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Jim Middleton – OET letter

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TASK 32.  Today’s date: 9/7/08

Patient Details: Jim Middleton aged 84 was admitted to your ward following surgery for a left inguinal hernia. His doctor has advised he can be discharged within 48hrs if there are no complications following the surgery. Jim reports some pain on movement but has recovered well from the surgery and is keen to return home.

Name  : Jim Middleton. Date of Birth          : 3 July 1924

Admitted        : 7 July 2008 Planned Discharge Date : 9 July 2008 Diagnosis       : Left inguinal hernia

Medical History Hypertension diagnosed 1998 Medication Atacand 4mg daily

Family History: Married 50 years to wife Olga DOB 8.2.32 – one son living in USA

Jim is Second World War veteran – served two years in Borneo -Prison of War 16 months.

Own their own home with large garden which they maintain without assistance. Very independent and proud that they have never applied for a pension or home assistance. Have always managed quite well on their income from a number of investments.

Olga told you she is worried as income from these investments has recently been significantly reduced due to severe stock market falls. She is concerned Jim will not be able to continue to maintain their garden and they will not be able to afford a gardener or any other help at this time.

Transport is also a problem as Olga does not drive. Not close to any reliable public transport so will have to rely on taxis. Olga thinks they may now be eligible to receive a pension and other assistance from the Department of Veteran Affairs but doesn’t know how to find out-doesn’t want to worry Jim.

Olga is in good general health but becoming increasingly deaf – finds phone conversations difficult. She would appreciate a home visit. You agree to enquire on her behalf. Their address is 22 Alexander Street, Belmont, Brisbane 4153 Phone (O 7) 6946 5173

Discharge Plan: Must avoid any heavy lifting. Should not drive for at least six weeks

Light exercise only. May take 2 Panadol six hourly for pain

Appointment made to see surgeon for post operation check at 10am on 11 August

Contact Department of Veterans Affairs re eligibility for pension and home help

WRITING TASK: Using the information in the case notes, write a letter to The Director, Department of Veterans Affairs, GPO Box 777 Brisbane 4001. In your letter, explain why you are writing and the assistance they are seeking.

Henry O’Keefe – OET letter

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TASK 31 Read the case notes below and complete the writing task which follows:

You are a nurse with the Blue Skies Home Nursing Centre. You visited this patient at home today for the first time following a referral from the Mater Public Hospital. He was discharged from hospital on 17.3.08.

Name  : Henry O’Keefe

Address          : 12 Donaldson Street, Greenslopes 4121 Phone        : (07) 3941 2267

Date of Birth: 2 February 1925

Admitted        : 14.3.08

Diagnosis        : Malignant Melanoma Left Shoulder

Medical History: Large lesion successfully removed 14.3.08.

Discharged 17.3.08

Needs assistance with showering and to dress wound prior to removal of sutures at Mater Public Hospital on 24.3.08

Family History: Married aged pensioner. Lives in housing commission home with wife Dorothy also an aged pensioner. No children

18.3.08 1st Home visit: Showered patient. Wound dressed- healing satisfactory no sign of infection Balance a little shaky- complaining of increased arthritic pains in hands and legs. Currently taking Glucosamine & Chondroitin Supplement recommended by GP. Pain relieved with 2 Panadol 3 times daily. Confused about (why he had operation).Dorothy concerned about future. Tells you she will be 83 in August. Says Henry has not been himself since the surgery. Keeps forgetting things. She finds it difficult to manage the house and garden. Neighbours are helping with shopping. Kitchen and bathroom disordered- trouble finding clean towels- dishes piled in sink, bed unmade.

19.3.08 Henry showered and wound dressed. Still a little unbalanced. Rests most of the day. Does not remember being showered yesterday. House still disorganised, washing piled up in bathroom.

Dorothy says she would be lost without help from neighbours who also appear to be cooking meals for the couple.

Concerns: Provided there are no complications with the wound healing, your role in providing nursing care ends when sutures are removed on 24 March. You consider that Jim and Dorothy need to be assessed for further on-going assistance in managing the house and garden and with shopping and the preparation of cooking.

Plan: Request a home visit by the Aged Care Assessment Team as soon as possible to fully assess their needs and to arrange for appropriate further assistance to be provided.

