The task
Assume that today's date is 5 November 2026. Mr Cheptoo is transferring from the acute admissions unit to the specialist respiratory ward today. This is original independent practice: all patient details, observations and individual treating-team orders below are fictional. Allow 45 minutes: 5 minutes for reading and 40 minutes for writing.
You are a registered nurse in the acute admissions unit. Using the case notes, write a transfer letter to Ms Cynthia Shariff, Respiratory Receiving Nurse, Respiratory Ward, Marton Road, TS4 3BW, United Kingdom. Ms Shariff already has Mr Ian Cheptoo's admission summary and medication/allergy chart. Provide a brief handover of his current condition, chest-drain care and planned respiratory review. 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?
Pneumothorax with a chest drain: transfer
You are a registered nurse in the acute admissions unit. Using the case notes, write a transfer letter to Ms Cynthia Shariff, Respiratory Receiving Nurse, Respiratory Ward, Marton Road, TS4 3BW, United Kingdom. Ms Shariff already has Mr Ian Cheptoo's admission summary and medication/allergy chart. Provide a brief handover of his current condition, chest-drain care and planned respiratory review. 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 Ian Cheptoo
- DOB: 18/06/1992 (34 yrs)
- Admitted 04/11/26; transfer to respiratory ward 05/11/26
- Respiratory registrar accepted transfer today; receiving nurse has admission summary and medication/allergy chart
Social background
- Lives with partner; independent with ADLs before admission; partner visiting this evening
- Enjoys chess; local club meets every Wednesday evening
- Complained that overnight staff were unfriendly and slow
- Partner disclosed a private disagreement about household spending
Medical history
- No previous pneumothorax or chronic lung disease; no regular medicines
- Appendicectomy aged 12; uncomplicated recovery
- Allergies: nil known
Admission and treatment
- 04/11: sudden R chest pain + breathlessness at rest; no trauma
- CXR: large R spontaneous pneumothorax
- R chest drain inserted 04/11
- 05/11 CXR: small residual R apical pneumothorax
Current assessment
- Current: alert; comfortable at rest; breathlessness ↓
- SpO2 97% room air; RR 18/min
- Afebrile
- Dressing dry/intact
- Drain secured; tubing unkinked
- R drain currently open to underwater seal; no suction
- Respiratory swinging present; intermittent bubbling with cough
- Scant serous drainage; no fresh bleeding
- Needs staff assistance with bottle when mobilising; worried about accidentally dislodging drain
Documented treating-team plan
- Registrar's order: continue free drainage; bottle upright below insertion site
- Registrar: do not clamp for transfer; further drain management decisions by respiratory team
- Continue routine ward chest-drain observations
- Team plan: urgent medical review for ↑ breathlessness/severe chest pain; acute deterioration → hospital emergency response + alert respiratory registrar
- Respiratory team review after arrival
- Drain observation record, imaging report and written team orders accompany transfer
Who is reading, and what do they need?
Ms Cynthia Shariff already has the admission summary and medication/allergy chart. She needs the current drain setup and function, safe handling instructions and escalation arrangements. Choose a few supporting current findings and practical care needs; the available admission history does not need retelling.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| CXR: large R spontaneous pneumothorax; 05/11 CXR: small residual R apical pneumothorax | The diagnosis establishes the transfer purpose; the latest result can briefly update the nurse on the remaining pneumothorax. |
| Current: alert; comfortable at rest; breathlessness ↓; SpO2 97% room air; RR 18/min | Selected findings give a concise picture of his present condition without an extended observation list. |
| R drain currently open to underwater seal; no suction; Respiratory swinging present; intermittent bubbling with cough | The receiving nurse needs the actual drain setup and observed function to continue care. |
| Registrar's order: continue free drainage; bottle upright below insertion site | These instructions explain how to maintain the prescribed drainage safely. |
| Registrar: do not clamp for transfer; further drain management decisions by respiratory team | This states the transfer restriction and identifies who will decide subsequent management. |
| Team plan: urgent medical review for ↑ breathlessness/severe chest pain; acute deterioration → hospital emergency response + alert respiratory registrar | The symptoms and deterioration require their corresponding escalation actions. |
| Continue routine ward chest-drain observations; Needs staff assistance with bottle when mobilising; worried about accidentally dislodging drain | Routine monitoring can be stated briefly; bottle assistance and reassurance are useful individual nursing needs. |
| Respiratory team review after arrival; Drain observation record, imaging report and written team orders accompany transfer | These details identify the planned review and supporting records available to the receiving ward. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Lives with partner; independent with ADLs before admission; partner visiting this evening | The current bottle-assistance requirement is more useful than his previous independence or visiting arrangements. |
| Enjoys chess; local club meets every Wednesday evening | The hobby and club schedule do not affect his inpatient drain care. |
| Complained that overnight staff were unfriendly and slow | This complaint identifies no current clinical problem or change to the transfer plan. |
| Partner disclosed a private disagreement about household spending | This private matter has no documented connection to his respiratory care. |
| Appendicectomy aged 12; uncomplicated recovery | The remote resolved operation does not affect the present handover. |
| 04/11: sudden R chest pain + breathlessness at rest; no trauma | The presenting episode is already in the admission summary; his current condition is the useful update. |
| No previous pneumothorax or chronic lung disease; no regular medicines | This background is already available in the admission summary and medication chart. |
| Allergies: nil known | The receiving nurse already has the allergy chart, and this letter introduces no medication change. |
| R chest drain inserted 04/11 | The insertion history is already available; current drain findings and orders guide continuing care. |
A paragraph plan for this case
Open with Mr Ian Cheptoo’s identification and the transfer purpose. Give a short current-condition update using selected observations and, if useful, the latest CXR. Describe the drain setup and function together. Follow with the handling orders and respiratory-team responsibility, adding practical bottle assistance if chosen. Finish with escalation and the planned review; accompanying records can be mentioned briefly.
Where candidates slip on this task
- The receiving nurse already has the admission history and medication/allergy chart. Repeating these can crowd out the current update.
- Report swinging and intermittent bubbling with cough as observations. Comfort at rest and a small residual pneumothorax do not establish resolution or readiness for drain removal.
- Preserve the documented transfer clamping restriction, respiratory-team responsibility and escalation actions. No repeat-imaging schedule, suction setting or removal plan is supplied.
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
Which information should take priority within the word limit?
Establish the right spontaneous pneumothorax, then explain the current underwater seal without suction, swinging and cough-related bubbling, free drainage and bottle positioning, transfer clamping restriction, respiratory-team responsibility and escalation. Select a few current findings or practical nursing needs to support this handover.
How should the drain observations and dislodgement worry be interpreted?
Report swinging and intermittent bubbling with cough without declaring the drain ready for removal or the pneumothorax resolved. Bottle assistance is a useful practical need, and his worry may guide reassurance. Neither establishes that dislodgement has occurred.
Sources
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