OET letter for a stoma patient: colostomy and ileostomy discharge
In an OET Nursing letter for a patient with a new stoma, say what operation was done and when, what type of stoma the patient has, and how well the patient or carer can manage the bag. Then ask the reader for the specific support in the case notes, such as checking the stoma and skin, reinforcing bag changes, watching output and fluids, and supporting the patient emotionally.
What makes stoma letters different
A stoma case usually comes after bowel surgery, and the notes tend to be long: the surgery, wound checks, stoma appearance on each day, output charts, diet, teaching sessions with the stoma nurse, and the patient's mood. The reader, often a community nurse, GP or stoma care nurse, needs a short picture of three things:
- The stoma itself: what type it is and what it looks like now.
- Self-care: what the patient or carer can do alone and what they still need help with.
- What to watch for: the problems the case notes ask the reader to monitor.
Everything else is background. For the general method, see how to select case notes and the guide to post-operative discharge letters.
Questions to answer before you write
- What operation, why, and when?
- Colostomy or ileostomy? Temporary or permanent, if the notes say?
- How is the stoma and the skin around it now?
- Can the patient empty and change the bag? Is a carer involved?
- Are there notes on output, fluids, diet or the wound?
- How does the patient feel about the stoma?
- What follow-up is arranged, and what exactly does the writer want the reader to do?
What to include and what to leave out
| Usually include | Usually leave out |
|---|---|
| Operation, reason and date | Surgical technique and anaesthetic |
| Type of stoma and current appearance | Day-by-day stoma descriptions |
| Skin around the stoma, if the notes mention it | Normal daily observations |
| Level of independence with the bag | Every teaching session |
| Output, fluid or diet advice in the notes | Ward meal choices |
| Wound status and any dressing plan | Wound checks that were normal and are finished |
| Mood, body image or worries recorded | Unrelated hobbies |
| Supplies, follow-up and contact plans | Hospital routines |
Turning stoma notes into sentences
| Notes | Letter sentence |
|---|---|
| Lap. sigmoid colectomy + end colostomy 3/5 | "She had bowel surgery on 3 May, during which a colostomy was formed." |
| Stoma pink, healthy, peristomal skin intact | "The stoma is healthy and the surrounding skin is intact." |
| Empties bag indep., needs prompting c changes | "She empties the bag herself but needs prompting to change it." |
| High output d3, IV fluids, now settled | "Output from the stoma was high for a short time after surgery but has now settled." |
| Pt tearful, avoids looking at stoma | "She has found the stoma upsetting and avoids looking at it." |
| Stoma nurse r/v 2/52 | "The stoma nurse will review her in two weeks." |
The time periods are invented. In the test, copy the exact instructions and dates in the case notes. For more help, see turning case notes into full sentences and OET writing abbreviations.
Writing about body image sensitively
Stoma patients often feel embarrassed or anxious, and the notes may record this. Report it factually and respectfully, without judging.
| Avoid | Better |
|---|---|
| "She refuses to deal with her bag." | "She has not yet felt ready to change the bag herself." |
| "He is obsessed with the smell." | "He is worried about odour, especially when going out." |
| "She is depressed about it." (unless diagnosed) | "She has been tearful and says she feels low about the stoma." |
For more on neutral wording, see writing sensitive information and non-adherence.
Worked example (invented case)
Case summary (invented): Mr Dariusz Fenwick, 67, retired bus driver, lives with wife (supportive, keen to help). Admitted 12 June with bowel obstruction; surgery 13 June, ileostomy formed, may be reversed later (surgeon to decide). Stoma healthy; small area of red skin around stoma day 5, new barrier cream, improving. Empties bag independently; changes bag with wife's help. Advised to drink plenty of fluids and to report very watery, high output or dizziness. Midline wound healing, clips removed day 10. Worried about going back to bowls club. Supplies ordered. Stoma nurse home visit planned. Enjoys gardening. Discharge 24 June. Task: write to the community nurse.
Selection decisions:
- In: surgery and reason, ileostomy and possible reversal, skin redness and cream, bag skills and wife's help, fluids and warning signs, wound status, worry about the club, supplies, stoma nurse visit.
- Out: bus driver, gardening, daily observations, clip removal details beyond "wound healing".
Sample letter body:
Dear Community Nurse,
Re: Mr Dariusz Fenwick, aged 67
I am writing to refer Mr Fenwick, who is being discharged home today after bowel surgery, for ongoing monitoring of his new ileostomy.
Mr Fenwick was admitted on 12 June with a bowel obstruction and had surgery the following day, during which an ileostomy was formed. The surgeon will decide later whether it can be reversed. The stoma is healthy. A small area of red skin developed around it, which is improving with a barrier cream. His abdominal wound is healing well.
He empties the bag independently and changes it with help from his wife, who is keen to support him. He has been advised to drink plenty of fluids and to report very watery or high output, or any dizziness. He is worried about returning to his bowls club. Stoma supplies have been ordered, and the stoma nurse will visit him at home.
I would be grateful if you could check his stoma and the surrounding skin, monitor his fluid intake, and support him and his wife with bag changes. Please do not hesitate to contact me if you require any further information.
Yours sincerely,
The stoma, the skin and the bag skills come first because they drive the reader's visits. The fluid advice is written as a full sentence because it is a safety point, and the patient's worry is included because it affects support.
Practise timed letters at /writing/, or check a letter you have written to see which case notes you included, missed or added unnecessarily.
Mistakes to avoid
- Retelling the surgery. One sentence about the operation is usually enough.
- Copying stoma charts. Summarise output; do not list volumes for each day.
- Missing the independence level. "Can empty, needs help to change" is the key care detail.
- Leaving out warning signs. Include the ones in the notes, in full sentences.
- Judgemental wording about body image. Report feelings factually.
Related: wound care letters, nutrition and weight loss letters and closing paragraph examples.
Sources
This guide is medEmu's writing advice, not official OET guidance or clinical advice; all patients, procedures, time periods and plans 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.