How to plan an OET Nursing letter before you write: a 4-step plan using the reading time
Plan an OET Nursing letter in four steps: identify the reader and what you want them to do, mark the case notes this reader needs, group those notes into paragraphs, and decide your opening sentence. Do the first three during the reading time, when you can read but not write, so that when writing starts you already know your purpose and paragraph order. A clear plan protects Purpose, Content, Conciseness & Clarity and Organisation & Layout at once.
Why planning matters
Most problems in OET Nursing letters start before the first sentence: the writer is not sure what they want the reader to do, so the purpose arrives late; they work down the notes in order, so the letter retells the admission; and they include everything, so key facts are buried. A short plan fixes all three. It affects four of the six criteria directly: Purpose, Content, Conciseness & Clarity and Organisation & Layout.
The 4-step plan
| Step | Question | Output |
|---|---|---|
| 1. Reader and purpose | Who is reading, and what should they do? | One-line purpose: "Request X for patient Y because Z" |
| 2. Relevant notes | Which notes does this reader need? | Notes marked in / out |
| 3. Paragraph groups | How do the kept notes group? | 3–5 paragraph labels in order |
| 4. Opening sentence | How will I state the purpose? | First sentence ready to write |
Step 1: reader and purpose
Read the writing task first, before the case notes. It tells you who the reader is (GP, community nurse, physiotherapist, aged care facility, parent) and why you are writing. Turn it into a one-line purpose:
Request home dressing care for Mr Alvarez (diabetic foot ulcer), discharged today.
Everything else is judged against this line.
Step 2: relevant notes
Now read the notes, asking of each one: does this reader need it to understand the situation or to do what I am asking? Typical "in" notes are the current problem, changes during admission, current medications that affect the reader's work, risks, social situation that affects the plan, and what you want done. Typical "out" notes are resolved, unrelated history, routine normal observations, and personal details unrelated to care. The full method is in selecting relevant case notes.
Step 3: paragraph groups
Group the kept notes by topic, not by date. A common order is purpose → current situation → relevant background → request, but let the case decide. See Organisation & Layout for chronological vs thematic order.
Step 4: opening sentence
Decide your first sentence before you type anything else. It should contain an action verb, the patient's name and age, the main problem and, if relevant, urgency. Examples by letter type are in opening sentence examples, and how Purpose is marked is in the Purpose criterion.
Worked example
Invented case notes:
Patient: Mr Luis Alvarez, 64. Lives with wife (works full-time). Retired bus driver. Diagnosis: Type 2 diabetes (15 yrs); peripheral neuropathy. Ulcer right heel, 2 cm × 1.5 cm. Admission 3–9 Sept: wound infection; IV antibiotics, then oral flucloxacillin, 5 days remaining. Wound care: saline clean, foam dressing, change every 2 days. Offloading boot; must wear when walking. Other: BGL 8–12 on discharge (insulin glargine dose increased). Hip replacement 2015. Enjoys fishing. Allergy: none known. Writing task: As the ward nurse, write to Ms Chloe Martin, community nurse, requesting continuing care after discharge today.
Planning grid:
| Step | Plan |
|---|---|
| Purpose | Request dressing care + monitoring for Mr Alvarez, heel ulcer, discharged today |
| In | Ulcer size/site; infection treated; antibiotics, 5 days left; dressing routine; offloading boot; BGL range + insulin increase; wife at work during the day |
| Out | Hip replacement 2015; retired bus driver; fishing; "no known allergy" (not needed for dressing care, though some writers include it briefly) |
| Paragraphs | 1 Purpose · 2 Wound and infection · 3 Diabetes control · 4 Home situation + request |
| Opening | "I am writing to request continuing wound care for Mr Alvarez, a 64-year-old man with type 2 diabetes, who is being discharged today following treatment for an infected right heel ulcer." |
Request paragraph from the plan:
As his wife works full-time, Mr Alvarez will be alone at home during the day. I would be grateful if you could change his dressing every two days, monitor the wound for signs of recurrent infection, and encourage him to wear his offloading boot whenever he walks.
The plan makes the letter almost write itself: every paragraph has a job, and nothing in the "out" row needs a sentence.
Using the time well
A simple way to split your time:
- Reading time: steps 1–3 in your head or, if allowed, on paper.
- Start of writing: step 4, then the heading and opening paragraph.
- Main writing time: paragraphs in the planned order.
- Last few minutes: proofread for language errors and check the request is specific.
OET sets the timing of the Writing sub-test, and test formats can change; check the current timing and any rules on note-making on oet.com. medEmu's own practice test uses 5 minutes' reading time, a 40-minute countdown and a live word count, so you can rehearse this plan under time pressure. For a week-by-week way to build this into your study, see the 4-week OET Writing practice plan.
Practise and check
Take a case from the medEmu practice case notes and fill in the planning grid before you write. When you have finished, check your letter: medEmu marks all six criteria and shows which relevant notes you included, missed, or included unnecessarily, which tells you whether your step 2 was right. 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.
Sources
This guide is medEmu's writing advice, not official OET guidance; the patient and case notes are invented. For OET's official Writing test format, timing and assessment criteria, see oet.com.