WRITING TASK: Using the information in the case notes, write a letter to The Director, Aged Care Assessment Team, Brisbane South Region, 78 Masterson St. Acacia Ridge, Brisbane 4110. Explain why you are writing and what types of assistance may be required

View sample answer by Lifestyle Training Centre

Phillip Satchell – OET letter by Lifestyle Training Centre

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Read the case notes and complete the writing task which follows
Notes
Name: Phillip Satchell
Age: 73
Marital status: Wife deceased (2007)
Family: Two sons in their 40’s in Darwin.
First attended community centre: March 2007
Last visit to community centre: Feb 2011
Diagnosis: Multiple sclerosis, Type 2 diabetes, chronic L & R leg ulcers
Social/Medical Background: Current: lives alone in public housing in Orange
Future: will move to equivalent housing in Maroubra to Î
access for MS treatment.
Income: aged pension
Poor compliance with oral diabetic agents and diabetic diet
MS currently stable but frequent relapses
2-3/12 Staphylococcus Aureus infections
in leg ulcers; pus ++
Lonely and isolated, but nil mental illness; good relations
with sons but rarely see them. They run a pet shop business.
Nursing management and progress: Medications: IV antibiotics twice daily and metformin for
diabetes three times per day.
Twice daily dressings to L & R legs
Monitored blood sugar levels, medication compliance
and provided education re diabetes.
Constantly monitored for signs of MS relapse
Discharge plan
Switch to oral antibiotics but continue same diabetic medications and dressings.
Please refer to Prince of Wales Diabetic Clinic (medication review + Î education).
Via your doctors, facilitate referral to neurologist for MS follow up.
Support to link with community services to Î coping and social network.
Writing task
Using the information in the case notes, write a referral letter to the Community Nurse, Community
Health Centre, Maroubra, outlining relevant information and requesting continued community care.
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.

Sample answer by Lifestyle Training Centre

Community Nurse,
Community Health Centre,
Maroubra

February 2011

Dear Nurse,
Re: Mr Phillip Satchell, aged 73 years.

I am writing to refer Mr Satchell, who requires on going care, particularly for multiple sclerosis, following his relocation to Maroubra. He has been undergoing treatment for MS, Type 2 diabetes, and chronic L & R leg ulcers with us since March 2007.

Though Mr Satchell’s MS is presently stable, it often worsens. He is regularly monitored for signs of MS relapse and now requires finer medical access in Maroubra to treat his condition. With the help of your doctors, kindly refer him to a neurologist for his MS follow up.

Mr Satchell has been suffering from leg ulcers along with Staphylococcus Aureus infections, which happens up two three times a year. Both his legs need to be dressed twice daily. As his medical compliance is poor, he was educated on diabetes and its diet.

Mr Satchell is a widower and his two sons, who live in Darwin, rarely visit him. As he is lonely and isolated, kindly connect him with community services, and help him to increase his social network. He has no mental illness.

Based on the above, please provide Mr Satchell care and assistance on his arrival to Maroubra. His IV antibiotics, twice daily, needs to be switched to oral. He also needs to continue taking metformin for diabetes, three times per day. Kindly refer him to Prince of Wales Diabetic Clinic for medication review and further education. If you have further queries, please do not hesitate to contact me.                                                                                                           

Yours faithfully,
Community Nurse.

(words used: 230)       

MR JOHN McINTYRE – OET letter by Lifestyle Training Centre

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Sample answer by Lifestyle Training Centre

Dr Joan Meagher,
General Practitioner,
Bannockburn Community Health Centre,
2 Pope Street Bannockburn Victoria 3331.

1/10/2009

Dear Dr Meagher,
Re: Mr John McIntyre, aged 68 years.

I am writing to refer Mr McIntyre, who needs sympathetic care and monitoring following his relocation to Lake Retirement Village at Bannockburn in a week. He suffers from Hypertension, Congestive cardiac failure,  and Chronic obstructive airways disease.

Since September 2001, Mr. McIntyre is consistently monitored by our Community Nurse to ensure medication compliance. His prescribed medications include diuretics, antihypertensives, vasodilators, and bronchodilators. A detailed description of his medical history can be found in his casebook, which is currently in his possession.

Mr. McIntyre has been engaging in excessive alcohol consumption and has been smoking 40 cigarettes per day for the past 30 and 35 years, respectively. He believes that he will be able to curtail these habits following the relocation.

