Welcome to the MELONS strategy of writing OET Letters. Follow these simple steps and write any OET letter without confusion. Before we proceed, let’s try to understand why we write a reference letter.

In hospitals and homecare, nurses and doctors have to deal with a very important step – discharge. That is, you have to discharge the patient and send home for rest, or transfer to another facility for further evaluation and treatment.

Sample Letters

Let’s now study a few sample letters. 

Sample Letter 1

28th February, 2024

Ms Samantha Bruin
Senior Nurse
Greywalls Nursing Home
27 Station Road
Greywalls – 55

Dear Nurse,

Re: Ms Gemi Baker; 33 years

Mr Gerald Baker requires continued care back at your facility. He is recuperating after a hip replacement surgery and is ready to be discharged tomorrow.

Mr Thomas was → admitted → on 12th January, 2026 → with the complaints of nausea and night chills. He underwent blood and urine tests → and was diagnosed with leptospirosis → His medication was commenced on doxycycline and continuous monitoring.

Mr Baker was admitted on 25 February, 2024 and underwent the surgery on the next day. During postoperative recovery, Mr Baker had disorientation regarding time and place, possibly relating to anaesthetic effect for which continued observation was provided. 3 units of packed red blood cells was transfused due to low Hb which is now stable. 

At present, Mr Baker is on Aspirin, 100 mg and Ramipril, 5 mg, both in the morning. He can also have two tablets of Panadeine Forte if required. He is receiving daily dressings on the surgery site along with range of motion, stretching and strengthening exercises. He is also receiving occupational therapy. 

Based on the information about Mr Baker, his staples need to be removed before 15 March. Also, follow-up with FBE and UEC tests at City Hospital Clinic. It is important to note that ongoing monitoring is required for anaemia.

A detailed list of his current medication is enclosed herewith. For any further information about Mr Baker, kindly contact me. 

Yours sincerely,

Charge Nurse.

Letter Sample 2

23 May 2024

Mrs Monica Hendrik
Senior Nurse Practitioner
University of March Bank Health Centre
Hills Dune Rd, March Bank

Dear Mrs Hendrik,

Re: Ms Jane Peterson; DOB: 17th March 2006

Mr Irene Parker requires continuity of care including medication administration back at your care home. He is recuperating after total hip replacement surgery and will be discharged tomorrow.

Mr Peterson’s alopecia began in August 2019, coinciding with a bullying incident at school. Despite a referral to a trichology specialist and treatment with steroid cream, the aetiology remained uncertain, and the treatment was discontinued due to adverse effects including personality changes, aggression and sleep loss.

Between 2019 and 2022, Mr Peterson experienced intermittent hair regrowth without further hair loss; however, in July 2023, he reported anxiety and pronounced hair loss. A general health check indicated a weight gain of 6 kg over 2 months. He was reluctant to consult a doctor and instead, pursued homeopathic remedies which were not effective.

In December 2023, Mr Peterson’s low mood and difficulties in peer relationships were affecting his sports participation. Although referred to the school counsellor in January 2024, he did not attend the sessions. A follow-up in March revealed increased alcohol consumption exacerbated during exam periods when he required special arrangements due to extreme anxiety.

Considering Mr Peterson’s present condition, it would be appreciated if you could monitor his health and hair loss closely. Special arrangements for exams and additional support from university counselling services are necessary.

Please contact me for any more additional information regarding Mr Peterson.

Yours sincerely,

Charge Nurse.

Sample Letter 3

26 June, 2024

Ms Angela Ferry
District Nurse
Mayor’s Ave., Pittsburgh 66

Dear Nurse,

Re: Baby Ivan Rich; 2 months old

Baby Ivan Rich requires daily visits to monitor progress and to help his parents with medication administration. He has lethargy, persistent vomiting and signs of severe dehydration. He is being discharged conditionally today.

On 22 May, 2024, Evan was evaluated by his pediatrician for concerns like reduced feeding and mild fever. Examination found elevated temperature. His heart rate was 160 bpm, respiratory rate was 50 breaths per minute and blood pressure showed 85/55 mmHg. He looked lethargic and irritable and poor weight-gain was observed.

Further systemic examinations revealed tachycardia, mild tachypnea with no retractions or wheezing. Additionally, Evan showed signs of dehydration, reduced bowel sounds, prolonged crying spells and irritability. However, his tone and reflexes were normal.

Based on further investigations, Ivan was provisionally diagnosed with bacterial or viral infection along with acute gastroenteritis and dehydration. Subsequently, he was admitted for three days and his management commenced on IV fluids for rehydration and electrolyte correction. Anti-emetics and oral rehydration solution for vomiting and diarrhea.

On 24 June, Ivan was presented with persistent high fever (39°C – 40°C) for a week along with reduced feeding and lethargy. Episodes of vomiting and diarrhea.

