The task
Original independent practice. Assume that today's date is 5 November 2026. Mr Ahmed Slingerland is being discharged home this afternoon.
You are a registered nurse in the inpatient rehabilitation unit. Using the case notes, write a discharge letter to Ms Gaby Pastoors, Community Rehabilitation Nurse, Home Transition Service, 18 Station Road, NSW 2000, Australia. Request a home assessment and continued rehabilitation support for Mr Slingerland, including safe continuity of assistance after discharge. 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?
Guillain-Barre syndrome recovery: discharge
You are a registered nurse in the inpatient rehabilitation unit. Using the case notes, write a discharge letter to Ms Gaby Pastoors, Community Rehabilitation Nurse, Home Transition Service, 18 Station Road, NSW 2000, Australia. Request a home assessment and continued rehabilitation support for Mr Slingerland, including safe continuity of assistance after discharge. 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: Mr Ahmed Slingerland
- DOB: 14/03/1968 (58 yrs)
- Home: 7 Park Road, NSW 2000, Australia
- Admitted 23/09/26; discharge home 05/11/26
Social background
- Lives with wife; accessible ground-floor flat
- Taxi driver; currently off work
- Enjoys collecting old postcards
- Wife privately complained about daughter's marriage
Medical history and admission
- Appendicectomy in childhood; no ongoing problems
- Guillain-Barré syndrome diagnosed 24/09 after progressive limb weakness
- IV immunoglobulin completed during acute admission
- Did not require ventilation
- Transferred to rehabilitation unit 12/10
Current assessment
- Residual bilateral leg weakness; fatigues easily
- No current breathing or swallowing difficulties
- 05/11, patient reports: transfers independently; help no longer needed
- 04/11, physiotherapist observed: bed→chair required 1-person physical assistance + frame; knees buckled with fatigue
- Independent feeding/grooming; seated rest breaks needed
Treatment and progress
- Current team plan: every transfer with 1 trained adult's physical assistance + frame; no unaided transfers pending reassessment
- Wife demonstrated prescribed assistance safely; continuously available through 06/11 nurse visit; returns to work afterwards
- Frame, raised chair and shower chair installed at home
- OT home assessment completed 03/11; equipment checked
- Individual pacing programme supplied: alternate activities with seated rest
- Separate home-care worker arranged for daily shower assistance; no cover for other transfers
- Complained that ward meals were repetitive
Discharge plan
- 06/11 Home Transition Service visit: observe transfers; liaise with physiotherapy before ↓ support. Trained carer rota confirmed: every transfer from visit's end until physiotherapy confirms independent transfers safe; nurse to check handover
- Patient accepts assistance pending review despite reporting independence
- Community physiotherapy home visit booked 09/11
- Neurology outpatient review booked 03/12
- Team safety advice: new/worsening weakness → contact neurology immediately; breathing difficulty → ambulance (000)
Who is reading, and what do they need?
Ms Pastoors is the community rehabilitation nurse taking over home support. She needs attributed transfer findings, prescribed assistance and the transition from the wife to the confirmed trained carer rota at the 06/11 visit. The accessible flat and completed occupational therapy assessment provide context, but neither establishes transfer independence nor replaces observation and checking the support handover.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 05/11: reports independent transfers and no longer needing help; accepts assistance pending review. | Preserves his perspective and cooperation without presenting self-reported independence as an established ability. |
| 04/11 physiotherapy: bed-to-chair transfer needed one-person physical assistance and frame; knees buckled with fatigue. | Provides dated observational evidence explaining why physical assistance remains necessary despite his account. |
| Every transfer: one trained adult’s physical assistance plus frame; no unaided transfers pending reassessment. | Defines the current care requirement so the receiving nurse can maintain the prescribed support. |
| Wife demonstrated prescribed assistance safely; continuously available through the 06/11 nurse visit, then returns to work. | Identifies the current trained helper and when responsibility must pass to the arranged carers. |
| 06/11 visit: observe transfers and liaise with physiotherapy before reducing support; check handover to the confirmed trained carer rota covering every transfer after the visit until physiotherapy confirms independent transfers are safe. | Connects assessment with uninterrupted assistance after the wife returns to work and makes the nurse’s coordination request actionable. |
| New/worsening weakness: contact neurology immediately; breathing difficulty: ambulance, 000. | Preserves both documented escalation routes for continuity of care after discharge. |
| Guillain-Barré syndrome diagnosed 24/09; residual bilateral leg weakness and easy fatigue. | Briefly explains the rehabilitation context and functional limitations underlying the transfer plan. |
| Separate daily shower assistance does not cover other transfers; community physiotherapy home visit booked 09/11. | Adds useful service boundaries and review timing without substituting either for continuous transfer assistance. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Taxi driver; currently off work. | Occupation may appear relevant to rehabilitation, but this handover requests immediate home assessment rather than vocational planning. |
| Enjoys collecting old postcards. | The hobby does not affect the requested transfer assessment or current assistance arrangements. |
| Wife privately complained about daughter’s marriage. | This private family complaint has no documented connection to care provision and should not enter the handover. |
| Childhood appendicectomy; no ongoing problems. | The resolved surgical history does not inform current rehabilitation or home support. |
| Complained that ward meals were repetitive. | The ward complaint does not require action from the community rehabilitation nurse. |
| IV immunoglobulin completed; no ventilation; rehabilitation transfer 12/10. | Compress or omit this treatment chronology when current function and the assistance plan already explain the rehabilitation needs. |
A paragraph plan for this case
Open with identification, discharge home on 05/11 and the agreed 06/11 home assessment request; keep the birth date and home address within identification or visit details. Present the dated patient and physiotherapist accounts, then the transfer prescription. Connect the wife’s demonstrated assistance and availability to the confirmed carer rota and requested handover check. Close with assessment and physiotherapy coordination, selected supporting arrangements and both documented escalation routes.
Where candidates slip on this task
- Distinguish the 04/11 physiotherapist observation from the 05/11 patient account; the receiving nurse visits on 06/11, community physiotherapy on 09/11 and neurology on 03/12. A booked review does not itself authorise independent transfers.
- Neither independent feeding and grooming nor absent breathing or swallowing difficulties establishes transfer independence; retain physical assistance and frame requirements until reassessment, despite the patient’s account.
- Home equipment and the pacing programme support rehabilitation but do not replace physical assistance. The wife’s availability ends after the nurse’s visit; the confirmed trained carer rota then covers every transfer until physiotherapy confirms independence is safe. Separate shower assistance does not cover other transfers.
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
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- 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 should the conflicting transfer accounts be selected and presented?
Retain both accounts with their dates and sources. The patient’s report describes his view, while the physiotherapist’s observation documents assistance and fatigue-related knee buckling. Connect these to the current team prescription and his acceptance of assistance pending review; do not resolve the discrepancy by declaring independence.
What support needs to continue after the nurse’s visit?
The wife can assist throughout the visit but returns to work afterwards. The confirmed trained carer rota covers every transfer from the visit’s end until physiotherapy confirms independent transfers are safe. Ask Ms Pastoors to check this handover and liaise with physiotherapy before reducing support. The completed occupational therapy assessment and separate shower assistance do not replace this transfer cover.
Sources
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