Mr. McIntyre is married and resides in his own home with his wife. He has three children and a grandchild, managing expenses from a small savings account and aged pension. Despite advice from his wife and children to modify his lifestyle, Mr. McIntyre does not yield.

Considering the provided information, I kindly request that you assume responsibility for Mr. McIntyre’s care. Please ensure that he receives sympathetic care and continuous monitoring. Kindly encourage him to cease smoking and drinking. Additionally, please monitor his medication compliance and diet closely, and motivate him to engage in regular exercise. If you have further queries, please do not hesitate to contact me.

Your sincerely,
Registered nurse.

Case notes:

MR JOHN McINTYRE – 68 year old Born: 1941
This 68 year old married man has been getting monitored at the Community Health Centre, Richmond. He and his wife are moving to The Lake Retirement Village Bannockburn
11/2001 – First attended Community Health Centre, Richmond
10/2009 – Last attended the Centre
DIAGNOSIS: Hypertension, Congestive cardiac failure, Chronic obstructive airways disease (COAD)
SOCIAL HISTORY: Married, Three children; one grandchild, Lives in own home with his wife
Wife has no control over his lifestyle or medication. He resents his children’s advice about the need to change his lifestyle. Now moving to a self-contained Unit at The Lake Retirement Village (Anticipate this will happen in one week’s time). Apart from a small amount of savings, Mr. and Mrs. McIntyre plan to live on the Aged Pension. Has been excessively drinking alcohol for past 30 years. Has been excessively smoking (40/day) for the past 35 years. Claims he will stop smoking once he moves to the new Unit. He will try and cut down on the drinking
NURSING MANAGEMENT AND PROGRESS
Medications include diuretics, antihypertensive, vasodilators and bronthodilators
Has received regular monitoring by Community Nurse to achieve medication compliance
Further details in patient’s personal casebook (with the patient)
DISCHARGE PLAN: Establish contact with a sympathetic medical practitioner
Monitor medication compliance and diet, Encourage patient to stop smoking
Encourage patient to stop drinking, Encourage patient to take moderate regular exercise
WRITING TASK: Mr. McIntyre needs to be monitored by a sympathetic GP so that his present regime continues in his new home. Using the information in the above case notes, write a letter referring the patient into the care of Dr Joan Meagher, General Practitioner, Bannockburn Community Health Centre, 2 Pope Street Bannockburn Victoria 3331. You must use full sentences in your letter – not notes / bullet points. Write no more than 25 lines about 180 to 200 words.

Joel Silbersher – OET letter by Lifestyle Training Centre.

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Name : Joel Silbersher Age 12
Admitted : 10 September 2008
Discharged : 13 September 2008
Reason for admission: Dehydration, weak rapid pulse, orthostatic hypotension, acetone breath, tachycardia, weakness, fatigue, N & V. abdominal cramps
Diagnosis: Diabetic ketoacidosis
History: IDDM Type 1; Joel was staying with his friends in Ballarat for the weekend; Insulin injections (Self-administered) neglected, increased sweet and fatty food intake; Stress levels were high; embarrassed by condition.
Nursing Notes: IV fluids, IV insulin administration, blood glucose monitoring; electrolyte replacement; K+ replacement. Pt. condition improved gradually with above, maintained consciousness; glucose added to IV when blood glucose normalized.Pt. commenced on low-fat, low-sugar diet
Discharge Plan: Pt. and family educated re prevention of future episodes, carry medical ID (indicating diabetic, name of GP, type and dose of insulin) at all times, tell friends and family how to respond in case of hypoglycemia; need for complying with dose and self- medication emphasized; diet plans given, exercise options outlined.

Writing Task: Using the information in the case notes, write a letter of referral to historical GP, Dr. Harry Coleman, St. Kilda Health Clinic, 35 Carlisle St, St Kilda 3182. DO NOT use note form in the letter. Expand the relevant case notes into full sentences. The letter should be approximately 200 words long.

Sample letter by Lifestyle Training Centre

Dr Harry Coleman,
St Kilda Health Clinic,
35 Carlisle St, St Kilda 3182.

13 September 2008

Dear Dr Coleman,
Re: Joel Silbersher, aged 12 years.

I am writing to refer Joel, who requires education on prevention of Diabetic ketoacidosis, following his discharge today as he is recuperating from an episode.

