The task
Original independent practice. Assume that today's date is 4 November 2026. Mr Segarra's crisis-team support ends today, and the community recovery team has accepted his transfer. Allow 5 minutes for reading and 40 minutes for writing.
You are a registered nurse in the community crisis team. Using the case notes, write a transfer letter to Ms Elvira Mateu, Community Mental Health Nurse, Community Recovery Team, 24 Park Road, NSW 2000, Australia. Request continued recovery support for Mr Segarra, highlighting his individual relapse signs, current assessment and agreed follow-up responsibilities. 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?
Bipolar disorder after a manic episode: transfer
You are a registered nurse in the community crisis team. Using the case notes, write a transfer letter to Ms Elvira Mateu, Community Mental Health Nurse, Community Recovery Team, 24 Park Road, NSW 2000, Australia. Request continued recovery support for Mr Segarra, highlighting his individual relapse signs, current assessment and agreed follow-up responsibilities. 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 Lucas Segarra
- DOB: 22/05/1988 (38 yrs)
- Address: 8 Garden Street, NSW 2000
- Transfer agreed 04/11/26; patient accepts community recovery support
Social background
- Lives alone; sister nearby, visits regularly
- Accountant; currently on leave; hopes to return gradually
- Consents to sister sharing observations with recovery nurse
- Sister described him as selfish and attention-seeking
- Dislikes clinic waiting-room music
Medical history
- Bipolar disorder diagnosed 2021; previous depressive episode
- Remote appendicectomy; no continuing problems
- Before recent episode: managing work and home independently
Admission and recovery
- 12/10/26: admitted with mania; minimal sleep, overnight business emails, unplanned purchases
- 27/10: discharged home under crisis-team support
- 04/11 review: usual sleep restored, calm speech; no reported suicidal thoughts/hallucinations
- Recognises admission followed change from usual routine
- Embarrassed by purchases; reluctant to seek help early
- Daily routine improving; prepares meals independently
- No current substance misuse reported
Agreed relapse prevention
- Personal early signs: ↓ sleep, renewed overnight business emails, unplanned purchases
- Patient and sister identified these changes together
- Patient agrees sister may help review spending voluntarily
- Recovery goal: rebuild regular routine before work return
Transfer plan
- Recovery team accepted transfer today; first home visit 05/11: monitor mood, sleep, warning signs, engagement/treatment adherence
- Crisis-team involvement ends today; recovery nurse to initiate 05/11 contact; missed contact → retry same day, discuss with duty clinician
- Current psychiatric medication list + monitoring plan attached to transfer; psychiatrist retains prescribing/physical monitoring; review 09/11; no nursing medication administration requested
- Individual plan: warning signs recur → same-day crisis-team assessment; after hours → NSW Mental Health Line 1800 011 511; immediate danger →000
- Patient given plan; understands emergency contact instructions
- GP informed of transfer; no new GP appointment requested
- Requests telephone reminder before first home visit
Who is reading, and what do they need?
Ms Mateu needs an actionable handover from a service ending today, with ownership of tomorrow's visit and escalation clearly assigned. The attached current psychiatric medication list and monitoring plan support treatment-adherence monitoring. Relevant context includes living alone, a nearby sister, recognition of changed routine, independent meal preparation and no current substance misuse reported. These support personalised recovery work; they do not replace the current mental-state assessment or define overall risk.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 04/11: usual sleep restored, calm speech; no reported suicidal thoughts or hallucinations. | This gives the receiving nurse the current assessment while preserving the limits of what was observed or reported. |
| Personal early signs: reduced sleep, renewed overnight business emails and unplanned purchases. | The patient and sister identified these specific changes, giving the receiving nurse concrete features to monitor. |
| First home visit 05/11: monitor mood, sleep, warning signs, engagement and treatment adherence. | This specifies the accepted team's first assessment and all listed monitoring responsibilities. |
| Crisis support ends today; nurse initiates 05/11 contact; missed contact: same-day retry, duty-clinician discussion. | Clear ownership and a missed-contact response prevent an unassigned gap between services. |
| Current psychiatric medication list and monitoring plan attached; psychiatrist retains prescribing/physical monitoring, review 09/11; no nursing medication administration requested. | The attachments provide treatment information for adherence monitoring, while the stated responsibilities keep prescribing and physical monitoring with the psychiatrist. |
| Relapse: same-day crisis assessment; after-hours NSW Mental Health Line 1800 011 511; immediate danger: 000. | The complete agreed escalation pathway gives the receiving nurse the response for recurrence, after-hours needs and immediate danger. |
| Sister may share observations; spending review is voluntary. | This defines the consented support available without implying compulsory financial oversight or wider information-sharing permission. |
| Accountant on leave; rebuild routine before gradual work return; reluctant to seek help early. | The recovery goal and engagement barrier help the nurse tailor support rather than focus solely on symptom surveillance. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Sister described him as selfish and attention-seeking. | These judgemental labels do not provide a clinical finding or agreed recovery action. |
| Dislikes clinic waiting-room music. | This preference does not affect the agreed home-visit handover. |
| Remote appendicectomy without continuing problems. | The resolved surgery creates no current mental-health recovery responsibility. |
| Bipolar diagnosis in 2021; previous depressive episode. | Compress diagnostic background if useful; the diagnosis date and earlier episode need not displace today's assessment and responsibilities. |
| GP informed; no new GP appointment requested. | This is useful coordination background but does not assign an additional action to the recovery nurse. |
A paragraph plan for this case
Open with patient identification, acceptance of recovery support and bipolar disorder; compress the 12 October admission, 27 October discharge home and former work/home independence into brief transition context. Follow with the current assessment, personal warning signs and agreed sister involvement, linking the recovery goal to engagement. Close with the nurse's contact and monitoring duties, requested telephone reminder, missed-contact response, attached current psychiatric medication list and monitoring plan, psychiatric responsibilities and complete escalation pathway.
Where candidates slip on this task
- The transfer date is 4 November, the first home visit 5 November and psychiatric review 9 November; make ownership and the same-day missed-contact response explicit.
- Embarrassment and reluctance to seek help merit supportive engagement; do not adopt the sister's insults, infer motives, or turn voluntary spending review into financial control.
- Retain the understood crisis instructions together: recurrent warning signs trigger same-day crisis-team assessment; after hours, NSW Mental Health Line 1800 011 511; immediate danger, 000.
- Refer to the attached current psychiatric medication list and monitoring plan so the nurse can check treatment information; do not invent medicine names, doses or monitoring frequencies, or imply that prescribing or physical monitoring has transferred to the nurse.
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
Does this transfer request nursing medication administration?
No. Distinguish monitoring engagement and treatment adherence from administering medicines. The current psychiatric medication list and monitoring plan accompany the transfer and should be referenced briefly. The psychiatrist retains prescribing and physical monitoring, with review on 9 November. The recovery nurse's requested work concerns contact, recovery support, monitoring and the agreed response to missed contact or recurrent warning signs.
Can the current review be summarised as no risk?
No. Preserve the specific findings: restored usual sleep, calm speech and no reported suicidal thoughts or hallucinations. These do not establish an absence of all risk. Pair the assessment with his individual warning signs, engagement needs and the complete documented escalation pathway.
Sources
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