The task
Assume that today's date is 21 October 2026. Mrs Rahman and her baby are being discharged home today.
You are a registered nurse on the postnatal ward at Eastwood Women's Hospital. Using the information in the case notes, write a letter to Ms Rebecca Moore, Child and Family Health Nurse, requesting an early home visit. Address the letter to Ms Rebecca Moore, Child and Family Health Nurse, Eastwood Child and Family Health Centre, 25 Mill Street, Eastwood. 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.
Case notes
Mother's details
- Name: Mrs Aisha Rahman
- DOB: 08/04/1994 (32 yrs); first baby
- Address: 14 Jacaranda Way, Eastwood
Social background
- Lives with husband (Omar), who has 2 weeks' paternity leave
- Husband works as an accountant
- Pt's mother arriving from overseas in 3 wks to help
- Interested in baby swimming classes
Pregnancy & birth
- Gestational diabetes (diagnosed 26 wks) — insulin from 30 wks; ceased after birth
- Postnatal BGLs within normal range
- Emergency caesarean section 17/10/26 at 38+2 wks for failure to progress
- Pt unhappy that obstetrician 'didn't try harder' for vaginal birth; considering a complaint
- Estimated blood loss 600 mL; Hb 108 g/L postnatally
- BMI 34 → enoxaparin 40 mg subcut daily, 18/10–27/10 inclusive (10 doses) — pt self-injecting competently
- Wound: clean, dry, dissolvable sutures
- Pain controlled with paracetamol and ibuprofen
Baby's details
- Name: Zara Rahman; born 17/10/26 at 09:00; female
- Birth weight 3,150 g
- Neonatal BGLs monitored for 24 hrs (maternal GDM) — all within normal range
- Day 4 weight 2,900 g (8% loss)
- Jaundice noted day 3; serum bilirubin 236 µmol/L at 72 hrs (phototherapy threshold 300); repeat today 241 µmol/L at 96 hrs (threshold 350) — no further blood test planned unless clinically worse
- Vitamin K given at birth; hepatitis B vaccine given
- Newborn hearing screen: passed
Feeding
- Breastfeeding; shallow latch → L nipple trauma
- Expressing after feeds; supplementing with expressed breast milk via syringe/cup
- 8–10 feeds/24 hrs; 5 wet nappies in last 24 hrs; stools changing to yellow
- Lactation consultant review 20/10 — positioning improved
Mood
- Tearful day 3, 'worried about not having enough milk'; EPDS 7
- Husband supportive
Discharge plan
- Child and family health nurse home visit within 48 hrs: weigh baby, feeding review, jaundice check, maternal mood
- 75 g oral glucose tolerance test at 6–12 wks postpartum (request form given)
- GP 6-wk check for mother and baby
- Return to hospital if baby jaundice worsens, poor feeding, fewer wet nappies
Who is reading, and what do they need?
Ms Moore is a child and family health nurse who will visit within 48 hours and has not met the family. She needs the baby's feeding, weight and jaundice findings, the mother's recovery and mood, and what to check. Detail should be specific and numerical where it guides the visit; routine newborn items need little space.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| First baby; emergency caesarean 17/10 at 38+2 wks | Gives the birth context and explains the mother's recovery needs. |
| GDM with insulin ceased after birth; neonatal BGLs normal | Explains why glucose was monitored and that it has been normal for both mother and baby. |
| Shallow latch, L nipple trauma; expressing and supplementing by syringe/cup | The main feeding problem and current method are what the visit must review. |
| 8–10 feeds, 5 wet nappies in 24 hrs; yellowing stools | Shows current intake and output so the nurse can compare at the visit. |
| Birth weight 3,150 g; day 4 weight 2,900 g (8% loss) | Weight change is a key visit task and needs both figures. |
| Bilirubin 236 at 72 hrs and 241 at 96 hrs; thresholds 300 and 350 | The nurse checks jaundice; both values with thresholds and the no-further-test plan unless clinically worse should be stated. |
| Tearful day 3, worried about milk; EPDS 7 | The visit includes maternal mood, so the finding and score give a baseline. |
| Enoxaparin 40 mg daily to 27/10 inclusive, self-injecting | A medicine the mother continues at home after discharge, with an end date the nurse may be asked about. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Unhappy with obstetrician; considering a complaint | A complaint and the patient's opinion are not relevant to the visit and could be sensitive. |
| Interested in baby swimming classes | Social detail that does not affect care. |
| Husband is an accountant | His occupation is irrelevant; only that he is supportive could be used. |
| Vitamin K, hepatitis B vaccine, hearing screen passed | Routine newborn items that can be compressed or omitted since nothing needs action. |
| EBL 600 mL, Hb 108; wound and pain control | Maternal recovery detail beyond what the child health nurse needs, so compress or omit. |
| OGTT at 6–12 wks; GP 6-week check | Later follow-up arranged elsewhere; mention briefly at most, since the visit is about the early days. |
A paragraph plan for this case
State the request for a visit within 48 hours and the birth context. Then cover the baby: feeding, output, weight and jaundice, followed by the mother's feeding difficulty, mood, enoxaparin and support. End with what you would like checked and the return-to-hospital advice she has been given.
Where candidates slip on this task
- Quote the two bilirubin values with their thresholds exactly and do not describe a trend or conclusion; the notes only say no further test is planned unless the baby becomes clinically worse.
- The weight loss is 8% from birth weight on day 4, and the notes give both weights; use them accurately rather than adding judgements about whether it is acceptable.
- Because discharge is today, the visit must be within 48 hours of today's date. Check the enoxaparin course ends on 27/10 inclusive and do not leave out the self-injection.
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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- Discharge to the community nurse: new colostomy in an older man living alone discharge letter
- Discharge to the school nurse: child newly diagnosed with epilepsy discharge letter
Your profession's guide: OET Nursing. Layout and structure: OET letter format.
Questions about this task
Should the complaint about the obstetrician appear?
No. It is the patient's view about care, not information the child and family health nurse needs for the visit. Keep the letter on feeding, weight, jaundice and mood.
Do I include the gestational diabetes follow-up test?
Only briefly if space allows. The letter's purpose is the early home visit. The glucose tolerance test and GP check are later arrangements, so spend the words on feeding, jaundice and mood first.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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