Joel, diagnosed with type 1 Insulin-Dependent Diabetes Mellitus, experienced a distressing incident over the weekend at a friend’s place. He consumed high-sugar and fatty foods, neglecting to self-administer his insulin injection. Consequently, Joel was admitted to the hospital, presenting symptoms such as dehydration, a weak rapid pulse, orthostatic hypotension, acetone breath, tachycardia, weakness, fatigue, nausea and vomiting, and abdominal cramps. The diagnosis confirmed Diabetic Ketoacidosis.

During hospitalisation, Joel received IV fluids and IV insulin. Continuous monitoring of his blood glucose levels was conducted, and electrolytes as well as potassium were replenished. To normalise his blood glucose levels, IV glucose was administered.

Joel is presently conscious and recuperating effectively; however, he is coping with stress and embarrassment following the recent episode. He was initiated on a low-fat and low-sugar diet.

In light of the above, it’s crucial to educate Joel and his family on preventing future episodes and ensuring prompt assistance in case of hypoglycaemia. Joel is advised to consistently carry a medical ID containing details about his condition, insulin dosage, and his GP’s name. Strict adherence to self-medication, dietary plans, and exercise is essential for effective management of his condition. If there are any further questions or concerns, please feel free to reach out to me.

Yours sincerely,
Registered Nurse.

Mavis Brampton OET letter by Lifestyle Training Centre

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Mavis Brampton  [5 mins reading / 40 mins writing] This patient has been in your care and is now going home from the Northern Community Hospital,  Moreland, 3051.

Patient: MAVIS BRAMPTON – 72 years old

Admitted: 10 January 2011        To be discharged: 15 January 2011

Diagnosis: Pleurisy

BACKGROUND:

D Mrs Brampton has been widowed 25 years. Has been an active member of the community all her life. Is the current President of PROBUS in her area. She with her husband ran the Sydney Road Newsagency until his death at which time she retired.

Attends the local Community Centre three times a week to play Bingo. Has been a smoker all her life (since 18 years of age). Current smoking 10 a day.

NURSING NOTES:

  • 10 Jan 2011 Overweight: BMI 29 Had CXR; IV Amoxycillin with supplementary O2
  • Advised to give up smoking.
  • BP 170/90 Pulse 92 Slightly raised temperature: 39oC Breathless 12 Jan 2011 On low-dairy diet Advised about Nicotine patches.
  • Productive cough – sputum culture done Pravastatin 20mg/day and Celecoxib 100mg/day

13 Jan 2011

  • Deep breathing exercises started. Is keeping to a non-smoking regime.
  • Using Nicotine patches and Zyban (150mg b.i.d).
  • To be discharged 15 Jan 2011.

DISCHARGE PLAN:

  • Support Mrs Brampton – needs monitoring for medication compliance
  • Needs help with nutritious meals (Meals on Wheels) and house keeping (Council Home Help)  –  Assistance with shopping
  • Monitor her quit-smoking plans – watch for side effects from Zyban such as dry mouth and difficulty in sleeping. If side effects occur Zyban should be stopped. Zyban to be withdrawn after 2 months. Nicotine patches to continue until smoking addiction is under control.

WRITING TASK:

Write a letter of referral to Brunswick Family Care Clinic, 44 Decarle Street, Brunswick, Vic 3056 requesting monitoring and ongoing care be arranged for Mrs Brampton.

Community Nurse to make sure Mrs Brampton continues her cessation of smoking – with the help of Nicotine patches and Zyban. Zyban tablets to cease as soon as side effects occur (if any). Both Zyban and Nicotine to cease as soon as craving for cigarettes has stopped. Letter should be 180 to 200 words long / only the first 25 lines will be considered.

Sample letter by Lifestyle Training Centre

Brunswick Family Care Clinic 44
Decarle Street
Brunswick Vic 3056

15/01/2011

Dear Sir/Madam,

Re: Mavis Brampton, aged 72 years. 

Mrs Brampton, a widow, requires your monitoring and ongoing care, following her discharge today. She underwent treatment for pleurisy in our hospital.

During hospitalization, Mrs Bramptor was administered with Amoxycillin with supplementary O2, Pravastatin 20mg/day, and Celecoxib 100mg/day. She had a slightly elevated temperature, and sputum culture was done on account of productive cough. Deep breathing exercises were started as she suffers from breathlessness. She was commenced on a low-diary diet for overweight, BMI 29.

