The task
Original independent practice. Time allowed: 45 minutes (5 minutes reading and 40 minutes writing). Assume that today's date is 3 November 2026. Mr Rokoduguni is transferring to inpatient rehabilitation today.
You are a registered nurse on a surgical ward. Using the case notes, write a transfer letter to Ms Alesi Nacuqu, Rehabilitation Nurse, Inpatient Rehabilitation Unit, 24 Rehabilitation Road, SW1P 3BT, United Kingdom. Explain Mr Rokoduguni's current transfer assistance, residual limb care and rehabilitation needs following his below-knee amputation. 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: Transfer letter.
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Which case notes belong in this letter?
Below-knee amputation: transfer
You are a registered nurse on a surgical ward. Using the case notes, write a transfer letter to Ms Alesi Nacuqu, Rehabilitation Nurse, Inpatient Rehabilitation Unit, 24 Rehabilitation Road, SW1P 3BT, United Kingdom. Explain Mr Rokoduguni's current transfer assistance, residual limb care and rehabilitation needs following his below-knee amputation. 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 Napolioni Rokoduguni
- DOB: 20/08/1969 (57 yrs)
- Admitted 25/10/26; transfer to inpatient rehabilitation 03/11/26
Social background
- Lives with wife in upstairs flat; no lift
- Wife supportive but unable to provide lifting assistance
- Worked as warehouse supervisor; independent mobility before injury
- Wants to resume gardening; anxious about returning home
- Wife discussed neighbour's marital problems during visit
Medical history
- No diabetes or previous mobility limitation
- No known drug allergies
- Remote tonsillectomy; no ongoing problems
25–29/10/26 — acute surgical course
- 25/10: machinery crush injury to L lower leg
- 26/10: L below-knee amputation; limb could not be salvaged
- Early postoperative vomiting resolved; now eating normally
- Temporary urinary retention resolved; catheter removed; voiding independently
- 29/10: surgical drain removed; no further drainage
02/11/26 — surgical review
- Residual limb incision closed/dry; mild swelling; no redness/discharge
- New protective dressing applied; surgical review booked 06/11
- Team: keep dressing intact until review; contact surgery sooner if wet/loose/soiled
- No prosthesis yet; compression garment not commenced
03/11/26 — function and nursing care
- Wheelchair mobility on ward; needs help positioning chair for transfers
- Physiotherapy assessment: bed–chair transfers with slide board + 1 staff member
- No independent standing transfers; occasionally attempts transfer alone
- Incision discomfort minimal; intermittent non-painful phantom sensations explained
- R foot skin intact; patient understands need to protect remaining limb
- Alert, oriented; participates in therapy despite anxiety
Transfer plan
- Continue stated transfer assistance; reinforce call bell use before moving
- Check dressing/surrounding skin daily; report ↑ redness, warmth, discharge or swelling to surgical team
- Continue physiotherapy/OT; request home-access assessment before discharge planning
- Prosthetic assessment when rehabilitation team considers him ready
- Wife requests involvement in rehabilitation goal-setting, with patient's consent
- Complained about another patient's snoring overnight
Who is reading, and what do they need?
Ms Nacuqu needs instructions that can be implemented immediately on arrival, especially the assessed transfer method and surgical dressing restrictions. Brief identifiers, previous independent mobility and absence of diabetes or earlier mobility limitation provide context; allergy status is optional background. Rehabilitation planning also needs the home-access barriers and available family support, rather than a detailed account of resolved postoperative problems.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 26/10 left below-knee amputation after machinery crush injury on 25/10; limb unsalvageable. | Establishes the operation, side, timing and injury context for rehabilitation. |
| Wheelchair mobility; chair-positioning help; bed–chair transfers using slide board and one staff member. | Gives the receiving nurse the assessed method and assistance needed immediately. |
| No independent standing transfers; sometimes attempts transfers alone; reinforce call bell before moving. | Highlights the mismatch between assessed ability and observed behaviour requiring consistent staff support. |
| Incision closed/dry, mildly swollen, without redness/discharge; new protective dressing; surgical review 06/11. | Provides the residual-limb baseline and the next surgical checkpoint. |
| Keep dressing intact until review; contact surgery sooner if wet, loose or soiled. | Preserves the surgical team's dressing instruction and every listed reason for earlier contact. |
| Daily dressing/skin checks; report increased redness, warmth, discharge or swelling to surgery. | Defines continuing surveillance and the complete recorded set of findings requiring surgical reporting. |
| Physiotherapy/OT and home-access assessment; upstairs flat without lift; wife unable to lift. | Connects rehabilitation needs with concrete barriers to eventual discharge home. |
| No prosthesis or compression garment yet; prosthetic assessment when rehabilitation team considers him ready. | Clarifies the current stage and avoids assuming prosthetic use or compression has already started. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Wife discussed a neighbour's marital problems. | Third-party personal information does not inform rehabilitation care. |
| Remote tonsillectomy without ongoing problems. | It has no practical consequence for current transfer assistance or residual-limb care. |
| Early postoperative vomiting resolved; eating normally. | No continuing intervention is requested; compress or omit in favour of current rehabilitation needs. |
| Temporary retention resolved; catheter removed; voiding independently. | The apparently relevant postoperative complication no longer requires catheter care and can usually be compressed or omitted. |
| Drain removed on 29/10; no further drainage. | Current incision and dressing findings usually provide sufficient wound context without the resolved drain chronology. |
| Complaint about another patient's snoring. | It does not explain the documented rehabilitation needs or change the receiving unit's plan. |
A paragraph plan for this case
Open with today's rehabilitation transfer following the left below-knee amputation, then prioritise wheelchair positioning, slide-board transfers with one staff member, prohibited independent standing transfers and call-bell reinforcement. Use the next paragraph for the residual-limb baseline, intact-dressing instructions, daily surrounding-skin checks and surgical review; minimal incision discomfort, explained non-painful phantom sensations and intact right-foot skin with remaining-limb protection may be compressed. Close with physiotherapy/OT, home-access assessment, conditional prosthetic assessment and goal-setting, using his gardening goal, anxiety despite active therapy participation and alert orientation where useful, and making the wife's involvement conditional on his consent.
Where candidates slip on this task
- Do not upgrade slide-board transfers with one staff member to independent standing transfers; occasional solo attempts reinforce the need to state the assessed assistance and call-bell instruction.
- Distinguish daily checks of the dressing and surrounding skin from dressing removal: keep it intact until 6 November and contact surgery earlier if wet, loose or soiled.
- Describe phantom sensations as intermittent and non-painful, without inventing phantom pain treatment; preserve assessment-dependent prosthetic timing and do not imply compression garments have already commenced.
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
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Your profession's guide: OET Nursing. Layout and structure: OET letter format.
Questions about this task
How much of the postoperative course belongs in this transfer?
The operation, current function, residual-limb findings and continuing instructions take priority. Resolved vomiting, retention and drain removal can usually be omitted or compressed because they do not generate current care requests. Previous independence may help establish rehabilitation context, but it must not obscure today's assessed transfer assistance.
Why include the home situation during an inpatient transfer?
An upstairs flat without a lift and a wife unable to provide lifting assistance directly affect home-access assessment and discharge planning. These are practical rehabilitation barriers, even though discharge home is not occurring today. Her requested involvement in goal-setting remains subject to the patient's consent.
Sources
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