How to write medications in an OET Nursing letter: which to include and how to phrase them
Include a medication in your OET letter only when the reader needs it to continue care: new or changed medicines, ones the reader must give, monitor or prescribe, and anything safety-critical such as anticoagulants, insulin or allergies. Write each one in full, formal English, for example 'metformin 500 mg twice daily' rather than 'metformin 500 mg bd', and group long-standing, unchanged medicines in one short sentence or leave them out if they do not affect the request.
The problem with medication lists
OET Nursing case notes often contain a full medication chart: six to ten medicines with doses, frequencies and routes, all in shorthand. Candidates either copy all of it into the letter, which adds length and note-form language, or drop it entirely, which can leave out something the reader needs.
Two questions settle almost every case:
- Does the reader need to do something with this medicine? Give it, monitor it, prescribe it, adjust it, or watch for its side effects.
- Is it relevant to the reason you are writing? A new antibiotic for the infection you are referring for is relevant; a long-standing eye drop usually is not.
Medication choices affect Content (did you include what matters and leave out what doesn't?) and Conciseness & Clarity (can the reader find the important points quickly?). See selecting relevant case notes for the general method.
Which medications to include
| Type of medication | Usually include? | Why |
|---|---|---|
| New since admission | Yes | The reader does not know about it yet |
| Changed dose or stopped | Yes | Prevents the old regimen being restarted |
| The reader will give or supervise it | Yes | They need the regimen |
| Anticoagulants, insulin, opioids | Usually | Safety-critical; affect many treatments |
| Linked to the reason for the letter | Yes | Explains the problem or the request |
| Drug allergies | Usually | Safety-critical if the reader prescribes or treats |
| Long-term, stable, unrelated | Often not, or grouped briefly | Adds length without changing care |
The reader matters. A discharge letter to a community nurse who will help with medicines needs more detail than a referral to a dietitian. Writing to a non-clinical reader? See OET letters to non-clinical readers.
Writing doses and frequencies in full
| Case notes | Letter |
|---|---|
| Amoxicillin 500 mg PO tds × 5/7 | amoxicillin 500 mg orally three times a day for five days |
| Enoxaparin 40 mg SC OD | enoxaparin 40 mg by subcutaneous injection once daily |
| Paracetamol 1 g QID prn | paracetamol 1 g up to four times a day as required |
| Furosemide ↑ 40 → 80 mg mane | her furosemide has been increased from 40 mg to 80 mg each morning |
| Ceased: ibuprofen | ibuprofen has been stopped |
| NKDA | she has no known drug allergies |
| Allergy: penicillin (rash) | she is allergic to penicillin, which causes a rash |
Keep units (mg, g, mL). Write frequency and route in words. Start a medicine's name with a lower-case letter unless it begins a sentence or the notes give a brand name.
Grouping medications in sentences
A sentence for each medicine makes the letter long and repetitive. Group them by purpose or by what has changed.
Too long (one sentence each):
She takes metformin 1 g twice daily. She also takes atorvastatin 40 mg at night. She takes ramipril 5 mg once daily. She takes aspirin 100 mg once daily.
Grouped:
Her regular medications for diabetes, cholesterol and blood pressure are unchanged.
Grouped, with the change highlighted:
Her regular medications are unchanged, except that her ramipril has been increased to 10 mg once daily because of persistently high blood pressure.
Whether the reader needs the unchanged names and doses depends on the task. If the reader will manage the medicines, name them; if not, one grouped sentence is usually enough.
Worked example (fictional patient)
Case notes (extract):
Mr Tomasz Wilk, 74 y.o. Adm 3/7 with community-acquired pneumonia. Commenced IV abx, now oral: amoxicillin 500 mg tds, to complete 5/7 (last dose 10/7). Regular meds: metformin 1 g bd, atorvastatin 20 mg nocte, apixaban 5 mg bd (AF), timolol eye drops OD. Allergy: sulfonamides (rash). D/C home 8/7. Lives with wife; she manages his tablets with a weekly organiser.
Writing task: Write a discharge letter to Mr Wilk's GP, Dr Ruth Halloran.
Medication paragraph:
Mr Wilk is continuing oral amoxicillin 500 mg three times a day, with the final dose due on 10 July. His regular medications, including apixaban 5 mg twice daily for atrial fibrillation, are unchanged. Please note that he is allergic to sulfonamides, which cause a rash.
What was done and why:
- Amoxicillin is new, linked to the admission, and has an end date the GP needs.
- Apixaban is named because an anticoagulant is safety-critical for any prescriber.
- Metformin, atorvastatin and the eye drops are grouped as "regular medications … unchanged": the GP already prescribes them.
- The allergy stays: the GP prescribes.
- The weekly organiser could go in a later sentence about home support if relevant to the request; it is not a medication fact.
Common medication mistakes
- Copying shorthand: "bd", "tds", "prn", "nocte", "5/7". Write them in full; see abbreviations in OET Writing.
- Listing everything when only one or two medicines matter.
- Leaving out the change. "Furosemide 80 mg" without saying it was increased hides the most useful fact.
- Inventing detail, such as an indication or duration that is not in the notes.
- A bullet list in the middle of a letter, which reads as notes rather than a letter.
Practise and check
Pick a discharge case from the practice case notes and write only the medication paragraph three ways: for a GP, for a community nurse and for a family carer. Then write the full letter and check your letter: medEmu's case-notes coverage check shows which notes you included, missed or included unnecessarily, and corrections are marked on your own sentences. 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. For turning note form into sentences generally, see OET case notes to full sentences.
Sources
This guide is medEmu's writing advice, not official OET guidance or clinical prescribing guidance; the patient, case notes and doses are invented for a writing exercise. For OET's official information about the Writing sub-test, see oet.com.