blood; no abdominal pain
- Mother relieved; child asking to return to nursery
Discharge teaching and plan
- Discharge supplies: oral rehydration sachets, measuring jug and recording sheet
- Team fluid plan: frequent small drinks, including supplied oral rehydration solution; prepare exactly per packet
- Team advice: usual food as tolerated; avoid fruit juice/fizzy drinks
- Mother needs prompts preparing solution; unsure when symptoms require medical help
- Can record drinks, urine and stools; asked to continue at home
- NHS-based advice taught: soap-and-water handwashing; nursery only after ≥48 hrs without vomiting/diarrhoea
- Safety advice: reduced urination, inability to retain fluids or bloody diarrhoea → urgent medical advice
- Green vomit/sudden severe abdominal pain → emergency assessment immediately; unresponsiveness/severe breathing difficulty → ambulance
- Mother given written advice; verbal recall incomplete
- Community nurse: home visit 06/11; assess hydration, review record, reinforce fluid/safety advice using demonstration and teach-back
- No discharge medicines prescribed
Who is reading, and what do they need?
Ms Agustin is the paediatric community nurse receiving this handover; prior involvement is not stated. She needs enough information to locate four-year-old Dinis Benito at 8 Willow Close and review his recovery. His mother, Ms Jordana Pena, is the main carer, available throughout recovery and consenting to the visit. Practical assessment and teaching needs deserve more space than routine background.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 06/11 home visit: hydration assessment, record review, fluid/safety teaching through demonstration and teach-back. | Defines the requested visit and gives the nurse specific assessment and teaching responsibilities. |
| 05/11: dehydration resolved; alert, drinking freely, urine back to usual. | Establishes the discharge baseline against which the community nurse can assess hydration. |
| Frequent small drinks, including supplied oral rehydration solution; prepare exactly per packet. | Identifies the home fluid regimen and preparation instruction that require reinforcement. |
| Mother needs preparation prompts; uncertain help-seeking; written advice supplied, verbal recall incomplete. | Explains why practical demonstration and checked understanding are necessary despite previous teaching. |
| Reduced urination, inability to retain fluids or bloody diarrhoea: urgent medical advice. | Preserves every listed trigger for urgent help, addressing the mother’s uncertainty about escalation. |
| Green vomit/sudden severe abdominal pain: immediate emergency assessment; unresponsiveness/severe breathing difficulty: ambulance. | Retains both emergency response levels and every listed trigger; these must accompany the urgent-help criteria. |
| Mother can record drinks, urine and stools; asked to continue at home. | Connects an existing caregiver skill with the record the nurse is asked to review. |
| Two loose stools today; no blood or abdominal pain. | Useful optional context showing diarrhoea remains present despite resolved dehydration; the exact count is not compulsory. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Enjoys drawing buses and collecting toy cars. | Personal interests do not explain the requested hydration review or caregiver teaching. |
| Mother criticised ward meals and complained about staff parking. | These complaints do not establish a home-care problem and could distract from her documented learning needs. |
| Otitis media six months ago; resolved. | This resolved episode has no stated connection to the current illness or follow-up. |
| Admission assessment: alert, dry mouth, no blood in stools. | Although clinically plausible background, these admission observations add little beyond the dehydration history and current assessment. |
| Mother relieved; child asking to return to nursery. | Emotional reactions and the child’s request do not determine recovery or nursery eligibility. |
A paragraph plan for this case
Open with identification, discharge home on 5 November and the requested 6 November visit. Briefly summarise gastroenteritis with dehydration, optionally compressing the 2 November onset, 3 November admission, observed oral rehydration, last vomiting on 4 November morning and the treating team’s decision against antibiotics, before presenting current findings. Finish with caregiver learning needs, the fluid and recording plans, all escalation advice together and the requested demonstration and teach-back; supplied sachets, jug and sheet, usual food as tolerated, avoidance of juice/fizzy drinks, soap-and-water handwashing and nursery exclusion are useful additional teaching context.
Where candidates slip on this task
- Separate resolved dehydration from ongoing diarrhoea: two loose stools occurred on 5 November. Neither the child’s nursery request nor the absence of vomiting establishes eligibility to return.
- Handwashing and nursery advice may be selected independently. If nursery advice is included, retain the requirement for both vomiting and diarrhoea to have stopped for at least 48 hours. The interval cannot start from the last vomit while diarrhoea continues.
- Do not invent fluid volumes, a gastroenteritis cause or discharge prescriptions. Previously well, no regular medicines, no known drug allergies and no discharge medicines are optional background, not the referral’s focus.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
More Nursing letter tasks
- Discharge to the community nursing service: new insulin and diabetic foot ulcer discharge letter
- Postnatal discharge to a child and family health nurse: feeding concerns after gestational diabetes discharge letter
- Discharge to the community nurse: new colostomy in an older man living alone discharge letter
Your profession's guide: OET Nursing. Layout and structure: OET letter format.
Questions about this task
How much admission history does Ms Agustin need?
Prioritise gastroenteritis with dehydration and the current hydration assessment. Symptom onset, observed oral rehydration and the last vomit can provide a brief recovery timeline, but each is optional. Avoid a day-by-day account that crowds out preparation difficulties, the visit request or the complete escalation advice.
How should the safety advice be selected and organised?
Keep all escalation advice together: reduced urination, inability to retain fluids or bloody diarrhoea require urgent medical advice; green vomit or sudden severe abdominal pain require immediate emergency assessment; unresponsiveness or severe breathing difficulty require an ambulance. Check recall rather than relying on written advice.
Sources
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