Noun phrases vs full clauses in OET letters: writing 'on discharge' or 'when she was discharged'
Both are correct in an OET Nursing letter: a noun phrase such as 'on discharge' or 'following her admission' is shorter, while a full clause such as 'when she was discharged' is often clearer. Use noun phrases for common, fixed time and reason expressions, and use full clauses when the sentence would otherwise become a dense chain of nouns that the reader has to unpack.
Two ways to say the same thing
Case notes are written in nouns: "admission", "discharge", "deterioration", "commencement". When you turn them into a letter, you can keep the noun inside a phrase or change it back into a verb in a full clause.
| Noun phrase | Full clause |
|---|---|
| on discharge | when she was discharged / when she is discharged |
| following her admission | after she was admitted |
| prior to surgery | before he had surgery |
| due to a deterioration in her mobility | because her mobility has deteriorated |
| since the commencement of insulin | since she started insulin |
| on review | when he was reviewed |
| despite treatment | although she was treated |
All of these are grammatical. The question is which one reads more clearly in your sentence.
When noun phrases work well
Noun phrases are useful when they are short and familiar to clinical readers. They save words and sound natural:
- "On discharge, her blood pressure was 128/80." (invented)
- "Following surgery, he mobilised with a frame."
- "Prior to admission, she lived independently."
One noun phrase at the start of a sentence, followed by a clear subject and verb, is a good pattern. For prepositions such as "on", "following" and "prior to", see prepositions in OET letters.
When full clauses are clearer
Use a full clause when the noun phrase is long, when it hides who did what, or when it piles up with others.
| Dense noun style | Clearer clause style |
|---|---|
| "Due to non-improvement of pain control with paracetamol, commencement of oxycodone occurred." | "Because paracetamol did not control her pain, oxycodone was started." |
| "Following completion of antibiotic therapy and resolution of fever, discharge was arranged." | "After she completed her antibiotics and her fever settled, her discharge was arranged." |
| "Patient education regarding inhaler technique improvement was provided." | "She was shown how to improve her inhaler technique." |
| "His reluctance regarding attendance at physiotherapy..." | "He has been reluctant to attend physiotherapy..." |
The clause versions use about the same number of words, sometimes fewer, and the reader understands them on the first reading. This supports the Conciseness & Clarity criterion: concise means no unnecessary information, not the fewest possible words.
Noun stacks: the main thing to avoid
A noun stack is three or more nouns in a row acting as one label. They are common in notes and in hospital forms, but they are hard to read in a letter.
| Noun stack | Rewrite |
|---|---|
| "wound dressing change frequency" | "how often the dressing is changed" |
| "medication administration time adherence" | "giving her medicines at the right times" |
| "falls risk assessment outcome" | "the result of her falls risk assessment" |
| "home care package commencement date" | "the date her home care starts" |
Two nouns together ("wound care", "blood pressure", "discharge plan") are normal. The problem starts at three or four.
Note form is not a noun phrase
A common mistake is leaving a note-style fragment in the letter:
- ✗ "Discharge home today with daughter."
- ✓ "She is being discharged home today with her daughter."
- ✗ "Good progress post-op."
- ✓ "She has made good progress since her operation."
Every sentence needs a subject and a finite verb. See turning case notes into full sentences.
Worked example (invented case)
Notes (invented): Mrs Ingrid Halvorsen, 67. Lap. cholecystectomy 14 Sep. Post-op N&V day 1, resolved with antiemetic. Mobilising independently day 2. Wound: 4 port sites, dry, clean. Discharge 16 Sep. Sutures dissolvable. Pain controlled with paracetamol. GP review if fever or wound redness.
Dense version:
Following laparoscopic cholecystectomy on 14 September and post-operative nausea and vomiting resolution with antiemetic administration, independent mobilisation was achieved on day two, with subsequent discharge on 16 September.
Clearer version:
Mrs Halvorsen had a laparoscopic cholecystectomy on 14 September. She had nausea and vomiting on the first day after surgery, which settled with an antiemetic. By the second day, she was walking independently, and she was discharged on 16 September.
Her four wound sites are clean and dry, and her sutures will dissolve. Her pain is controlled with paracetamol.
I would be grateful if you could review her if she develops a fever or any redness around her wounds.
The clearer version keeps two useful noun phrases ("after surgery", "by the second day") and changes the rest into clauses with real subjects and verbs.
Quick checklist
- Does each sentence have a subject and a verb?
- Is there any run of three or more nouns? Rewrite it.
- Is there more than one long noun phrase in a sentence? Turn one into a clause.
- Can the reader tell who did what? If not, use a clause with a clear subject.
- Are you repeating "following" in every paragraph? Vary with "after" or a clause.
For grammar more broadly, see the Language criterion and the passive voice in OET letters.
Practise and check
Practise a timed letter at /writing/, or check a letter you have written to see grammar and clarity corrections with the reason for each. medEmu covers OET Writing for Nursing only; its grades are estimates, and it is not affiliated with OET.
Sources
This guide is medEmu's writing advice, not official OET guidance; all patients and details 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.