Her chest X-ray was taken and was advised to give up her long-term smoking habit. At present, she smokes 10 cigarettes a day. She has to continue her cessation of smoking with the help of Nicotine patches and Zyban. Both have to be stopped as soon as the craving for cigarettes come to an end. Zyban tablets, 150mg, twice a day, should be stopped after 2 month or immediately if any side effects occur, such as dry mouth or difficulty in sleeping.

In view of the above, please assist Mrs Brampton by monitoring her medical compliance and quit- smoking plans. Please also arrange for Mrs Brampton, through Council Home help: assistance with shopping and housekeeping. To help her continue a nutritious diet, kindly connect her to Meals on wheels. If you have any further queries, please do not hesitate to contact me.

Yours faithfully,
Registered nurse                                                                                                       

(Words used: 203)

Nina Sharman- OET letter

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Case Notes: Nina Sharman. Today’s Date: 21/03/12

Patient Details:

• Name: Ms. Nina Sharman

• DOB: 09/02/1951

• New resident of Dementia Specific Unit, Westside Aged Care Facility

• Single; Under the Australian Guardianship and Administration Council protection

• Medical History

• Ischemic heart disease (IHD) since 2005, takes Nitroglycerine patch, daily

• Stroke May 2011, after stroke – unsteady gait

• In 2011 – diagnosed with severe dementia – able to understand simple instructions only,

confused and disorientated

• Diabetes mellitus (type 2) since 2000 – on a diabetic diet

• Osteoarthritis of both knees 20 yrs. Voltaren Gel to both knees BD

• Weight gain 10 kg over the last 5 months, current weight 106kg (BMI of 30)

• Chronic constipation, takes Laxatives PRN

• No allergies to medication or food

• No teeth – has entire upper or lower dentures, sometimes refuses to wear dentures due to

confusion and disorientation

• Increased appetite– usually eats full portion of offered meals x 3 times daily and, also, goes

into other residents’ rooms and eats their food as bananas, biscuits or lollies

Social History

• No friends

• Lack of interests, but likes colouring and watching TV

• ↑emotional dependence on nursing staff

• Non-smoker, no use of alcohol or illegal drugs

Recent Nursing Notes: 15/02/12

• Chest infection. Keflex 500mg QID x 7 days 26/02/12

• Occasional cough & episodes of SOB with ↑RR

27/02/12: Sporadic throat clearing after eating yoghurt

20/03/12, 1700 hrs: Episode of choking on a piece of food (? food not chewed properly). She suddenly turned

blue, grabbed the throat with both hands and coughed. The piece of solid food was removed.

1710 hrs: Nursing assessment after treatment

 Pulse 110 BPM

 BP 120/70 mmHg

 RR – 22/min

1800 hrs: :No complaints

 Pulse – 88 BPM

 BP – 115/70 mmHg

 RR – 16/min

 T- 37.0 °C

 Skin: normal colour.

 Hospital visit not required

WRITING TASK: You are a Registered Nurse at the Dementia Specific Unit. Using the information in the case notes, write a letter to Dietician, at Department of Nutrition and Dietetics, Spirit Hospital, Prayertown, NSW 2175. In your letter explain relevant social and medical histories and request the dietician to visit and assess Ms. Sharman’s swallowing function and nutritional status urgently due to a high risk of aspiration.

Sample letter by Lifestyle Training Centre


Dietician
Department of Nutrition and Dietetics
Spirit Hospital
Prayertown, NSW 2175.

21/03/12        

Dear Dietician,
Re: Ms Nina Sharman

Ms Sharman urgently needs a visit to assess her swallowing function and nutritional status. She has high risk of aspiration.

Yesterday, Ms Sharman choked on a piece of solid food, probably due to improper chewing, and turned blue. The food was successfully removed, and she recovered afterwards.

Ms. Sharman, weighing 106 kg with a BMI of 30, has gained 10 kg in the last 5 months. She suffers from chronic constipation and uses laxatives. She has no allergies to food or medication and consumes three meals daily with additional snacks. Despite having no teeth, she chooses not to wear dentures, and sporadic throat clearing was noted from her after consuming yogurt.

Ms Sharman does not smoke, drink, or use illegal drugs. She recently had a chest infection and has been experiencing occasional coughing and shortness of breath. She has had Ischemic heart disease since 2005 and her gait is unsteady after an episode of stroke in May 2011; she suffers from Osteoarthritis on both knees. She is on diabetic diet since 2000 since the onset of type 2 Diabetes mellitus.

