The task
Original independent practice. All patient details, observations and treating-team orders below are fictional case facts, not general treatment recommendations. Assume that today's date is 6 November 2026. Mr Bhatti is transferring this afternoon. Allow 5 minutes for reading and 40 minutes for writing.
You are a registered nurse on an orthopaedic ward. Using the case notes, write a transfer letter to Ms Sara Oquendo, Orthopaedic Rehabilitation Nurse, Step-down Ward, Orthopaedic Rehabilitation Unit, Hills Road, CB2 0QQ. Explain Mr Bhatti's ongoing rehabilitation needs, reconcile the conflicting dated weight-bearing instructions and request confirmation that the verified current instruction has been received and recorded before mobilisation. 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?
Pelvic fracture managed without surgery: transfer
You are a registered nurse on an orthopaedic ward. Using the case notes, write a transfer letter to Ms Sara Oquendo, Orthopaedic Rehabilitation Nurse, Step-down Ward, Orthopaedic Rehabilitation Unit, Hills Road, CB2 0QQ. Explain Mr Bhatti's ongoing rehabilitation needs, reconcile the conflicting dated weight-bearing instructions and request confirmation that the verified current instruction has been received and recorded before mobilisation. 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 Waqas Bhatti
- DOB: 12/03/1954 (72 yrs)
- Admitted 03/11/26; transfer to step-down ward 06/11/26
Social background
- Lives alone; daughter visits weekends; unable to provide daily physical assistance
- Previously independent indoors and with personal care; stick outdoors
- Flat reached by stairs; OT home assessment pending
- Enjoys radio quizzes; retired accountant
- Reports daughter's private marital difficulties
Medical history
- Appendicectomy 1987; uncomplicated
- No known allergies
Assessment and dated instructions
- Fall 03/11: R pubic rami fractures; conservative management
- CT 04/11: stable injury; no acetabular or posterior-ring fracture
- 03/11 provisional order: non-weight-bearing R leg pending CT review
- 05/11 signed consultant order: weight bear as tolerated both legs, walking frame, staff assistance
- 06/11 registrar verified consultant's newer order; 03/11 order withdrawn, superseded copy clearly marked
- Outdated transfer draft found this morning; corrected before departure
- Pt reassured after asking which instruction to follow
Treatment and progress
- 06/11 physio assessment under verified order; tolerated short supervised walk without dizziness
- Current mobility: transfers and walks with frame + one staff member; no independent mobilisation
- Pain manageable at rest; ↑ during transfers
- Alert, orientated; follows instructions
- Help needed with lower-body washing/dressing; upper-body care independent
- Passing urine normally; bowels opened yesterday
- Complained that ward tea was cold
- Skin intact; repositions independently in bed
- Motivated for rehabilitation; requests encouragement during walking practice
Plan
- Orthopaedic review booked 19/11; transport arranged; team to reassess weight-bearing then
- Continue assisted rehabilitation under current order; medical reassessment if pain suddenly worsens or mobility deteriorates
- Receiving nurse: confirm receipt, understanding and entry of verified order in nursing/mobility records before first mobilisation
- Signed current order and marked superseded copy enclosed for reconciliation
Who is reading, and what do they need?
Ms Oquendo is the receiving orthopaedic rehabilitation nurse who needs actionable instructions for continuing care. Prior knowledge of the conflicting orders cannot be assumed. Prioritise their reconciliation, current assistance requirements and confirmation before mobilisation. Mr Bhatti’s identifiers and transfer timing need little space; allergy status, alertness and the supervised walking assessment provide optional supporting detail.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 03/11 fall: right pubic rami fractures, managed conservatively. | Establishes the injury and treatment context for the rehabilitation transfer. |
| 03/11 provisional order: right-leg non-weight-bearing pending CT review. | Identifies the earlier restriction that must be explicitly reconciled to prevent conflicting mobility instructions. |
| 05/11 signed consultant order: weight-bearing as tolerated, both legs, walking frame and staff assistance. | Defines the verified replacement instruction, including its equipment and supervision requirements. |
| 06/11 registrar verification; 03/11 order withdrawn and superseded copy clearly marked. | Explains why the newer instruction governs care and removes ambiguity about the earlier restriction. |
| Transfers and walks with frame and one staff member; no independent mobilisation. | Translates the current order into the assistance the receiving ward must provide. |
| Pain manageable at rest, greater during transfers; lower-body washing/dressing assistance; upper-body care independent. | Adds useful detail for planning transfers and personal care without implying dependence in every activity. |
| Lives alone; weekend daughter visits, no daily physical assistance; stairs; OT home assessment pending. | Provides concise discharge-planning context, particularly the limits of available help and unresolved home access assessment. |
| Receiving nurse: confirm receipt, understanding and recording of verified order before first mobilisation. | States the specific handover action required before rehabilitation proceeds. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Enjoys radio quizzes; retired accountant. | These personal details do not determine immediate rehabilitation assistance or order reconciliation. |
| Daughter’s private marital difficulties. | Third-party private information adds nothing beyond the stated limits on daily assistance. |
| Uncomplicated appendicectomy in 1987. | This remote, resolved operation does not explain current mobility or care needs. |
| Complaint that ward tea was cold. | The complaint has no bearing on safe mobilisation or rehabilitation planning. |
| Normal urination, bowels opened yesterday, intact skin and independent repositioning in bed. | These routine findings can be omitted or compressed because the central handover concerns assisted mobility and conflicting orders. |
| Outdated transfer draft corrected; patient reassured about which instruction to follow. | These appear relevant to the conflict, but completed administrative correction and reassurance cannot replace verified reconciliation or receiving-nurse confirmation. |
A paragraph plan for this case
Open with the transfer on 06/11 for conservatively managed right pubic rami fractures and the need for assisted rehabilitation. Next, reconcile the dated orders and verification, mention the enclosed signed current order and marked superseded copy, and specify the confirmation required before first mobilisation. Close with mobility, transfer pain and personal-care needs; selectively compress the previous functional baseline, home barriers and requested walking encouragement, with the 19/11 review, arranged transport and planned weight-bearing reassessment where space permits.
Where candidates slip on this task
- Preserve the sequence: provisional right-leg non-weight-bearing on 03/11, signed replacement on 05/11, and registrar verification with withdrawal on 06/11; a stable CT alone does not authorise mobilisation.
- Weight-bearing as tolerated applies to both legs, with a walking frame and staff assistance; it does not permit independent mobilisation or remove the requirement for confirmation before mobilisation.
- If including the treating team’s reassessment plan, retain both triggers: sudden worsening of pain or deteriorating mobility; distinguish this from the booked 19/11 review to reassess weight-bearing.
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 should the two weight-bearing instructions be selected and explained?
Retain both dated instructions because reconciliation is explicitly requested. Identify the 03/11 restriction as provisional and withdrawn, then prioritise the signed 05/11 replacement and its 06/11 verification. Preserve both-leg weight-bearing as tolerated, the walking frame and staff assistance, together with confirmation of receipt, understanding and recording before mobilisation.
Must every useful rehabilitation detail appear within 180–200 words?
Prioritise the injury, order reconciliation, current assisted mobility and required confirmation. Transfer pain, personal-care help and home barriers can then support continued rehabilitation. Select other details according to available space and immediate usefulness; the CT findings, previous independence and routine normal observations are not individually compulsory.
Sources
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