How to start an OET Nursing letter: opening sentence examples for referral, discharge and transfer
Start the letter body with one or two sentences that name the patient, say why you are writing, and say what you need the reader to do. For example: 'I am writing to refer Mr Daniel Okafor, a 74-year-old man who is being discharged home today following a hip replacement, for daily wound care and support with his mobility.' A sentence that only introduces the patient ('I am writing regarding Mr Okafor') leaves the purpose unclear.
Why the opening matters so much
OET Writing is marked on six criteria, and one of them, Purpose (0–3), is mostly decided in your first paragraph. The assessor asks: is it immediately clear why you are writing, and what the reader is being asked to do? A reader who has to reach the last paragraph to find your request has not had the purpose made clear early.
The opening also sets up Organisation & Layout and Conciseness & Clarity. If the first two sentences tell the reader exactly what the letter is for, every later paragraph has a job to do.
A three-part formula
A strong opening sentence usually contains three things:
| Part | What it does | Example wording |
|---|---|---|
| Who | Names the patient with one identifying detail | "Mrs Leila Haddad, an 81-year-old widow…" |
| Why now | The event that triggers the letter | "…who is being discharged home today following treatment for a urinary tract infection…" |
| What you need | The action you want from the reader | "…for daily medication supervision and a home safety assessment." |
Put together: "I am writing to refer Mrs Leila Haddad, an 81-year-old widow who is being discharged home today following treatment for a urinary tract infection, for daily medication supervision and a home safety assessment."
That is one long sentence. If it feels heavy, split it in two: the first sentence introduces the patient and the event, the second states the request.
Worked examples by letter type
All patients and details below are fictional.
Referral to a community nurse
I am writing to refer Mr Tomasz Nowak, a 68-year-old man who underwent a below-knee amputation of his left leg and is returning home tomorrow. I would be grateful if you could visit him daily to dress his stump wound and monitor his blood glucose levels.
Why it works: the patient, the event, the timing and two specific requests all appear before the reader has finished the first paragraph.
Discharge letter to a GP
I am writing to inform you that Ms Priya Raman, aged 45, was discharged from the cardiology ward today following an admission for atrial fibrillation. Her medication has been changed, and I would appreciate it if you could review her heart rate and kidney function within the next week.
Why it works: "inform you" is fine here because the second sentence adds the action. The reader also learns straight away that medication has changed, which is what a GP most needs from a discharge letter. See discharge and transfer letters for what to put next.
Transfer letter to an aged care facility
I am writing regarding Mr Arthur Bell, an 88-year-old man with moderate dementia, who will be transferred to your facility on 14 March. The purpose of this letter is to outline his current care needs so that his transition is as smooth as possible.
Why it works: in a transfer letter the "action" is to take over care. Saying so explicitly gives the receiving nurse a reason to read on.
Update letter to a specialist nurse
I am writing to update you on the progress of Ms Grace Mensah, whom you referred to our clinic on 2 May for management of a venous leg ulcer. Her wound has improved, but she has developed signs of infection, and I would be grateful if you could review her this week.
Why it works: the reader already knows the patient, so the opening reminds them of the link and goes straight to what has changed.
Openings that weaken Purpose
| Weak opening | The problem | Stronger version |
|---|---|---|
| "I am writing regarding Mr Nowak." | Names the patient but gives no reason or request | "I am writing to refer Mr Nowak for daily wound care following his amputation." |
| "Mr Nowak is a 68-year-old retired builder who was admitted on 3 March…" | Starts the story; the purpose is buried | Put the purpose first, then the background |
| "I hope this letter finds you well." | Social filler that wastes words | Leave it out; go straight to the purpose |
| "Please find below the details of Mr Nowak." | The reader still doesn't know what to do with the details | State the action you need |
| "I am writing to refer Mr Nowak who is pt with DM and post BKA." | Note form and abbreviations from the case notes | Write in full: "who has diabetes and has had a below-knee amputation" |
How to plan the opening in your reading time
Before you start writing, answer two questions from the writing task and the case notes:
- Who is the reader, and what is their role? A GP, a community nurse, a physiotherapist and an aged care nurse need different things.
- What exactly do I want them to do? Look for the verbs in the writing task and the plan section of the notes: visit, review, monitor, assess, continue, arrange.
Your answer to question 2 becomes the second half of your opening sentence. If you can't say what you want the reader to do, the letter's purpose isn't clear yet, and the rest of the letter will drift.
Useful phrases
- "I am writing to refer… for…"
- "I am writing to request your assistance with…"
- "I am writing to hand over the care of…, who is being discharged today."
- "I would be grateful if you could…"
- "The purpose of this letter is to…"
- "…so that you can continue her care at home."
Keep the language formal but plain. "I would be grateful if you could" is polite and direct; there is no need for longer formulas. For more on register, see formal tone in OET letters.
Expand the purpose later
The opening states the purpose; the final paragraph should expand it with specific requests, timings and contact details. A strong opening paired with a vague ending still loses marks. See how to end an OET Nursing letter for closing paragraphs that match these openings.
Practise and check your opening
Write a full letter against the clock with the practice case notes, or check a letter you have already written. medEmu marks Purpose separately from the other five criteria and shows the sentence behind the mark. Your first letter is graded free without an account. Grades are estimates for practice, not official OET results, and medEmu is not affiliated with OET.
Related guides: OET Nursing referral letter structure · OET Writing criteria explained.
Sources
This guide is medEmu's writing advice; it is not official OET guidance. For the official description of the Writing sub-test and its assessment criteria, see oet.com.