Based on the above, kindly visit Ms Sharman at her new residence in Dementia Specific Unit, Westside Aged Care Facility and assess her condition. Please note that she can only comprehend simple instructions as she is confused and disorientated. If you have any further queries, please do not hesitate to contact me.

Yours faithfully,

Registered Nurse.

                                                                                                                        (words 232)

OET writing task 1. Robin Williams

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Patient History: Robin Williams 42-year-old man
Admitted to hospital for endoscopic removal of gallstones Admitted 22 May 2005
Discharged 24 May 2005
Today’s date: 25 May 2005

Social History: Married with two children 3,6
Policeman, works shifts at night
Wife away on business overseas for one week No family in Victoria

Nursing Notes: Routine post-operative recovery
Walking normally
Minimal pain-relieved with 3x Panadol daily Wound healed
Ultrasound showed operation successful

Discharge Plan: Rest for one week
No heavy lifting
Observe wound for infection. Council childcare for one week

Writing Task
Using the information in the case notes, write a letter of referral to Dr. Phillip Adams, 399 Bourke St, Melbourne, 3000, who will provide follow up care in this case.

Sample answer by Lifestyle Training Centre

Dr. Phillip Adams
399 Bourke St,
Melbourne, 3000

Dear Dr Adams,

Re: Mr Robin Williams, aged 42 years.

I am writing to refer Mr Williams, who requires follow-up care and management. He is currently recuperating from an endoscopic removal of gallstones.

Yesterday, Mr Williams was discharged after a smooth post-operative recovery as confirmed by the ultrasound. His wound was healed, and he ambulates well. He is advised to take Panadol, three times a day, to manage his minimal pain.

Mr Williams is a policeman and works night shifts. He is married and has two kids of 3 and 6 years of age. Mrs Williams is currently overseas on a business trip. They have no family in Victoria.

Based on the above, please provide care for Mr Williams. He needs to rest for one more week and must avoid heavy lifting. As the parents are not in a position to help, kindly arrange for them childcare for a week. If you have any queries, please do not hesitate to contact me.

Yours sincerely,
Registered nurse.

OET writing task 20: Nasser Ali

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Task 20: Today’s date: 19/02/2012

You are Louise Nagatani, a registered nurse in the Coronary Care Unit at a General Hospital. Nasser Ali is a patient in your care.

Discharge Summary

Name: Nasser Ali

Address: 1052 Moorvale Rd, Moorooka, Phone: 046538762, Date of Birth: 4 February 1964, Date of admission: 09/02/2012

Diagnosis: MI,  Date of discharge: 19/02/2012,  Name of Surgery:Angioplasty

Reason for admission:  Patient arrived at the hospital via ambulance 10 days ago suffering from acute Sub sternal chest pain radiating to left arm.

He complained of severe chest pain, pain in jaws and left arm, diaphoresis, dizziness and shortness of breath.

Patient has been diagnosed with myocardial infarction. Condition has now stabilised, however, he appears restless and worried about his condition. He is overweight and is a smoker.  He has high blood pressure.

Treatment:  Sereptolunanse, anticoagulants and anti-cholinergic drugs.

Continuous ECG monitoring, angioplasty on 10/02/2012

Post-surgery physiotherapy Karvea 150mg daily 1⁄2Aspirin  daily

Social History:  Family are refugees from Afghanistan arrived by boat in Australia in 2010.

Marital Status: Married, seven children. Aged 6 months to 22

Next of kin: Fatima Ali (Wife)

Employment: Nasser works as a Taxi Driver, Fatima: Housewife

Accommodation: Living in rental flat, No family doctor

Language: Dari. Nasser attends TAFE English classes but only has basic English conversational ability.

Discharge Plan: Follow up appointment made with cardiologist, Dr R Lang, Hospital Outpatients 2pm 26/2/2012. Order medications from hospital pharmacy – Explain usage and stress the importance of taking medication regularly as directed.  Arrange for dietician to provide dietary advice

Discuss importance of giving up smoking and provide advice on available quit smoking programs

Advice patient to continue with the exercise program recommended by the hospital physiotherapist, particularly deep breathing exercises with Triflo. Arrange for a community social worker to provide a support service to the family to ensure a smooth transition back to normal life

WRITING TASK: Using the information in the case notes, write a letter to the social worker, Sarah MacDonald, Annerley Community Centre, 1122 Ipswich Rd Annerley, 4121 explaining the patient’s situation and needs.

