The task
Assume that today's date is 5 November 2026. Mr Marco Browne is being transferred from the emergency department to the inpatient mental health ward today. This is original independent practice material.
You are a registered nurse in the emergency department. Using the case notes, write a transfer letter to Ms Wadha Alotaibi, the receiving psychiatric nurse, handing over Mr Marco Browne's current condition and agreed observation and safety arrangements. Address the letter to Ms Wadha Alotaibi, Receiving Psychiatric Nurse, Inpatient Mental Health Ward, 24 Hospital Road, SW1P 3AA, United Kingdom. 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?
Severe depression after emergency assessment: transfer
You are a registered nurse in the emergency department. Using the case notes, write a transfer letter to Ms Wadha Alotaibi, the receiving psychiatric nurse, handing over Mr Marco Browne's current condition and agreed observation and safety arrangements. Address the letter to Ms Wadha Alotaibi, Receiving Psychiatric Nurse, Inpatient Mental Health Ward, 24 Hospital Road, SW1P 3AA, United Kingdom. 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 Marco Browne
- DOB: 12/02/1980; 46 yrs
- Emergency assessment and ward transfer: 05/11/26
Social background
- Lives alone; daughter accompanied him to ED
- Consents to daughter receiving care updates; contact details verified
- Library assistant; currently on sick leave
- Collects stamps; previously attended collectors' meetings
- Complained that reception staff seemed unfriendly
- Daughter discussed an unrelated family inheritance dispute
Medical history
- Depressive episode 2018; recovered following treatment
- Appendicectomy during adolescence; no ongoing problems
- No regular medicines reported; reconciliation completed
- No known drug allergies
Assessment today
- Low mood 6/52; poor sleep, ↓ appetite and reduced intake
- Latest review: suicidal thoughts persist; cannot say he would remain safe alone
- Disclosed plan to overdose on tablets at home; reports no ingestion
- Medical assessment completed; physically stable for psychiatric transfer
- No hallucinations reported; orientated and able to discuss care
- Psychiatric assessment: severe depression; inpatient care recommended
- Agrees to voluntary admission; requesting treatment
- Responds to calm explanations; allow time for answers
Documented individual safety plan
- Team plan: continuous 1:1 observation within eyesight, including bathroom use; privacy arrangements explained/agreed
- Medicines/sharps secured; collaboratively reassess belongings/environmental hazards on arrival
- Continue observation throughout transfer → direct handover to receiving observing nurse; no gap
- Ward psychiatrist to review on arrival; observation unchanged until reviewed
- ↑ distress/suicidal intent or request to leave: stay with him, immediate registrar assessment; imminent harm → emergency response
Treatment/Progress
- No psychiatric medicine started; treatment decisions await psychiatric review
- Encourage food/fluids; record intake
- Accepted sandwich and water with encouragement
- Quiet/cooperative; suicidal thoughts remain present despite calm behaviour
Who is reading, and what do they need?
