How to write vital signs and test results in an OET Nursing letter
Include a vital sign or test result in an OET letter only if it explains the patient's condition or the action you are asking for; normal, stable observations can be summarised in a few words or left out. When you include one, write it as a sentence with the value, the unit and what it means or how it changed, for example 'Her temperature has risen to 38.4 °C' rather than copying 'T 38.4'.
Numbers are where many letters go wrong
Case notes are full of numbers: temperature, pulse, blood pressure, oxygen saturation, blood tests, scans. Copying them all makes a letter long and hard to read; leaving out the one that matters makes it incomplete. Both affect how a letter is marked, mainly under Content and Conciseness & Clarity.
The rule is the same as for any other case note (see case-notes selection): include a value if the reader needs it to understand the situation or to act.
Decide: include, summarise or omit
| Type of value | What to do | Example |
|---|---|---|
| Abnormal and linked to the reason for the letter | Include with the number | "Her oxygen saturation is 91% on room air." |
| Changing over time, and the trend matters | Include the change | "His blood pressure has fallen from 150/95 to 128/80 mmHg since his dose was increased." |
| Normal and stable | Summarise in a few words | "Her other observations are within normal limits." |
| Normal and unrelated | Omit | A normal cholesterol result in a wound-care referral |
| A result that is still pending | Mention if the reader must follow it up | "A urine culture was sent on 4 June; the result is pending." |
Sentence patterns
Turn note shorthand into clear sentences. Each pattern names the measurement, gives the value with its unit and, where useful, shows the change or meaning.
| Note | Letter sentence |
|---|---|
| T 38.4, ↑ from 37.2 | "His temperature has risen to 38.4 °C from 37.2 °C this morning." |
| BP 168/98 (usu. 130s/80s) | "Her blood pressure is 168/98 mmHg, which is higher than her usual readings." |
| SpO2 91% RA | "Her oxygen saturation is 91% on room air." |
| HR 112, irregular | "His pulse is 112 beats per minute and irregular." |
| Hb 92 (low) | "Her haemoglobin is low at 92 g/L." |
| CXR: R lower lobe consolidation | "A chest X-ray showed consolidation in the right lower lobe." |
| Obs stable | "His observations have remained stable." |
A few points to keep in mind:
- Units: keep them (mmHg, °C, %, mmol/L, g/L). They are standard and save words.
- Measurement names: write them in full (blood pressure, oxygen saturation, haemoglobin), as explained in the abbreviations guide.
- Time words: say when it was measured if it matters ("this morning", "on admission", "on 12 May"). See dates and times.
- Grouping: if several values tell one story, put them together: "On admission, she was febrile at 38.9 °C, with a pulse of 118 and an oxygen saturation of 90%."
Words that describe change
| Direction | Useful verbs and phrases |
|---|---|
| Up | has risen to, has increased to, remains elevated at |
| Down | has fallen to, has decreased to, has returned to normal |
| Same | has remained stable, is unchanged |
| Comparison | higher than her usual, lower than on admission |
Use the present perfect for changes that continue to now ("has risen"), and the past simple for a finished event with a time ("was 38.9 °C on admission").
Worked example (invented case)
Case summary (invented): Mr Tomasz Nowak, 74, at home with community nursing for COPD. Visit 9 November: increasing breathlessness for 2 days, productive cough with green sputum. Obs: T 38.1 °C, HR 104, BP 132/78 (usual), RR 26, SpO2 88% RA (usual 92–93%). Blood glucose 6.2 (normal). Weight unchanged. Last week's routine bloods normal. Task: write an urgent letter to his GP requesting same-day review.
Selection decisions:
- In: temperature, pulse, respiratory rate and oxygen saturation (all abnormal and linked to the concern), with his usual saturation for comparison.
- Summarise: blood pressure as "normal for him" or omit.
- Out: blood glucose, weight and last week's normal bloods.
Sample paragraph:
Over the past two days, Mr Nowak has become increasingly breathless, with a productive cough of green sputum. Today his temperature was 38.1 °C, his pulse 104 beats per minute and his respiratory rate 26 breaths per minute. His oxygen saturation was 88% on room air, compared with his usual 92 to 93%. His blood pressure was within his normal range.
Closing request:
In view of these findings, I would be grateful if you could review him today.
The paragraph keeps every value that supports the urgent request and drops the rest. For urgent wording, see the urgent letter guide.
Common mistakes
- Copying observation charts. A list of every reading reads as notes, not a letter.
- Leaving abbreviations. "BP", "HR", "RR", "SpO2" should be written in full.
- No comparison. "Saturation 88%" is more meaningful with the patient's usual value.
- No meaning. If a value is the reason for concern, the reader should not have to work that out.
- Wrong tense. "His temperature rises to 38 °C" should be "has risen" or "was".
Practise it
Take a timed case in practice and check which numbers you kept, or upload a letter to see your case-notes coverage and sentence-level corrections.
Sources
This guide is medEmu's writing advice, not official OET guidance and not clinical advice; all patients, values and case notes are invented. 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.