OET Sample Referral Letter (Nurse) Writing Sub-test

Today’s Date
21 September 2018

You are the Nurse at a Women’s and Children Health Clinic in Adelaide. Julia Roberts is your recent patient with 2 visits:

Patient Details
Name: Julia Roberts
Address: 287 Goodwood Road, Goodwood
Phone: 08 4898742
Date of Birth: 18/05/1999
Next of kin: Ann Roberts (Mother)

General Health
No known allergies
No current medications
No significant medical or surgical history
Weight: 75kg, Height: 166cm
No reported drug use
Commenced smoking 11 months ago, smokes 15/day
Alcohol on weekends. Drinks 2 wine glasses at night

Sexual and reproductive health
On oral contraceptive pill for last 12 months
Regular menstrual period each 28 days. LMP 7 days ago
No previous Pap test
No history of STI
No pregnancies
Recently ended monogamous relationship of 10 months and now has a new partner of 2 months – not sure if monogamous. Does not use condoms. Last sexual contact 14 days ago

18 September 2018
Julia presented to clinic requesting a Pap test. Pap test suggested by Mother.
Julia concerned about weight gain of 10kg over last 12 months and wants to know about other methods of contraception.
Sexual and reproductive health history taken
Partner risk discussed – no IV drug use, no recent overseas travel
No reports of pain, discharge or irregular bleeding
Urine PCR test for chlamydia collected
Pelvic exam undertake – NAD
Pap smear taken
Patient to return in 3-4 days for chlamydia results. 
Safer sexual practices discussed, including barrier protection
Cervical screening information sheet provided
Risks of smoking and benefits of quitting discussed with patient.
Referred to Quitline
Referred to Women’s health nutritionist

21 September 2018
Returned for results: PCR test positive for chlamydia tracomatis
Patient informed of results
Arranged notification of partners
Prescribed azithromycin 1gram as a single dose
Advised not to have sexual contact for 7 days after treatment
For referral to GP for further testing and contraceptive advice

OET Writing Task

Write a referral letter to the Dr Silver Bullet, Medical Practitioner at the Prospect Medical Centre 22 Prospect Road, Prospect 5086 requesting review of your patient to discuss contraceptive options and further testing for sexually transmitted infections and blood borne viruses.

In your answer
Expand the relevant case notes into complete sentences
Do not use note form
Use correct OET letter format
The body of your OET letter should be approximately 180 – 200 words

Two most important items in introduction of any OET referral letter are chief complaint and purpose. The reader (Dr Silver Bullet) of your letter would be more interested in finding out what the main issue is and what is expected of her. This can be found in Diagnosis/assessment.

Remember this is a referral letter, so, you can write in your answer:  I am writing to refer

Add name, age and marital status:  Ms Roberts, a 19-year-old single lady

Now, if any OET nurse thinks that weight loss or pap test is the main issue, then she hasn’t understood the scenario well. If you look closely, you will find that the patient was found to have Chlamydia Trachomatis possibly due to which she was referred to the above doctor. Hence, writing chlamydia trachomatis in the introduction of your OET referral letter leads to more accurate introduction.

Add chief complaint: who was diagnosed with chlamydia trachomatis.

The next step is writing the purpose. It is always better to give purpose in an overview form rather than writing all tasks to be performed by the reader. Here the purpose of OET letter can be found in the OET Writing Task (to discuss contraceptive options and further testing for sexually transmitted infections and blood borne viruses).  So, the overview of this purpose would be – advice and management.

Purpose: She requires your advice and management.

So introduction of your OET letter would be like this:

 I am writing to refer Ms Roberts, a 19-year-old single lady who was diagnosed with chlamydia trachomatis. She requires your advice and management

Try to summarise aspects of past medical history that are either normal or not very important. Below are such aspects of medical history from the given case notes:

• No known allergies
• No current medications
• No significant medical or surgical history
• No reported drug use
• No history of STI
• No pregnancies

Hence writing this would make more sense:Ms Robert’s medical history is unremarkable.

Things worth mentioning:
• Commenced smoking 11 months ago, smokes 15/day
• Alcohol on weekends. Drinks 4 wine glasses at night

You can combine the above in one sentence: She is a regular smoker (15 cigarettes/day) and drinks moderately on weekends.

Next in line of your OET letter is weight:
• Weight: 75kg, Height: 166cm
• Julia concerned about weight gain of 10kg over last 12 months

She has gained 10kg over the past 12 months and currently weighs 75kg.

Let’s write all the sentences together with the help of transitions to make a cohesive paragraph

Ms Robert’s medical history is unremarkable, but she has gained 10kg over the last 12 months. Apart from that, she is a regular smoker (15 cigarettes/day)  and drinks moderately on weekends.

As the patient’s condition might have been caused due to sexual relationships, it is worth discussing sexual health in your OET letter:

• Recently ended monogamous relationship of 10 months and now has a new partner of 2 months – not sure if monogamous. Does not use condoms. Last sexual contact 14 days ago

Here we haven’t changed much but you may rewrite to showcase your OET writing skills:

Ms Roberts recently ended a monogamous relationship of 10 months and now she has a new partner of 2 months.

