OET Writing practice · Nursing
Discharge after elective hip replacement – community nurse
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your discharge letter in 40 minutes, about 180–200 words in the body.
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Case notes
NURSING — WRITING TASK (practice) Time allowed: Reading time 5 minutes, Writing time 40 minutes Read the case notes below and complete the writing task which follows. Notes: Today's date: 13/09/2026 Patient: Mrs Beatriz Oliveira, DOB 21/05/1947 (79 yrs) Orthopaedic Ward 4C, Harbourview Hospital, Easton Admission date: 07/09/2026 Discharge date: 13/09/2026 Social background: - Born in Portugal, moved here 1972. Fluent English, prefers Portuguese when tired - Widowed 2020. Lives alone in single-storey house, 3 steps at front entrance - Daughter (Sofia, 50) works full-time, lives 30 min away; can visit evenings only - Retired seamstress. Volunteers at local charity shop (Tuesdays) - Non-smoker, no alcohol - Cat at home, neighbour feeding during admission Medical history: - Severe osteoarthritis R hip (5 yrs) - Hypertension, perindopril 4 mg daily - Hypercholesterolaemia, rosuvastatin 10 mg daily - Mild chronic kidney disease (eGFR 55) - Tonsillectomy age 12 - Allergy: penicillin (rash) Nursing management and progress: 07/09 Elective R total hip replacement (THR), posterior approach, spinal anaesthetic. Uneventful surgery - Post-op Hb 118 g/L. Pain 6/10 → regular paracetamol, oxycodone PRN 08/09 Mobilised with physio, walking frame. Mild nausea, resolved with ondansetron 09/09 Hb 102 g/L. Dizzy on standing, BP 98/60 → perindopril withheld, oral fluids encouraged 10/09 BP 132/78, perindopril recommenced. Constipation (BNO 3 days) → Movicol, BO 11/09 11/09 Wound 22 cm, Opsite Post-Op dressing intact, small serous ooze. Staples in situ - Pain 3/10 at rest, 5/10 on mobilising 12/09 Stairs assessment passed with physio (rail + stick). Walks 40 m with frame - OT: raised toilet seat, shower chair, over-toilet frame delivered to home 12/09 - Hip precautions reinforced (no flexion > 90°, no crossing legs, no twisting); pt occasionally forgets - Pt asked about returning to charity shop; advised to discuss at 6-week review 13/09 Wound dry, dressing changed. Afebrile. Pt anxious about showering alone Medications on discharge: - Paracetamol 1 g QID - Oxycodone 5 mg PO 6-hrly PRN (max 3 doses/day) - Rivaroxaban 10 mg daily until 18/10/2026 (DVT prophylaxis) - Perindopril 4 mg daily; rosuvastatin 10 mg daily - Movicol 1 sachet daily PRN Discharge plan: - Community nurse visits: wound check, dressing change 16/09, staple removal 21/09 (day 14) - Monitor for signs of wound infection and DVT (calf pain, swelling) - Hip precautions for 6 weeks; home exercise programme (physio sheet given) - Community physio 2×/week - Orthopaedic clinic review with X-ray 20/10/2026 - Daughter to arrange meal delivery service Writing Task: Using the information in the case notes, write a letter to Mr Daniel Whitmore, Community Nurse, Easton Community Nursing Service, 12 Quarry Lane, Easton, who will be visiting Mrs Oliveira at home following discharge. 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.
How to approach this discharge letter
- The reader takes over care after discharge. Open with who the patient is, why they were in hospital and that they are going home, then say what you need the reader to do.
- Give the current condition, medication changes and the follow-up plan. Summarise the hospital stay instead of retelling it day by day.
- Leave out resolved problems and background that does not change care at home.
Members also get the model answer, the note-selection table and task-specific tips for this task.