View model answer by Lifestyle Training Centre

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OET writing tasks

Martin Wilson OET letter by Lifestyle Training Centre

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Time allowed: Reading time: 5 minutes

Writing time: 40 minutes

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

Notes

Hospital: Lyell McEwin Hospital

Patient Details: Name: Martin Wilson

Age: 62

Admission Date: 13 October 2009

Discharge Date: 24 October 2009

Diagnosis: Attempted suicide – overdose of Mogodol

Past Medical History: Heavy smoker (40 cigarettes/day)

Bronchitis (multiple episodes)

Underweight – 66kg, BMI 18

Psoriasis

Social History: Retired 2 years ago (bookkeeper with Holden Car Company)

Lives with wife, Joan, and adult son in housing trust maisonette in

Elizabeth. Wife works at Coles, son unemployed. 2 married daughters and 5 grandchildren. Regular social drinker

Depression related to gambling addiction

Began gambling 2 years ago

Has lost a lot of money including superannuation funds and is in debt.

Wife and family previously unaware of addiction – very angry but also upset about suicide attempt

Patient remorseful and ashamed

Wants to overcome addiction

Used to be a keen lawn bowls player

Has lost friends as result of gambling

Nursing Management: Weak and depressed. Anti-depressants prescribed – Lovan 200g. BP 130/95. Diagnosed with Type II diabetes.

Diabetes education regarding diet and oral medications

Wheelchair use from 20/10

Psoriasis on Torso and scalp – Diprosone OV cream 2x/day,

Ionil T Shampoo

Poor appetite

Physically unfit

Discharge Plan: Encouragement to maintain anti-depressant medication routine as the SSRI is established. Mrs Wilson will help with supervision

Monthly follow-up appointments with psychologist Dr Brian Murphy, Lyall McEwen Hospital

Social worker appointment to be made for gambling addiction therapy

Strong encouragement and assistance to join Gambling Addiction Action Group, Elizabeth Community Centre

Contact with Quitline needs to be encouraged

Wheel chair required for another week. Frame advised after this Maintain psoriasis treatment

Maintenance of low GI diet for diabetes – involvement of wife necessary

Encouragement in social sporting activities eg lawn bowls?

Writing Task

Using the information in the notes, write a letter to the social worker, Ms Jennifer Adams, at the Elizabeth Community Health Centre, 125 Munno Parra Avenue, Elizabeth, 5098 requesting followup care. Stress that Mr Wilson’s case needs urgent attention. In your answer:

expand the relevant case notes into complete sentences

do not use note form

use letter format

The body of the letter should be approximately 180-200 words.

Sample letter by Lifestyle Training Centre

Ms Jennifer Adams,

Elizabeth Community Health Centre,

125 Munno Parra Avenue,

Elizabeth, 5098

24/10/2009

Dear Ms Adams,

Re: Mr Martin Wilson, aged 62 years.

I am writing to refer Mr Wilson who requires your urgent attention and follow-up care, particularly to overcome gambling addiction, following his discharge today. He is currently recuperating from an attempted suicide, overdose of Mogodol.

At present, Mr Wilson is weak, physically unfit and depressed. He is remorseful, ashamed and wants to overcome his addiction; he is under anti-depressants. He suffers from Bronchitis, Psoriasis, Type II diabetes and has poor appetite. 

Mr Wilson started gambling 2 years ago, following his retirement, without the knowledge of his family at first. Eventually, he lost his friends as well as a lot of money including superannuation funds, ending up in debt, which led him to depression.

Mr Wilson lives with his wife and son. He heavily smokes as well as drinks alcohol.  He used to play lawn bowl.

Based on the above, please provide therapy and help Mr Wilson to recover from his gambling addiction. Actively assist and encourage him to join the Gambling Addiction Action Group in Elizabeth Community Centre as well as to connect with Quitline. Encourage him to take part in social sporting activities such as lawn bowls as well as to continue his anti-depressant medication regimen. He needs the use of wheel chair for another week and walking frame thereafter.

Should you have further queries, please do not hesitate to contact me.

Yours sincerely,

Registered nurse.

(words count: 221)