How about combining information about contraception together?
• Does not use condoms. Last sexual contact 14 days ago
• On oral contraceptive pill for last 12 months

She has been using oral contraceptive pills since last year, and she does not use condoms. Her last sexual contact was 14 days ago.

Notice the use of conjunction and transition

Ms Roberts recently ended a monogamous relationship of 10 months, and now she has a new partner of 2 months. Besides, she has been using oral contraceptive pills since last year, and she does not use condoms. Her last sexual contact was 14 days ago.

It makes more sense to discuss nursing management here, but before that let us discuss OET case notes which are not necessarily required and why so

• Julia presented to clinic requesting a Pap test. Pap test suggested by Mother. (Since pap test was carried out after she had visited the clinic, reason for visit is no longer important for the reader.) 

• Julia concerned about weight gain of 10kg over last 12 months and wants to know about other methods of contraception. (Weight gain was already discussed in the medical history and ‘methods of contraception’ will be written in the last paragraph as it is already a part of the OET Writing Task. Remember, we need to avoid repetition in our OET letter!)

• Sexual and reproductive health history taken (Look closely, case notes already include sexual and reproductive history. The case note adds no value.)

• No reports of pain, discharge or irregular bleeding (There are not issues here)

• Urine PCR test for chlamydia collected (Since we already wrote about chlamydia in introduction this note adds no real value)

• Patient to return in 3-4 days for chlamydia results. Pap test results in 2-4 weeks (Again no need)

• Patient informed of results (No need)

• Arranged notification of partners (Focus on the patient)

You need not worry about the dates and write entire nursing management in one paragraph. An easy way to do so is to find out common verbs.

• Partner risk discussed – no IV drug use, no recent overseas travel
• Safer sexual practices discussed , including barrier protection
• Risks of smoking and benefits of quitting discussed with patient.

Risks of smoking, benefits of quitting, partner risk and safer sexual practice were discussed

• Referred to Quitline
• Referred to Women’s health nutritionist
She was referred to Quitline and a Women’s Health nutritionist

You can now use a conjunction (and) to combine the above two sentences.

Risks of smoking, benefits of quitting, partner risk and safer sexual practice were discussed, and she was referred to Quitline and a Women’s Health nutritionist.

• Pelvic exam undertake
• Pap smear taken
A pelvic exam and PCR were done

• Cervical screening information sheet provided
A cervical screening information sheet was provided/given.

Now, let us use conjunction (and) and write the above two sentences into one. 

A pelvic exam and PCR were done, and a cervical screening information sheet was provided/given.

• Prescribed azithromycin 1gram as a single does
• Advised not to have sexual contact for 7 days after treatment

She was prescribed azithromycin 1 gram and advised to avoid sexual contacts for 7 days after the treatment.

When all sample sentences written together, the paragraph would be:

Risks of smoking, benefits of quitting, partner risk and safer sexual practice were discussed, and she was referred to Quitline and a Women’s Health nutritionist. Also, a pelvic exam and PCR were done, and a cervical screening information sheet was provided. As well as this, She was prescribed azithromycin 1 gram and advised to avoid sexual contacts for 7 days after the treatment.

In case when writing an OET letter to a doctor, tasks to be performed can be written like the following:

• requesting review of your patient to discuss contraceptive options and further testing for sexually transmitted infections and blood borne viruses.

It would be greatly appreciated if you could review Ms Robert and provide contraceptive options and further tests for sexually transmitted infection and blood borne viruses.

Now you can close by writing this:

For any queries, please do not hesitate to contact me.

21/09/2018

Dr. Silver Bullet
Prospect Medical Center
22 Prospect Road
Prospect 5086

Dear Dr Bullet,
Re: Julia Roberts, D.O.B: 18/05/1999

I am writing to refer Ms Roberts, a 19-year-old single lady who was diagnosed with chlamydia trachomatis. She requires further advice and management.

Ms Robert’s medical history is unremarkable, but she has gained 10kg over the last 12 months. Apart from that, she is a regular smoker (15 cigarettes/day)  and drinks moderately on weekends.

Ms Roberts recently ended a monogamous relationship of 10 months and now she has a new partner of 2 months. Besides, she has been using oral contraceptive pills since last year and she does not use condoms. Her last sexual contact was 14 days ago.

Risks of smoking, benefits of quitting, partner risk and safer sexual practice were discussed, and she was referred to Quitline and a Women’s Health nutritionist. Also, a pelvic exam and PCR were done and a cervical screening information sheet was provided. She was prescribed azithromycin 1 gram and advised to avoid sexual contacts for 7 days after the treatment.

It would be greatly appreciated if you could review Ms Robert and provide contraceptive options and further tests for sexually transmitted infection and blood borne viruses.

For any queries, please do not hesitate to contact me.

Yours sincerely,

Nurse