Ms Wadha Alotaibi is the receiving psychiatric nurse for Mr Marco Browne, aged 46 (DOB 12 February 1980), transferring on 5 November 2026. She needs his persistent suicidal thoughts, inability to affirm safety alone, disclosed tablet-overdose plan at home and his report of no ingestion, alongside voluntary admission and uninterrupted observation arrangements. Prioritise actionable instructions; brief clinical context can support them, while routine background should not crowd out the handover.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Suicidal thoughts persist; cannot say he would remain safe alone. | Establishes the current risk that the receiving nurse must manage immediately; concise wording must retain both findings. |
| Agrees to voluntary admission and requests treatment. | The receiving nurse needs his voluntary admission status, which may be conveyed in equivalent wording that clearly expresses his agreement to admission voluntarily. His request for treatment is optional supporting information; neither removes suicide risk. |
| Continuous 1:1 observation within eyesight, including bathroom use; privacy arrangements explained and agreed. | Defines the exact observation arrangement; compression must retain continuity, one-to-one eyesight coverage, bathroom use and the explained and agreed privacy arrangements. |
| Medicines/sharps secured; collaboratively reassess belongings and environmental hazards on arrival. | Hands over completed precautions and the receiving team's arrival checks; these may be combined without losing either responsibility. |
| Observation throughout transfer; direct handover to receiving observing nurse, with no gap. | Makes continuous observation and responsibility explicit across transfer; a concise account must still identify direct handover without interruption. |
| Ward psychiatrist review on arrival; observation unchanged until reviewed. | Identifies who reviews him and when; both the arrival review and unchanged observation pending review must survive compression. |
| Increased distress/suicidal intent or leaving request: stay; immediate registrar assessment; imminent harm: emergency response. | All triggers and corresponding actions are needed; they may share a sentence if staying with him, immediate registrar assessment and emergency escalation remain explicit. |
| Severe depression; tablet-overdose plan at home, no ingestion reported; calm despite persistent suicidal thoughts. | The specific overdose plan and patient-reported non-ingestion must be handed over. Severe depression and calm behaviour offer optional context and must not minimise concern. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Library assistant; currently on sick leave. | Employment details do not change the immediate observation, transfer or escalation arrangements. |
| Collects stamps; previously attended collectors' meetings. | Hobbies add little to this immediate safety handover and can be explored during subsequent assessment. |
| Complained that reception staff seemed unfriendly. | This service complaint does not establish a current clinical problem or alter the agreed ward plan. |
| Daughter discussed an unrelated family inheritance dispute. | The notes explicitly identify this dispute as unrelated; including it risks inventing an explanation for his presentation. |
| Appendicectomy during adolescence; no ongoing problems. | The resolved operation has no documented bearing on psychiatric transfer or immediate nursing care. |
| Accepted sandwich and water with encouragement. | One episode of intake adds little to ongoing care; encouragement and intake recording are more useful if nutritional support is covered. |
A paragraph plan for this case
Open with identification, today's transfer, voluntary admission and current suicide risk, including his disclosed plan to overdose on tablets at home and his report of no ingestion. The severe depression assessment can provide concise context. Group the complete observation, hazard-control, uninterrupted transfer, psychiatric review and escalation arrangements together; they may be combined or compressed without losing conditions, responsibilities or actions. Optional background can briefly cover six weeks of low mood, poor sleep, reduced appetite/intake and recovery after treatment for the 2018 depressive episode. Close with practical care needs where space permits: calm explanations and time for answers, encouragement of food/fluids with intake recording, and living alone with a daughter authorised to receive updates whose contact details are verified.
Where candidates slip on this task
- Do not treat calm cooperation, orientation or no reported hallucinations as evidence of low risk; suicidal thoughts persist, and he cannot say he would remain safe alone.
- Keep physical stability separate from psychiatric risk: medical assessment supports transfer, while no regular medicines, no known drug allergies and no psychiatric medicine started are distinct details.
- Preserve every observation and escalation condition, including bathroom eyesight, agreed privacy, uninterrupted handover and immediate registrar assessment for increased distress, suicidal intent or leaving requests; imminent harm requires emergency response. Concise or combined sentences are appropriate when all conditions, responsibilities and actions remain clear.
- Do not replace the disclosed tablet-overdose plan at home with a general reference to suicidal thoughts. Attribute non-ingestion to his report; do not invent a tablet type, quantity or an actual overdose.
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 voluntary admission or calm behaviour justify less observation?
Neither changes the documented arrangement. His suicidal thoughts persist, and he cannot say he would remain safe alone. The handover should retain continuous observation within eyesight, including bathroom use, without interruption during transfer, and unchanged until psychiatric review.
How much background belongs in this short transfer letter?
The disclosed tablet-overdose plan at home and his report of no ingestion must accompany the current suicidal thoughts. Symptom history, medication status, communication approach and consent for daughter updates are useful optional background. Combine or compress information where helpful, while retaining his agreement to voluntary admission and every safety condition, responsibility and escalation action. Equivalent wording that accurately conveys his voluntary agreement to admission is appropriate; separately mentioning his request for treatment is optional.
Sources
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