OET Writing practice · Nursing
Discharge after paracetamol overdose – community mental health 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: Mr Daniel Okafor, DOB 19/02/2004 (22 yrs) Acute Medical Unit, Ward 4C, Harbourside General Hospital, Port Ellery Admission date: 07/09/2026 Discharge date: 13/09/2026 Social background: - 3rd-year architecture student; failed two exams June 2026, repeating year - Lives in shared student flat with 2 flatmates. Moved from Lagos to study in 2023 - Parents live abroad. Older sister (Grace, 27) lives locally, visits daily, very supportive - Weekend café job — resigned 08/2026 - Alcohol approx. 20 units/week, increased over summer. Denies illicit drug use - Plays bass guitar in a band (has not played since July) Medical history: - Childhood asthma, salbutamol inhaler PRN (rarely used) - Low mood since approx. 04/2026. GP started sertraline 50 mg daily 10/07/2026; pt stopped after 2 wks (nausea) - Fractured L wrist 2019 (football) - NKDA Nursing management and progress: 07/09 Found drowsy by flatmate approx. 02:00. Reported taking approx. 40 × paracetamol 500 mg (20 g) with alcohol ~6 hrs earlier. Paracetamol level above treatment line → IV acetylcysteine (21-hr regimen). 1:1 observation 08/09 ALT 410 U/L, INR 1.4. Vomiting ×2 → ondansetron 09/09 Mental health liaison assessment: moderate–severe depressive episode. Overdose impulsive, after argument with partner (relationship since ended). Expressed regret, no current plan. Protective factors: sister, wish to finish degree. Obs reduced to 15-min 10/09 ALT 180 U/L, INR 1.1. Eating and drinking well. Asthma stable 11/09 Psychiatry review: mirtazapine 15 mg nocte commenced (poor sleep; previous nausea with sertraline). Safety plan completed with pt and sister 12/09 ALT 95 U/L. Slept 6 hrs. Mood "a bit better". Denies suicidal intent but reports fleeting thoughts of "not wanting to be here" - Agreed to cut down alcohol; declined referral to alcohol service at present - University requests letter supporting exam deferral (GP to provide) Discharge plan: - Discharge to sister's home for 2 wks: 14 Kestrel Close, Port Ellery - Mirtazapine 15 mg nocte, 7-day supply only; sister to store medication; no paracetamol or other analgesics kept at home - Community mental health nurse: first contact within 48 hrs; monitor mood, risk, medication adherence and side effects, alcohol intake - Crisis line number given to pt and sister - Repeat LFTs with GP in 1 wk - Psychiatry outpatient appointment in 4 wks Writing Task: Using the information in the case notes, write a letter to Ms Niamh Gallagher, Community Mental Health Nurse, Port Ellery Community Mental Health Team, 22 Quayside Road, Port Ellery, who will be supporting Mr Okafor after 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.