OET Writing practice · Nursing
Alcohol withdrawal managed in hospital – alcohol service 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 Liam Doherty, DOB 02/06/1981 (45 yrs)
Medical Ward 3, St Bride's Hospital, Aldermoor
Admission date: 04/09/2026 Discharge date: 11/09/2026
Social background:
- Unemployed since 03/2026 (IT support technician; lost job due to lateness)
- Separated from wife 2025. 2 children (8 and 11); supervised contact alternate weekends; wants regular contact
- Lives alone in rented flat, 12B Mill Road, Aldermoor; rent arrears
- Alcohol: approx. 150 units/week (vodka and beer) for approx. 2 yrs; drinks on waking. No previous detox. Attended AA twice (2025)
- Smokes 15 cigarettes/day. Occasional cannabis at weekends
- Friend (Sean) supportive; will check on him daily
- Enjoys fishing
Medical history:
- Depression (2025), citalopram 20 mg — self-discontinued 01/2026
- Gastritis, omeprazole 20 mg daily
- Fractured nose 2019 (fall while intoxicated)
- NKDA
Nursing management and progress:
04/09 Brought to ED by neighbour. Last drink 12 hrs earlier. Tremor, sweating, anxiety, HR 112, BP 158/96. CIWA-Ar 22 → chlordiazepoxide reducing regimen; IV thiamine (Pabrinex) TDS × 5 days
05/09 Visual hallucinations overnight ("insects on wall"). CIWA-Ar 18; additional PRN chlordiazepoxide. No seizures
06/09 Hallucinations resolved. CIWA-Ar 9. Eating small amounts
07/09 GGT 412 U/L, ALT 88 U/L, bilirubin normal, platelets 110 × 10⁹/L. Liver ultrasound: fatty liver, no cirrhosis. Blood-borne virus screen negative
08/09 CIWA-Ar 3. Mobilising independently. Changed to oral thiamine 100 mg TDS
09/09 Chlordiazepoxide course completed. Pt motivated to stop drinking "for my kids"; agrees to community alcohol service referral
10/09 Acamprosate 666 mg TDS commenced
- Low mood, poor sleep, tearful about children. Denies suicidal thoughts. Mental health liaison: GP to review antidepressant after 2–4 wks of abstinence
- Declined smoking cessation support
11/09 Wt 64 kg, BMI 19. Dietitian: nutritional supplement drink BD
Discharge plan:
- Medications: thiamine 100 mg TDS, vitamin B compound strong 2 tabs daily, acamprosate 666 mg TDS, omeprazole 20 mg daily, supplement drink BD
- Referral to community alcohol and drug service: relapse prevention, psychosocial support, monitor abstinence and mood
- Advised: if drinking restarts, do not stop suddenly (seizure risk); contact service or GP
- GP: repeat LFTs 4 wks; ongoing acamprosate prescription
- Housing advice leaflet given re rent arrears
Writing Task:
Using the information in the case notes, write a letter to Ms Farah Siddiqui, Clinical Nurse, Aldermoor Community Alcohol and Drug Service, 31 Victoria Terrace, Aldermoor, referring Mr Doherty for ongoing support.
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.