OET Writing practice · Nursing
New colostomy after Hartmann's procedure – stoma care nurse
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your referral letter in 40 minutes, about 180–200 words in the body.
Write this letter and get feedback
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: 11/09/2026
Patient: Mr Thanh Nguyen, DOB 17/11/1959 (66 yrs)
Surgical Ward 10, Eastmoor University Hospital, Eastmoor
Admission date: 31/08/2026 Discharge date: 12/09/2026
Social background:
- Owns small restaurant with wife (Lan); long hours, standing and lifting stock
- Lives in house at 6 Jasmine Court, Eastmoor. Son (Minh, 35) lives nearby
- Grandchildren (2) visit at weekends
- Enjoys fishing and tai chi
- Non-smoker; occasional alcohol
Medical history:
- Type 2 diabetes: metformin 1 g BD, gliclazide 80 mg BD
- Hypertension: losartan 50 mg daily
- Diverticular disease (dx 2021)
- Age-related macular degeneration R eye — reduced vision
- Bilateral inguinal hernia repair 2018
- NKDA
Nursing management and progress:
31/08 ED: severe L iliac fossa pain, fever. CT: perforated sigmoid diverticulitis. Emergency Hartmann's procedure (laparotomy + end colostomy, L iliac fossa)
01/09–03/09 IV antibiotics, PCA morphine. BGLs 13–17 mmol/L → insulin sliding scale
03/09 Stoma: 35 mm, oval, healthy red, oedematous; mucocutaneous junction intact
04/09 Stoma active: flatus and liquid output. Drainable pouch
05/09 First pouch change education with ward stoma nurse. Pt reluctant to look at stoma, tearful ("feels disgusting")
07/09 Output semi-formed. Empties pouch independently. Stoma now 32 mm. Needs help cutting template; difficulty seeing lower edge of stoma (vision) → using mirror
08/09 Leak overnight → small area of redness at 6 o'clock position. Barrier spray applied; template re-measured
09/09 Midline wound clips removed; wound healing well
10/09 Son attended education session; able to assist with pouch changes. Pt more accepting of stoma; worried about odour and leaks when back at restaurant
11/09 Metformin and gliclazide restarted; BGLs 7–11 mmol/L. Eating normal diet
Discharge plan:
- Discharge home 12/09
- Drainable pouch (change to closed pouch when output formed); 2 wks' supplies given; GP to prescribe ongoing supplies
- Re-measure stoma weekly for 6–8 wks (still shrinking)
- Barrier spray for peristomal skin
- No heavy lifting 12 wks; support garment fitting required (parastomal hernia prevention)
- Dietary advice given: regular meals, chew well, adequate fluids
- Surgical outpatients 6 wks; possible reversal to be discussed (approx. 6 months)
- Community stoma nurse home visit requested within 1 wk
Writing Task:
Using the information in the case notes, write a letter to Mrs Olivia Hartley, Stoma Care Nurse Specialist, Eastmoor Community Stoma Care Service, 14 Wellington Place, Eastmoor, referring Mr Nguyen for follow-up at home.
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 referral letter
- The reader has never met the patient. State the reason for referral, and how urgent it is, in the first paragraph.
- Select the history, findings and investigation results that support the referral, and group them by topic rather than by date.
- End with what you are asking the reader to do, and any action you have already taken.
Members also get the model answer, the note-selection table and task-specific tips for this task.