Occupational English Test

WRITING SUB-TEST: NURSING

TIME ALLOWED: READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

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

Today’s Date: 10/02/2018

Patient Details
Name: Bronwyn Green
DOB: 15/03/1949
Widow, no children
Lives alone in low set house, no stairs
Uses home oxygen NP 1L
Ex- smoker: 20cig/day (20 years). Recently stopped smoking

Medical history
COPD since 2004: Takes Tiotropium inhaler 1 puff Mane, Fluticasone & Salmeterol 250/25mcg
inhaler 2 puff BD
HTN since 1993: Takes Amlodipine 5mg Mane, BP stable
Anxiety and depression since 2013: Takes Oxazepam 15mg Nocte, Citalopram 10mg Mane
Recently, pt dx w/ low grade adenocarcinoma and admitted surgical ward, North West hospital
18/01/2015
Pt had R/ hemicolectomy 20/01/2018
Post-op complication (metabolic and respiratory acidosis) after 5hours anaesthetic. Patient
transferred to ICU, then transferred to Thoracic ward 24/01/2018

Post-operative condition
Patient using oxygen 2L NP daily
Very anxious and c/o of SOB during mobility. Requires reassurance.
Able to walk 10m with 4w/walker Assist x 1
Takes regular analgesic: Paracetamol 1g QID and PRN Endone 2.5mg (Max dose 20mg) PRN
for surgical pain.
Takes regular laxative: Coloxyl and Senna 2 tabs BD. Bowels open regularly.
Urgent incontinence of urine: Wears pull up pad.
Lost 5kg after operation. Poor appetite.
Regular dietician review; HP Diet and monitor oral intake.
Observation stable. Sats 98% with NP2L. Aim Sats 88-91%. The goal is weaning oxygen to
NP1L.
Abdo wound: pain well controlled with paracetamol, minimal exudate.

Social History
Lives alone. Patient's sister lives close and comes to help sometimes.
Patient uses community services (Meals on Wheels, cleaning and shopping).

Recent Nursing Notes

30/01/18
Patient became very anxious during shower.
Required prompting and moderate assistance.
Sat 98% with NP2L. Suggested patient oxygen 1L, but patient refused to change.
Patient required encouragement with mobility.
Abdo wound redressed.
Minimal exudate.
Complained minimal pain.
Poor appetite.
Notified Dietician.

04/02/2018
Patient only required minimal assistance with shower and ADL's.
Sat 91% NP1L.
Mobilizing with 4w/walker, required supervision.
SOB with long distance, and temporary required NP2L after mobility.
Mood and appetite improved.
ACAT (Aged Care Assessment Team) completed for TCP (Transition Care Program) this
morning.
Plan for OT HV (home visit) today.

05/02/18
Patient requires modifying bathroom and toilet as a result of HV; applying rails.
OT will organize prior to discharge.
Patient is keen to go home with community service.
Existing home oxygen need to be checked prior to discharge.

10/02/2018
Patient is able to walk with (Single point stick) SPS. Supervision required.
Mood is stable, appetite ↑
Occasional incontinence of urine, still wears pull up pad.
OT reports home modifications completed.
Plan for discharge 11/02/2018.
Patient's sister will escort to home by taxi.
Patient is happy to take own medication at home.
Requires 3/7 dressing change for abdo wound.
Monitor anxiety & O2 usage

Writing Task
You are a Registered Nurse at the Thoracic Ward Spirit Hospital. Using the information, write a
referral letter to Nursing Director, North West Transition Care Program Community Service 12
West St Northbridge, QLD, 4543
Do not use note form in the letter
Expand on the relevant case notes into complete sentences
The body of the letter should be approximately 180~ 200 words long Use correct letter format