Modal verbs in OET letters: should, could, would and polite requests
Use modal verbs in an OET Nursing letter to make requests polite and advice clear: 'I would be grateful if you could…' for the main request, 'should' for what needs to happen, and 'may' or 'might' only when something is genuinely uncertain. The common errors are adding 'to' after a modal ('could to check'), using 'must' or 'have to' in a way that sounds like an order, and stacking several modals into a long, unclear sentence.
Why modal verbs matter in an OET letter
Modal verbs (can, could, may, might, must, shall, should, will, would) do two jobs in a nursing letter. They make requests polite, which matters for the tone a professional reader expects, and they show how certain or necessary something is: "he should have his bloods rechecked" is advice, "he will have his bloods rechecked" says it is arranged, and "he may need oxygen at night" says it is uncertain.
Getting them wrong does not just cost grammar marks. "The patient must be visited by you" sounds like an order to a colleague, and "he might need his antibiotics" makes a definite plan sound optional. Both affect how clearly and appropriately the letter reads.
What each modal means in a nursing letter
| Modal | Use it for | Example |
|---|---|---|
| would | Polite requests and offers | "I would be grateful if you could review her medication." |
| could | Polite requests; possibility | "Could you please arrange a home visit this week?" |
| should | Advice, recommendations, expected actions | "His dressing should be changed every two days." |
| will | Plans already made; certain future | "She will attend the clinic on 4 March." |
| may / might | Real uncertainty | "He may need help with showering at first." |
| must | Strong necessity or safety (use sparingly) | "The fistula arm must not be used for blood pressure readings." |
| can | Ability or permission | "She can walk short distances with a frame." |
The three grammar rules candidates break most often
1. No "to" after a modal. The verb after a modal is the bare infinitive.
- ✗ "Could you to check her wound?"
- ✓ "Could you check her wound?"
2. No "-s", "-ed" or "-ing" after a modal.
- ✗ "He should takes his tablets with food."
- ✓ "He should take his tablets with food."
3. Use "have/be" for past or passive meaning.
- ✗ "The dressing should change daily." (the dressing does not change itself)
- ✓ "The dressing should be changed daily."
- ✓ "She should have been reviewed yesterday." (only if the notes say this was missed)
For more on passive forms, see passive voice in OET letters.
Polite request phrases that work
Most OET letters end with a request. These forms are polite without being wordy:
- "I would be grateful if you could assess his mobility at home."
- "I would appreciate it if you could arrange a follow-up blood test."
- "Could you please monitor her blood glucose levels?"
- "It would be helpful if you could review his pain relief."
- "Please contact me if you require any further information."
Notice the structure after "I would be grateful if you could": a bare verb, then the specific action. Avoid "I would be grateful if you would…" repeated in every sentence, and avoid "I would be grateful for you to…", which is less natural.
If you have several requests, introduce them once and list the actions in one sentence:
I would be grateful if you could check his wound, monitor his blood pressure and review his medication in one week.
For full closing paragraphs, see OET letter closing paragraph examples.
Matching the modal to the case notes
The modal you choose tells the reader how firm the plan is. Read the notes carefully.
| Notes say | Write | Not |
|---|---|---|
| "OPD appt booked 6/4" | "She will be seen in the outpatient clinic on 6 April." | "She should be seen…" (it is already booked) |
| "Recommend repeat FBC 1/52" | "Her blood count should be repeated in one week." | "Her blood count will be repeated…" (not yet arranged) |
| "?needs O2 overnight – sleep study pending" | "He may need oxygen at night; a sleep study is pending." | "He needs oxygen at night." |
| "Keep wound dry until sutures out" | "The wound must be kept dry until the sutures are removed." | "The wound might be kept dry…" |
| "Able to self-administer insulin" | "She can give her own insulin." | "She could give her own insulin." (sounds hypothetical) |
Tone: avoiding orders and over-politeness
Too direct: "You must visit him tomorrow and you have to check his INR." This reads as an instruction to a junior, not a request to a colleague.
Better: "I would be grateful if you could visit him tomorrow and check his INR."
Too indirect: "I was wondering whether it might perhaps be possible for you to possibly consider visiting him." This is long and unclear about what you want.
Better: "Could you please visit him tomorrow?"
For urgent cases, polite language and urgency are compatible: "As his condition may deteriorate quickly, I would be grateful if you could see him today." See urgent letter language.
Worked example (invented case)
Notes (invented): Mr Daniel Okafor, 58. Discharged after cellulitis left leg. Oral antibiotics until 22 Oct. Leg elevated when sitting. Check leg for spreading redness; GP appt booked 24 Oct. ?needs compression stockings – vascular review pending.
Weak version:
You must to check his leg every day and you should to tell the GP. He will need compression stockings. He might take antibiotics until 22 October.
Improved version:
Mr Okafor will continue oral antibiotics until 22 October and should keep his leg raised when sitting. He may need compression stockings, but this depends on a vascular review, which is pending. His GP will see him on 24 October. I would be grateful if you could check his leg for any spreading redness at each visit and inform his GP if it worsens.
The improved version removes "to" after modals, uses "will" for the booked appointment and the definite antibiotic course, "may" for the stockings that depend on a review, and one polite request at the end.
Write a full letter under timed conditions at /writing/, or check your letter to see sentence-level corrections with the reason for each one.
Quick checklist
- No "to", "-s", "-ed" or "-ing" directly after a modal.
- "Will" only for plans already in the notes; "should" for recommendations.
- "May/might" only for real uncertainty.
- "Must" only for safety points, never for requests to a colleague.
- One clear polite request form, then the specific actions.
Related: the Language criterion, formal tone and Genre & Style and prepositions in OET letters.
Sources
This guide is medEmu's writing advice, not official OET guidance; all patients and plans are invented for practice. 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.