The task
This is original independent practice. All patient-specific observations, events and individual care arrangements are fictional. Assume that today's date is 4 November 2026. Urgent transfer has been accepted after today's community nursing assessment. Allow 45 minutes: 5 minutes for reading and 40 minutes for writing.
You are a registered nurse in the community nursing clinic. Using the case notes, write a transfer letter to Ms Elisa Bayona, Surgical Receiving Nurse, Emergency Surgical Unit, 32 Station Road, NSW 2000, Australia. Highlight Mr Gargallo's current wound findings, the uncertainty requiring surgical assessment and his immediate nursing handover needs. 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?
Postoperative wound separation: transfer
You are a registered nurse in the community nursing clinic. Using the case notes, write a transfer letter to Ms Elisa Bayona, Surgical Receiving Nurse, Emergency Surgical Unit, 32 Station Road, NSW 2000, Australia. Highlight Mr Gargallo's current wound findings, the uncertainty requiring surgical assessment and his immediate nursing handover needs. 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 and background
- Name: Mr Rafa Gargallo; DOB 09/08/1968 (58 yrs)
- Transfer: 04/11/26, community nursing clinic → emergency surgical unit
- Lives with partner; normally independent with personal care
- Partner informed of transfer with patient's consent
- Patient upset about parking charges at previous appointments
- Medical history: hypertension; no diabetes
- No known drug allergies; no anticoagulant treatment
Surgery and earlier wound care
- 24/10: open sigmoid colectomy for recurrent diverticulitis
- 29/10: discharged; incision closed, scant serous drainage
- 30/10: small dressing stain; no wound-edge separation
- 01/11: dry wound; changed to smaller dry dressing
- 03/11: clips removed as scheduled; edges remained approximated
- 03/11: pain 2/10; walking independently
- Old shoulder wound, 2018: required prolonged dressing care; fully healed
Current assessment — 4 November
- 04/11 10:30: coughing → sudden blood-stained wound drainage
- 10:40: lower incision open over 3 cm; subcutaneous tissue visible; moderate blood-stained drainage
- Depth/fascial integrity not established; no visible bowel; no probing
- Current pain 6/10; ↑ from yesterday
- 10:45: T 37.6°C; pulse 96 beats/min; BP 118/74 mmHg; RR 18/min; SpO2 97% air
- Alert; no vomiting; abdomen not distended; no dizziness or shortness of breath
- Last food and drink 08:00 today
Treatment and immediate transfer plan
- 10:50: sterile absorbent dressing applied; no packing
- 11:10: registrar accepted urgent transfer; ambulance arranged
- Registrar: no further wound manipulation before surgical assessment; nil orally pending review
- No antibiotics commenced; wound swab not taken
- Please notify registrar on arrival; reassess wound/observations/pain; escalate deterioration immediately
- Operative report, current medication list and community nursing assessment accompanying patient; receiving team alerted
- Previously booked routine dressing review 06/11 now superseded
- Patient asks whether another operation will be necessary; registrar to discuss after assessment
Who is reading, and what do they need?
Ms Bayona is receiving an accepted urgent transfer for a postoperative wound problem on 4 November. She needs current findings, unresolved fascial integrity, the registrar's restrictions and immediate reassessment priorities. Hypertension, no diabetes, no known drug allergies and no anticoagulant treatment can be concise context; the operative report and medication list reduce the need for a full background narrative.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 24/10 open sigmoid colectomy for recurrent diverticulitis; 04/11 10:30 drainage after coughing. | The operation and timed onset establish the context and immediate change requiring surgical assessment. |
| 10:40: lower incision open over 3 cm; visible subcutaneous tissue; moderate blood-stained drainage. | These observed findings explain urgency without assigning an unconfirmed depth or diagnosis. |
| Depth/fascial integrity unestablished; no visible bowel; no probing. | The receiving team must understand what remains unknown and avoid interpreting absent visible bowel as confirmed intact fascia. |
| Pain 6/10; T 37.6°C, pulse 96/min, BP 118/74, RR 18/min, SpO2 97% air. | Current pain and observations provide a baseline for arrival reassessment and deterioration recognition. |
| 11:10: registrar accepted urgent transfer; ambulance arranged. | This confirms the accepted pathway and transport arrangements rather than presenting an unaccepted referral. |
| Registrar: no further wound manipulation; nil orally pending review; last intake 08:00. | Restrictions and last intake are immediately relevant to nursing care while surgical assessment is pending. |
| 10:50 sterile absorbent dressing; no packing, antibiotics or swab. | The handover must distinguish care already provided from interventions not undertaken. |
| Arrival: notify registrar; reassess wound, observations and pain; escalate deterioration immediately. | Specific arrival actions make the urgent handover usable for the receiving nurse. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Upset about parking charges at previous appointments. | This complaint does not affect the current wound assessment or immediate surgical nursing priorities. |
| Old shoulder wound required prolonged care; fully healed. | A resolved wound at another site does not establish the cause or depth of today's postoperative separation. |
| Earlier scant serous drainage, small dressing stain and subsequently dry wound. | The routine dressing chronology can be compressed; today's separation and unresolved depth drive the urgent transfer. |
| Normal personal-care independence and yesterday's independent walking. | Previous function is less useful than current pain, wound findings and restrictions during this urgent handover. |
| Routine dressing review booked for 06/11, now superseded. | The accepted urgent transfer replaces this routine appointment; its original date need not distract from immediate actions. |
| Alert; no vomiting, distension, dizziness or shortness of breath. | These supporting findings can be compressed or omitted; they do not resolve the uncertainty about fascial integrity. |
A paragraph plan for this case
Open with Mr Gargallo's identifiers, urgent accepted transfer and operation, then prioritise the coughing-associated onset, current wound findings and uncertain depth; yesterday's clip removal with approximated edges can provide brief context. Follow with the timed observations, current pain, dressing already applied, interventions not undertaken, last food and drink, and the registrar's restrictions. Close with arrival notification, reassessment and escalation requests, noting the accompanying operative report, current medication list and community nursing assessment, the receiving team's prior alert and the partner's notification with consent only as useful handover context.
Where candidates slip on this task
- Do not diagnose fascial disruption, evisceration or infection from these notes; visible subcutaneous tissue and absent visible bowel leave depth and fascial integrity unresolved until surgical assessment.
- Record the observations as the 10:45 measurements and distinguish the 10:30 onset from the 10:40 wound examination; the documented pain increase does not establish another unrecorded trend.
- Keep the registrar's restrictions explicit and avoid promising another operation; the patient's question belongs with the registrar after assessment, while the receiving nurse needs immediate reassessment and notification priorities.
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
Should this be described as a superficial wound separation?
No. The notes establish an opening with visible subcutaneous tissue but explicitly leave depth and fascial integrity unknown. No visible bowel is an observation, not confirmation of a superficial problem. Select language that preserves the uncertainty requiring urgent surgical assessment.
How much earlier wound history should be included?
The operation and a brief recent baseline may help explain the change. Yesterday's approximated edges after clip removal are useful optional context; reproducing every dressing visit is unnecessary. Prioritise today's findings, current observations, restrictions and requested arrival actions over the routine chronology.
Sources
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