OET letter for a patient with anaemia: how to write about haemoglobin, iron and blood transfusion
In an OET Nursing letter about a patient with anaemia, give the reason for admission, the key haemoglobin results with units and dates from the notes, the treatment given (for example a blood transfusion or iron) and the plan the reader must follow, such as a repeat blood test or further investigation. Show the change in results in one clear sentence rather than listing every value, and copy doses and dates exactly from the case notes.
What makes an anaemia letter different
Anaemia appears in many nursing case notes: an older patient who is tired and breathless, a patient with heavy bleeding, a patient with kidney disease, or a postnatal patient after blood loss. The notes often contain many blood results, several treatments and a plan for further tests.
The main skills are:
- Selecting results. Choose the values that show the problem and the response to treatment.
- Writing numbers clearly. Keep every unit and date; see numbers, units and measurements.
- Stating the plan. The reader usually needs to repeat a test, continue a medicine or arrange an investigation.
What to include and what to leave out
| Usually include | Usually leave out |
|---|---|
| Presenting symptoms (tiredness, breathlessness, dizziness) | Every full blood count value |
| Haemoglobin on admission and most recent, with dates | Normal results that change nothing |
| Transfusion: number of units and date, if given | Routine observations during the transfusion if uneventful |
| Iron or other treatment: name, dose, frequency, duration | Long lists of past conditions unrelated to the anaemia |
| Known or suspected cause, as worded in the notes | Your own theory about the cause |
| Planned or requested tests and when | Hospital bed moves and administrative details |
Writing the results sentence
A good results sentence shows change over time. Compare these:
- Weak: "Hb 72, 81, 85, 94, 96."
- Better: "Her haemoglobin was 72 g/L on admission on 1 April and rose to 96 g/L after a blood transfusion."
The second version gives the reader the units, the dates and the meaning in one line. Values and units in this guide are invented; in the test, use the exact values and units in the case notes. Our guide to vital signs and test results has more patterns.
Writing about the cause carefully
Sometimes the notes give a confirmed cause; sometimes they say "?GI bleed" or "for investigation". Match your wording to the certainty in the notes. Our hedging language guide explains this in detail.
| Case notes (invented) | Letter wording |
|---|---|
| Iron deficiency confirmed (ferritin low) | "Blood tests confirmed iron deficiency." |
| ?GI blood loss — colonoscopy booked 22/4 | "Bleeding from the bowel is suspected, and a colonoscopy has been booked for 22 April." |
| Cause unclear, haematology r/v requested | "The cause has not yet been identified, and a haematology review has been requested." |
Worked example (invented case)
Case summary (invented): Mr Tomasz Nowak, 74, retired teacher, lives with wife. Adm 1 April: 3 weeks increasing fatigue, SOB on stairs, pale. Hb 72 g/L. Ferritin low — iron deficiency. 2 units blood transfused 1–2 April, no reaction. Hb 96 g/L on 3 April. Started oral ferrous sulfate 200 mg once daily, 3 months. Mild constipation since starting iron, advised fluids/fibre. Taking aspirin for previous heart attack (2018) — continue per cardiology. Colonoscopy booked 22 April to look for bleeding. Knee replacement 2015. Discharge 4 April. Task: write to GP.
Selection decisions:
- In: symptoms, haemoglobin before and after transfusion, iron deficiency, transfusion with no reaction, iron dose and duration, constipation advice, aspirin continued (relevant to bleeding risk), colonoscopy date, repeat blood test request.
- Out: knee replacement, retirement, details of the transfusion observations.
Sample letter body:
Dear Dr Hassan,
Re: Mr Tomasz Nowak, aged 74
I am writing to inform you that Mr Nowak, who was admitted with iron deficiency anaemia, is being discharged home today. I would be grateful if you could monitor his haemoglobin and his response to iron treatment.
Mr Nowak was admitted on 1 April with three weeks of increasing tiredness and breathlessness on stairs. His haemoglobin was 72 g/L, and blood tests confirmed iron deficiency. He received two units of blood on 1 and 2 April without any reaction, and his haemoglobin rose to 96 g/L on 3 April.
He has started ferrous sulfate 200 mg once a day for three months. He has had mild constipation since starting it and has been advised to increase his fluid and fibre intake. He continues to take aspirin following a heart attack in 2018, as recommended by his cardiologist.
The cause of his iron deficiency is still being investigated, and a colonoscopy has been booked for 22 April. In the meantime, I would appreciate it if you could repeat his blood count and review his symptoms.
Yours sincerely,
Notice how the 2018 heart attack is included only because it explains the aspirin, which matters when bleeding is suspected. The knee replacement does not affect the plan, so it is left out. Note also that the request to repeat the blood count is written in general terms because the invented notes give no date; in the test, include a date if the notes give one.
Mistakes to avoid
- A list of numbers without meaning. Say what changed.
- Missing units or dates. "Hb went up to 96" leaves the reader guessing.
- Overstating the cause. If the notes say "?", your letter must sound uncertain too.
- Forgetting side effects and advice already given. The reader may be asked about them.
- No request. End with what the reader should do; see closing paragraph examples.
Practise and check
Practise selecting results in a timed letter, or check a letter you have written to see which notes you included, missed or included unnecessarily. medEmu is an independent practice tool for OET Writing for Nursing; its grades are estimates, and it is not affiliated with OET.
Sources
This guide is medEmu's writing advice, not official OET guidance and not clinical advice. All patients, results, units and medicines are invented for language practice; in the test, copy every clinical detail from the case notes. The network used for this run could not reach oet.com, so no OET test facts are stated beyond the criterion names. For OET's official Writing information, see oet.com.