Based on Ivan’s current condition, kindly repeat his CBC and CRP in 48 hours. Monitor for any signs of deterioration, such as increased lethargy, persistent vomiting, or signs of severe dehydration. Please ensure regular feeding and hydration. Educate parents on signs of dehydration and when to seek immediate medical attention. Please note, he will be referred back to pediatrician Dr. Richards Aringrosa for continued care and monitoring in three days.

For more information, please contact me.

Yours faithfully,

Charge Nurse.

Sample Case Notes

Occupational English Test – Writing (Nursing)

Read the case notes below and complete the writing task which follows. 

Notes:

Imagine that today is 26 June, 2024. The two-month old is being presented to his Pediatrician where you are his charge nurse.

Patient Information:

• Name: Ivan Rich.
• Age: 2 months.
• Mother: Sarah Rich. 
• Father: David Rich.
• Hospital: Holy Angels’ Hospital, Pittsburgh, United States.

History:

• Birth History: Normal birth, all parameters within normal range.
• Duration of Illness: 1 month.
• Previous Hospitalizations: Once.

Previous Medical Visits:

22/05/2024

• Evaluated by Pediatrician.
• Concerns: Reduced feeding and mild fever.

Examination Findings:

• Temperature: 39°C.
• Heart Rate: 160 bpm
• Respiratory Rate: 50 breaths per minute
• Blood Pressure: 85/55 mmHg.
• General Appearance: Appears lethargic and irritable.
• Poor weight gain observed.

Systemic Examination:

• Tachycardia noted.
• Mild tachypnea, no retractions or wheezing.
• Signs of dehydration, reduced bowel sounds.
• Prolonged crying spells, irritability, normal tone and reflexes.

Investigations:

• WBC: 18,000 cells/µL (elevated).
• Hemoglobin: 10.5 g/dL (slightly low).
• Platelets: 450,000 cells/µL (elevated).
• C-Reactive Protein (CRP): 25 mg/L (elevated).
• Blood Culture: Pending.

Diagnosis:

• ? Bacterial or Viral Infection.
• ? Acute Gastroenteritis.
• Dehydration.

Management Started (Patient admitted for three days).

Immediate Treatment.

• IV fluids for rehydration and electrolyte correction.
• Antipyretics for fever management (e.g., acetaminophen).
• Anti-emetics and oral rehydration solution for vomiting and diarrhea.

24/06/2024

• Persistent high fever (39°C – 40°C) for the past week.
• Reduced feeding and lethargy.
• Episodes of vomiting and diarrhea.
• Failure to gain weight adequately.
• Increased irritability and prolonged crying spells.
• Managed with the same medicines prescribed previously. Patient admitted.

26/06/2024

• Being discharged today (conditionally).
• Referral back to Pediatrician Dr. Richards Aringrosa for continued care and monitoring (in three days).

Plan

• Await results of blood and stool cultures.
• Repeat CBC and CRP in 48 hours.
• Monitor for any signs of deterioration, such as increased lethargy, persistent vomiting, or signs of severe dehydration.
• Ensure regular feeding and hydration.
• Educate parents on signs of dehydration and when to seek immediate medical attention.

Writing Task

Using the information in the case notes, write a letter to the District Nurse, to visit the patient daily to monitor progress and to help Ivan’s parents with, for example, medication administration, etc. Address your letter to Ms Angela Ferry, District Nurse, Mayor’s Ave., Pittsburgh 66.

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.

Melons Steps

1. Marking: PPRRAADDDDDWK

2. Elimination

3. Launching → DADR

• 15th January, 2026
• Address (NDA)
• Dear Doctor / Dr Flora,
• Re: Mrs Ryana; 18 years

4. Opening → PRPPD | Present

• PRPPD
• UPRPPD (+who | Known)
• TPRPPD (+who | Appointment)
• PPRPPD (Parent + Patient)

5. Narration:

Me1 – Recent (Past PADC. TDM)

• Baby Ivan was presented.
• Mr Rich presented … (self)
• Mr Rich was brought (ambulance)
• Baby Ivan was admitted.

Me2 – Present (Present Tense)

• At present,
• Progress / worsening
• … is allergic to penicillin…
• She has had diabetes mellitus since….

Me3 (PMH) Dr Past

• In 2022, Mr Rich was diagnosed.
• Please note, he was hospitalized …

LONS (?) Present 

1. 1. Lifestyle (SDDE)
   2. Occupation (Ex manager…)
   3. Nutrition (BMI, Diet)
   4. Social (Wife / husband / children / dog)

6. Signing (Plan) Future + Present

1. 1. Request 
      1. Nurses: Instru + Infor
      2. Dr: Information
   2. Yours
      1. faithfully,
      2. sincerely,
   3. Charge Nurse.