How to describe pain and pain relief in an OET Nursing letter
In an OET Nursing letter, describe pain by its site, current severity and effect on function, then state the pain relief the patient is taking now, including drug, dose, route and frequency, and whether it works. Summarise the trend instead of copying every pain score, and tell the reader what to monitor or review, such as reducing an opioid or watching for constipation.
Why pain needs careful wording
Pain appears in many OET Nursing cases: after surgery, after a fall or fracture, in cancer and palliative care, in chronic back pain and in older patients with arthritis. Case notes often record pain scores several times a day and every dose of pain relief given. The reader cannot use that raw list. They need a clear picture of where the pain is, how bad it is now, what it stops the patient doing, what controls it and what to watch for.
A simple pattern for describing pain
Use this order when you write about pain. Not every part is needed for every patient.
- Site: where the pain is ("in her right hip", "lower back").
- Current severity: a score if the notes give one, or plain words ("mild", "well controlled").
- Trend: better, worse or unchanged since admission, if relevant.
- Effect on function: walking, sleep, eating, therapy.
- Current treatment: drug, dose, route, frequency, and how often an as-required dose is used.
- Side effects or precautions: if recorded.
- Plan: what the reader should continue, reduce or review.
What to include and what to leave out
| Usually include | Usually leave out |
|---|---|
| Site and nature of pain if it matters (for example, burning, worse at night) | Every pain score from the chart |
| Current score and change since admission | Pain medicines that were stopped and are not relevant |
| Effect on mobility, sleep or therapy | Times of individual doses |
| Regular pain medicines with dose, route, frequency | Pain that has fully resolved and does not affect the plan |
| As-required medicines and how often used | Brand names when the generic name is given |
| Side effects and preventive measures | Detailed descriptions of hospital pain pumps no longer in use |
| Plan to reduce or review medicines | |
| Non-drug measures the reader can continue (for example, heat pack, positioning) |
Turning pain notes into sentences
| Notes | Letter sentence |
|---|---|
| Pain R hip 7/10 adm → 3/10 now | "Her right hip pain has improved from 7 to 3 out of 10." |
| Pain limits mobilising > 10 m | "Pain currently limits her walking to about 10 metres." |
| Paracetamol 1 g QID regular | "She takes paracetamol 1 g four times a day." |
| Oxycodone 5 mg PO 4/24 PRN, used x2/day | "She also has oxycodone 5 mg orally every four hours as required, which she has needed about twice a day." |
| Constipated, macrogol started | "She became constipated, so a daily laxative has been started." |
| Pain worse nights, poor sleep | "Her pain is worse at night and is disturbing her sleep." |
Copy names, doses and frequencies exactly. Writing "every four hours" when the notes say "every six hours" is a safety error. For more on setting out medicines, see medications in OET letters.
Matching the plan to the reader
- GP: current regimen, how often strong pain relief is used, any plan to reduce it, side effects.
- Community nurse: what to give or supervise, what to check (pain score, bowels, drowsiness), when to seek review.
- Physiotherapist or rehabilitation unit: how pain affects activity, when to give pain relief before therapy if the notes suggest it.
- Patient or carer: what to take, when, and when to call for help, in plain words. See writing to a non-clinical reader.
Worked example (invented case)
Case summary (invented): Mrs Ingrid Larsen, 82, fell at home on 6 June and fractured her left wrist and bruised her right hip. Wrist in plaster cast; hip X-ray showed no fracture. Hip pain 7/10 on admission, now 3/10 at rest, 6/10 when walking. Walks 10 m with frame before pain stops her. Regular paracetamol 1 g four times daily. Oxycodone 5 mg orally up to every 4 hours as required, used about twice daily, mainly before physiotherapy. Constipated on day 3; macrogol one sachet daily started. Mild drowsiness after evening oxycodone on day 2 only. Lives alone; son lives nearby. Cast clinic 20 June. Likes gardening. Discharge 12 June. Task: write to her GP.
Selection decisions:
- In: fall and injuries in one sentence, current hip pain at rest and when walking, effect on walking, both pain medicines with use, laxative, earlier drowsiness (relevant to opioid safety), lives alone, cast clinic.
- Out: gardening, every score, X-ray wording beyond "no fracture".
Sample letter body:
Dear Dr Ahmed,
Re: Mrs Ingrid Larsen, aged 82
I am writing to inform you of Mrs Larsen's discharge home today and to request a review of her pain relief.
Mrs Larsen was admitted on 6 June after a fall at home, in which she fractured her left wrist and bruised her right hip. Her wrist is in a plaster cast, and an X-ray showed no hip fracture. Her hip pain has improved from 7 out of 10 on admission to 3 out of 10 at rest, but it rises to 6 out of 10 when she walks and currently limits her to about 10 metres with a frame.
She takes paracetamol 1 g four times a day. She also has oxycodone 5 mg orally up to every four hours as required, which she has needed about twice a day, mainly before physiotherapy. She was mildly drowsy after one evening dose, and she became constipated, so a daily laxative has been started.
Mrs Larsen lives alone, although her son lives nearby. She has a cast clinic appointment on 20 June.
I would be grateful if you could review her pain relief, with a view to reducing the oxycodone as her hip improves, and monitor her bowels. Please contact me if you require further information.
Yours sincerely,
The letter gives two pain scores, not twelve, and links pain to function (walking) and safety (drowsiness, living alone). That is what the reader uses.
Practise a timed case at /writing/, or check a letter you have written for estimated criterion marks.
Mistakes to avoid
- Copying the pain chart. Give the current score and the trend.
- "Analgesia given" with no detail. Name the drug, dose, route and frequency.
- Leaving out how often as-required doses are used. The reader needs it to plan reductions.
- Ignoring side effects. Drowsiness and constipation affect safety at home.
- Pain without function. Say what the pain stops the patient doing.
Related: palliative care letters, post-operative discharge letters and falls risk and mobility.
Sources
This guide is medEmu's writing advice, not official OET guidance or clinical advice; all patients, medicines, doses and scores are invented for practice and must not be used to guide care. 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.