Articles (a, an, the) in OET Writing: the mistakes nurses make and how to fix them
In OET Nursing letters, use 'a' or 'an' when you mention something for the first time or one of many ('she has a pressure injury'), 'the' when the reader knows which one you mean ('the wound has improved'), and no article for general uncountable ideas ('she needs assistance with mobility'). Case notes leave articles out, so they are easy to drop when you rewrite notes as sentences; checking every noun phrase once before you finish fixes most of them.
Why articles go wrong in OET letters
Case notes are written in telegraphic style. They drop articles completely: "Pt admitted with chest infection", "dressing changed daily", "wound healing well". When you turn notes into a letter, every one of those noun phrases needs a decision: a, an, the, or nothing?
Many candidates speak first languages without articles, or with different article rules, so the notes' style feels natural. The result is a letter that reads like notes: "Patient was admitted with chest infection and was started on antibiotic." Each missing article is small, but together they affect the Language criterion and the sense that the letter is written in full, professional sentences. See the Language criterion guide for how grammar fits into marking overall.
The four rules you need for letters
You do not need every rule in a grammar book. Most article decisions in nursing letters come down to four rules.
| Rule | Use | Example |
|---|---|---|
| First mention, one of many, countable singular | a / an | "She has a pressure injury on her sacrum." |
| The reader knows which one (already mentioned, unique, or clear from context) | the | "The wound is now 2 cm across." |
| General idea, uncountable noun, or plural in general | no article | "She requires assistance with mobility." / "He enjoys visits from family." |
| Names, titles, most diseases | no article | "Mrs Chen has diabetes." / "Dr Rossi" |
A or an? Choose by sound: an before a vowel sound ("an elderly man", "an hour", "an MRI scan"), a before a consonant sound ("a urinary tract infection", "a one-off dose", "a home visit").
Common article errors in OET letters
| Error | Correct | Why |
|---|---|---|
| "She was admitted with chest infection." | "She was admitted with a chest infection." | Countable, first mention. |
| "He was started on antibiotic." | "He was started on an antibiotic" / "on antibiotics". | Countable singular needs an article, or use the plural. |
| "Wound has been dressed daily." | "The wound has been dressed daily." | The reader knows which wound. |
| "She needs a assistance with showering." | "She needs assistance with showering." | Uncountable noun. |
| "He has the diabetes." | "He has diabetes." | Disease names usually take no article. |
| "I am writing to refer Mrs Lee to the your clinic." | "...to your clinic." | Never use an article with a possessive (your, her, his). |
| "Please arrange the follow-up appointment." | "Please arrange a follow-up appointment." | First mention, one of many possible appointments. |
| "The Mrs Silva lives alone." | "Mrs Silva lives alone." | No article before a name. |
Countable or uncountable? Words that trip nurses up
Some nouns used often in letters are uncountable in English, so they never take "a" and have no plural:
- assistance, advice, information, equipment, support, education, mobility, nutrition, care, pain (in general), progress, swelling (often)
Write "She has been given advice about her diet", not "an advice", and "some information", not "informations".
Other words are countable and need "a/an" in the singular:
- fall, wound, ulcer, infection, appointment, referral, assessment, dressing, catheter, cannula, walking frame, prescription
"She had a fall at home" is correct; "she had fall" is not.
Worked example: from notes to correct sentences
Notes (invented):
Pt 81 y/o F, fall at home 2/11, # R wrist, cast applied. Lives alone, has walking frame. Needs assist w/ showering. Daughter visits wkly. Cast clinic appt 16/11. Requires info re: falls prevention.
Letter sentences with articles in bold:
Mrs Hana Novak, aged 81, had a fall at home on 2 November, in which she fractured her right wrist. A plaster cast has been applied. She lives alone and uses a walking frame. She requires assistance with showering, and her daughter visits weekly. She has an appointment at the cast clinic on 16 November. I would be grateful if you could provide her with information about preventing falls.
Notice: "a fall" (countable, first mention), "a plaster cast" (first mention), "a walking frame", "assistance" and "information" (uncountable, no article), "an appointment" (vowel sound), "the cast clinic" (the specific clinic, known in context).
A 60-second article check before you finish
Use the last minutes of the writing time for a quick pass that targets articles only:
- Underline (mentally) each singular countable noun. Does it have a/an, the, or a possessive (her, his, your)? If not, add one.
- Check first mentions. Is the first mention of a fall, a wound, an appointment using a/an?
- Check uncountables. Remove any "a" before advice, assistance, information, equipment, support.
- Check a/an by sound. "an hour", "a urinary", "an MRI".
- Check names. No article before Mrs, Mr, Dr or a person's name.
This takes about a minute and often removes several errors. It also helps with turning case notes into full sentences, since a letter without articles is the clearest sign of copied note style.
Practise and get feedback
Articles improve fastest with feedback on your own letters. Write a timed letter at /writing/, then read it once for articles only. You can also check your letter with medEmu: it marks your letter against the six OET criteria and points out language corrections in your own text. Grades from medEmu are estimates, and medEmu is not affiliated with OET.
Related: common OET Writing mistakes, passive voice in OET letters and linking words and cohesion.
Sources
This guide is medEmu's writing advice based on standard English grammar, not official OET guidance; all patients and 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, including the assessment criteria, see oet.com.